A Case of Thyrotoxicosis
Introduction
Diseases of the endocrine glands can produce a multitude of symptoms directly and indirectly due to the cascade of follow on effects for both body and mind. This problem then poses a major obstacle for the homeopath in attempting to orient their mind in an effort to “perceive the portrait of the disease” . Further complications abound when suppression takes place via surgery and drug treatment, both allopathic and homeopathic.
The case presented here was recommended radioactive Iodine as treatment for her condition. If she had undertaken her medical practitioner’s advice it is likely that in the years to come she would be required to take daily doses of thyroid hormone (T4) for an under active thyroid for the remainder of her life. The cost to the health care system and to the individual involved have been kept to a minimum by effective homeopathic treatment. The physician was indeed fortunate that the condition was diagnosed soon after treatment had started for another matter and susceptibility was not tampered with.
The Case
46 years old female computer operator
Marital status: Single (married twice previously)
First consultation: 15.3.00
Chief Complaint
Location |
Sensation / Pathology |
< >, AF |
Concomitants |
Skin; torso, pubic |
Rashes, erratic, |
> Allocon daily |
"drives you bonkers" |
Dermatologist diagnosed eczema. Allergist suggested decreasing chocolate, coffee, sugar, yeast and dairy
Past History of complaints: Chicken pox, shingles: at the site of first sign of rash
Family history of complaints:
Father: asthma
Mother: diverticulitis, HBP, emotional
Brother1: asthma/eczema
Brother 2: ok
Thermals: Best temp is 24°, prefers cold, but likes to be warm. Averse to temperatures above 28°. Warm showers in hot weather.
GIT: BLOATING like a rock, sudden, obstruction> passing wind. < fruit, tight clothes, stress++: hold everything in.
Cravings: chocolate , bread sweets
Tongue: coated creamy, PHO3
FMP: 15 33/1-2 MTP twice (when narrating this information she rubbed her abdomen and stated it was sore)
Before Menstruation: occasionally swelling, irritable, bloating. HO thrush
Skin: Ho warts down one leg > sunburn. Impetigo once
Perspiration: average but if is sweaty will be from her scalp
Extremities: warm, cold hands in winter
Dreams: HO water, houses
Interests: her pets, reading fantasy/suspense
Appearance: Thin, fair, slightly flushed, thin wispy hair. Appeared reticent to divulge too much personal details
Relations: close to Mother and Father. Mother is best friend. Had a great childhood.
Prescription:
Sulphur 200C OR weekly prn.
Baccillinum 200C one dose the day prior to taking Sulphur 200c; next week if no change
placebo bd.
Prescription Follow Up
23.2.00
skin <2
Interpretation: Hypersensitive patient, Sulphur has long action, thus wait on placebo till improvement perceived.
Prescription: Placebo tds. Sulphur 200C once improvement begins (not taken)
6.4.00
Skin had been bad, improved slightly then < lately again: always something itchy < heat, sweating, bed less < shower: > cool application. Skin and body feels very hot. Some stinging.
Body not, radiating form inside.
Bloating better.
Work: afternoon shift with 60 women: “cat fights galore”.
Stresses: I take things on a lot, not a good track record with relationships. Has been married twice. Living on own for 3.5 years. Her relationship was with a HepB carrier.
In the past made the wrong choices, “I became what ever they wanted me to be and not me”
Not a lot of friends; doesn’t go out much; a home body.
With emotional stress I cry, with draw, anger/frustration and then shut that part off.
More of a loner, does not need a lot of people, likes routine, gets off balance if her routine is thrown out.
Interpretation: Wrong remedy, review of case points directly to Nat mur. Apis is related acute with amelioration by cold applications to skin.
Precsribing Totality ( Non repertorial)
-
H3 C2
- Bloating “hold everything in”
- Not may friends-Loner
- Heat internal
- Routine required
- Attachment to Mother
- Withdraws with emotional upsets
- Craves cheese, bread
Repertorial analysis; Kent’s Method
1:KT:MIND:COMPANY aversion to
2:KT:MIND:IRRITABILITY menses, before
3:KT:MIND:MALICIOUS
4:KT:MIND:ANGER,irascibility ailments after
5:KT:FEVER:INTERNAL heat
6:KT:STOMACH:DESIRES bread
7:KT:ABDOMEN:DISTENSION painful
Prescription: Nat mur 200C single dose; Apis 30C prn after 4 days
(she had self prescribed a second dose of Nat mur 200C on 14.4.00 as first dose lapsed after diagnosis of Hyperthryoid)
27.4.00
Had been to MD for check up, TFT showed hyperthyriod: has been in a major panic ever since.
Comment: Consistent with thyrotoxicosis
99mTc04 QUANTITATIVE THYROID SCAN (18.4.00)
The thyroid gland is normal in size the right lobe measuring 49mm and the left 52mm in maximal bipolar length. Pertechnetate distribution was uniform throughout the gland and uptake levels were within normal limits. There was no significant increase in thyroidal perfusion.
Conclusion: The thyroid scans were consistent with evolving Graves’ Disease and indicated suitability for radio-iodine therapy. They were negative for thyroiditis.
Over the last few weeks she had been experiencing shakes, heat, rapid heart beat with exertion and in the last few days with eating.
Sensitive to loud noises at work, makes her irritable
Skin >2 after new remedy for 2 weeks
Some < strong odorous, perfume
General subjective well-being much improved after new remedy, felt fantastic, under control
Weight: 66 kg
Bloating< stress, evening
Prescription:
Nat mur is correct remedy. Deeper nature of pathology now emerging, with sycotic miasm manifestations of hyperthyroidism (in hind-sight this interpretation of miasm classification is incorrect). Skin now not a major factor in relation to thyroid.
