A Case of Depression Later Diagnosed as Hyperprolactinaemia - homeopathy360
Clinical

A Case of Depression Later Diagnosed as Hyperprolactinaemia

Introduction
The normal levels of prolactin in the blood are 1.20–29.93 ng/dl in females and 2.58–18.12 ng/dl in males. For some woman, 20 can be an abnormal range. These high levels of prolactin (hyperprolactinaemia) can cause cycle irregularities, infertility and galactorrhoea. The levels more than 50 are high and may be due to tumour in the lactotropic cells of anterior pituitary gland or hypothalamic disease. The prolactin levels can be reduced by using homeopathic medicine is not an epic but a factual truth. Symptoms associated with excess prolactin are shown in the table below.
Case Study
Case no. A/108, young girl, unmarried, aged 18 years consulted me on March 12, 2000 for her depression. Continuing her treatment regular/irregularly according to their need and choice came again on November 10, 2009 with diagnosed hyperprolactinaemia and made a thorough separate case analysis paper as stated below.
Family History 
Mother: H/o depression, weeping tendency, cholecystectomy, high prolactin and raised TSH in mother
Paternal grandmother: H/o cancer in grandmother
Paternal Uncle: H/o fistula in uncle
Birth, Pregnancy and Past History 
  • Second issue of parents
  • During pregnancy, mother craved for pan-parag (an addiction to chewing of betel nut preparation) and to take the smell of cigarette
  • Milestone of developments—normal
  • All vaccinations done, BCG reaction was poor
  • Craving for ash of cigarettes at the age of one and a half years
  • Prolonged nocturnal enuresis with dreams of urination outside bed
  • H/o recurring tonsillitis; amelioration by warmth
  • Inability to utter words; T instead of K, and D instead of G
  • Depression and anxiety about the health of parents since the death of paternal grandmother due to cancer. He was prescribed Aconite 200, Ignatia 30, 200, Nat-m., but her depression persisted. Dark circles around eyes and tendency to weep.
  • July 15, 2008.  I verified the case history and considered Aur-met. and applied 0/1 then 0/5, 0/7, 0/10, 0/12, 0/14 and 0/16, twelve doses of each potency on alternate days according to the Hahnemannian parameter (The Organon §246). Within this period, the patient also complained about ecchymosis (August 27, 2008) and was cured without any further medicine. She also complained of inflamed neck glands which were cured by Morbillinum (March 7, 2009) and bilateral tonsillitis relieved by warmth that were cured by Kali-iod 0/1 and 0/2 (August 8, 2009).
  •  On September 10, 2009, the patient was again brought to me with a lab report of raised prolactin level and made a further thorough case record as stated below:
Women Men
Loss of libido Loss of libido
Mood changes / depression Mood changes / depression
Hostility, anxiety, infertility Impotence
Headache Headache
Menopausal symptoms, even when oestrogen is sufficient Infertility
Signs of increased testosterone levels Decreased testosterone levels
Weight gain, peripheral vision problems Weight gain, peripheral vision problems
Painful intercourse because of vaginal dryness, irregular menstruation  Gynaecomastia
Present Complaints as on September 10, 2009
  • Irregular menstruation and pain in the breast before and during menses, previously excessive and now ameliorating since the application of Aurum metallicum. 
  • On the advice of gynaecologist, parents got the laboratory investigations done that showed raised prolactin level of 63.59 ng/ml on August 18, 2009. Other investigations likes T3, T4, TSH and insulin fasting were normal.
  • June 21, 2009: Menses scanty, then improving and on October 28, 2009, quantity increased. Breast pain before menstruation also reduced.
  • Weeping with or without any apparent cause, extreme sadness, dark-ring around eyes improved
  • Stammering, previously too, now improving
  • Headache during summers, now less
  • Pain in lower extremities aggravated at moon phase
  • Allergy to aroma which causes sneezing and itching of eyes
On Examination (September 10, 2009)
  • Bright complexion
  • Average health
  • Sad, darkness around eyes, shyness while answering
  • Tongue dry
  • Red lips
  • Bilateral inflammation of tonsils especially right
Generalities
  • Thirsty; occasionally at midnight also
  • Appetite ++, irritable when hungry
  • Stool clear
  • Urine normal
  • Sleeps on right side
  • Neither hot nor chilly
  • Desires sour, sweets, warm food
  • Aversion to raw onion
Mind
  • Tidy/washing mania ++
  • Fear of ghosts, cockroaches and dark
  • Jealousy with relatives
Miasmatic Analysis 
Depression at the early age, washing mania, family history of depression and cancer indicates the presence of syphilitic miasm from the very beginning.
Treatment—September 10, 2009
Aurum metallicum 0/17, one dose, one globule no. 10 in 15 ml of distilled water, full quantity of medicine to be mixed in 30 ml of water and only spoon of dilution to be taken empty stomach in the morning.
Basis of Selection of the Medicine and Potency 
Aurum metallicum was selected before this nosological diagnosis and had already proved effective by relieving his acute problems such as weeping sadness and irregular menstruation. I decided to repeat the same medicine in more controlled dose.
   It should be noted here again that Aurum metallicum was selected according to the picture presented in the Materia Medica of Dr Kent and by taking the following rubrics into consideration:
  • MIND–SADNESS–periodical
  • MIND–AILMENTS FROM–grief
  • MIND–WEEPING–meeting people, when
Moreover, there was a miasmatic support.
As the basis selection was strong, (The Organon, §246), fifty milliesimal scale of potentisation was preferred.
Follow Up—December 5, 2009
  • Weeping is less
  • LMP–November 28, 2009; continued for three days, breast pain during the menses reduced
  • Patient came with a complaint of pain in left leg
  • Aurum metallicum 0/17 one dose with 10 strokes as before
Follow Up—January 1, 2010
  • LMP–December 28, 2010; continued for three days
  • Patient took orthopaedic consultation for leg pain. On further investigation, it was diagnosed that L5 vertebra was not visualized, which suggested that a rudimentary disc is present between S1 and S2
  • Aurum metallicum 0/17, one dose with 20 strokes as before
Follow Up—April 7, 2010
  • Within this time, Aurum metallicum 0/17 was applied two times and 0/18, only dose on March 31, 2010. The patient came with symptoms of frequent deep sighing.
  • Ignatia amra 0/1, eight doses, one globule no. 10 to be dissolved in 60 ml of water. Add 20 drops of rectified spirit and divide it into eight doses. One dose is to be dissolved in 30 ml of water and one spoon to be taken every morning.
  • Ignatia was selected on the basis of frequent deep signing, dark rings around eyes, tendency to weeping, h/o grief etc.
Follow Up—July 28, 2010
  • Within this time, Ignatia was applied up to 0/11. Patient had further verification of previous laboratory investigation where prolactin level was 31.18 ng/ml (July 9, 2010). Now, the patient complained of tonsillitis.
  • Ignatia 0/12, eight doses to be prepared and taken as before but at one day interval
Final Comments (November 13, 2011)
This patient is still having homeopathic benefits. She came on October 28, 2011. The prolactin level has come down to almost normal. There is no more sadness and weeping.
References
  1. Kasper, D.L. et al. Harrison’s Principles of Internal Medicine. 16th Ed. New Delhi: McGraw Hill, 2005.
  2. Hahnemann, S. The Chronic Diseases their Peculiar Nature and their Homoeopathic Cure. Low Price Edition, August 2002, 2005, 2006, New Delhi: B. Jain Publishers Pvt. Ltd.
  3. Kent, J. T. Repertory of the Homoeopathic Materia Medica. Enriched Indian Edition. New Delhi: B. Jain Publishers Pvt. Ltd.
  4. Kent, J. T. Lectures on Homoeopathic Materia Medica. New Delhi: B Jain Publishers Pvt. Ltd.
  5. Schroyens, Frederick. Synthesis Repertory Version 9.2. New Delhi: B. Jain Publishers Pvt. Ltd.
  6. Hahnemann, Samuel. Organon of Medicine—5th & 6th Ed. New Delhi: B. Jain Publishers Pvt. Ltd.
  7. Stedman. Stedman’s Medical Dictionary. 26th edition. UK: Lippincott Williams and Wilkins, 1995.
  8. Behrnman, RE et al. Nelson’s Text Book of Pediatrics. 17th Ed. Philadelphia: Sounders Elsevier, 2004.
  9. Colledge, Nicki R. et al. Davidson’s Principle and Practice of Medicine. 20th Ed. UK: Churchill Livingstone Publication

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