Medorrhinum (hot antisycotic remedy) 200C weekly. Nat mur 200 twice weekly
18.5.00
>3 for 2-3 days thus needed to repeat remedy
scalp itchy, till bleeds, occiput.
Very tired. Hot.
Shaking comes and goes< concentrating eg: fine needle work, using a knife
Weight: 67 kg
Pulse rate: 100
Digestion ok.
M/E: feeling depressed lately, why bother with anything, why care < last week, not want to go out much.
Mx: 28/4: first time ever in her life. HO 35/1.5
Prescription: continued treatment as previously
8.6.00
TFT last week, no change.: Symptoms <2.: Fast heart rate, hot, insomnia
LMP: 34/4
Weight: 67kg
Heart rate: 85
Rash < lately
Nose some bloody mucous on blowing
Interpretation: Little change. Thus increase repetition.
Prescription: Nat mur 200C nightly. Medorrhinum 200C weekly.
13.7.00
Had phone call 2 weeks ago with < of skin; stinging < hot water > 2
MD: “clinically a lot better, surprised to see > in TFT”
Weight: 66 kg
Heart rate: 84
Has been anxious; decreased appetite.
Less heat, little shakes, Heart rate may go up.
Energy good, able to do more.
Bloody mucous > after Pulsatilla 200 qid for cold
Patient revealed that she is being sued and taken to court , the proceeding started Aug 1999.
Received court summons 2 weeks ago. In a panic she went to her MD who prescribed Serapax for mini panic attacks at night
Interpretation: Improvement started. Plan to maintain frequent doses till >3 as evidenced by symptoms and blood assays.
Prescription: continued treatment as previously
10.8.00
Comment: thyroid function consistent with treated hyperthyroidism
SAI lump in throat after sore throat
Skin<++: all over back < heat.
Feeling good . No shakes.
Weight: 66 kg
Heart rate: 80
BP: 100/70
Interpretation: Correct treatment for thyroiditis. Can now decrease Nat mur in frequency. Sore throat/skin more Tubercular.
Prescription: Tub 1M weekly. Nat mur 200 twice weekly.
29.9.00
Itching is insane, needing a lot of ii; crawling under skin < shower.
Shakes are holding with decrease in remedy.
Weight: 65.5 kg
Heart rate: 80
Mx: last two painful, bloating , crampy. BMX: irritable
Generally feeling well, peaceful.
Interpretation: At this interview discussion focused on her past relationships/ marriage which had a good therapeutic effect over the following weeks.
Prescription: continued treatment as previously
10.10.00
Patient asked to have a few counseling sessions to discuss a few matters.
Rang last week saying shakes < eating
Skin <2, needs cortisone daily.
Family: Her two brothers are very successful and happily married. She feels a little inadequate, part of her feels that she should have the same things. Realizes that her first marriage could have given her this.
Friends: has always been wary of making friends, did not want to give all because she knows she will get dumped on therefore has not many friends. Loves her own time and loves to be by herself.
Prescription: continued treatment as previously
19.10.00
Skin better with Apis 200C nightly prn. No cortisone cream.
Now sees that her skin < since last relationship ended.
Partner was Hep B carrier and did not inform her for 9 months: she was very angry, hurt, resentful (and still is). Partner was bisexual, alcoholic, unemployed and wanted her to support him.
She sees that in the past she has always tried to please the partner by being what they might want her to be. Always felt it important to be a “silly female”, seductive and not show the sensible/intellectual side of herself.
Prescription:
Baccillinum 200C as intercurrent instead of TUB 1M: hypersensitive skin with tubercular miasm.
14.12.00
Normal TFT October.
TSH: 0.41 (0.40-4.70)
Heart rate: 76
Feeling well. Job change: going well.
Abdominal pain > with Treatment.
Mx painful, bloating < clothing.
Prescription / Interpretation:
Has taken Baccillinum 200C weekly, Nat mur 200C twice weekly. Had tried Apis 200C prn and Placebo which gives relief for skin.
8.2.01
Skin shocking in hot weather< night, sleep.
Sores behind ears++ Not > Apis200 qid.
Very good in self. Work well, got award for productivity.
Over the next few weeks her skin did not > with trying Ars iod, Rhut tox, Graphites....
Finally she found a pattern of being < after using flea tablet on her cat every month.
Skin >3 after stopping the flea tablet.
TFT repeated June 2001 NAD.
Interpretation: Generally> but skin not >. Thus try another acute.
Prescription: Ars iod 200C/ Rhus tox 200C and continue Baccillinum weekly.
After numerous trials nothing aided the skin until the patient realised there was <+++ after applying monthly flea treatment to her cat. Has discontinued this with >+++
Twelve month follow up (7.2.2002)
Throid function: NAD
CASE WORKINGS:
Hyperthyroidism and correlations with theory of chronic disease (miasms)
PSORIC PHASE
Normal thyroid scan
Emotionally labile
Hypersensitivity: mind and nerves
No structural changes
Other: skin rashes with modalities, food cravings and aversions.
SYCOTIC MIASM
Hyperplastic nodule
Secreting adenoma
TUBERCULAR MISAM
Autoimmune condition: antibodies stimulate the thyroid uncontrollably
Eratic nature
Other: skin
Thyriod crisis: AF Infection
Fever/delirium
SYPHILITIC MIASM
Psychosis
Mania => Violence => Destruction
SUSCEPTIBILITY
Some Psoric signs. Abberant immune response: Moderate
SENSITIVITY
High