An Evidence Based Study Showing Efficacy Of Individualized Homoeopathic Medicine In Treatment Of Hypothyroidism: A Case Report - homeopathy360
Articles Contemporary

An Evidence Based Study Showing Efficacy Of Individualized Homoeopathic Medicine In Treatment Of Hypothyroidism: A Case Report

Authors:
Dr Nitesh Jangid, Research Associate, CCRH (New Delhi)
Posted at Motiwala Homoeopathic Medical College and Hospital Nashik (Maharastra)
Formerly PGT Department of Homoeopathy Philosophy, Dr. MPK Homoeopathic Medical College, Hospital and Research Centre, A Constituent College of Homoeopathy University, Saipura, Sanganer, Jaipur (Rajasthan).
Dr Minakshi Kamboj, Formerly PGT, Department of Homoeopathy Philosophy, Dr. MPK Homoeopathic Medical College, Hospital and Research Centre, A Constituent College of Homoeopathy University, Saipura, Sanganer, Jaipur (Rajasthan).

Abstract
Hypothyroidism is the most common endocrine disorder, which is increasing with time.1 It is divided in two types where primary hypothyroidism is due to cause within the thyroid gland itself and Secondary Hypothyroidism is due to failure of TSH production following pituitary or hypothalamic disease.2 A patient with Hypothyroidism reported to OPD of Motiwala Homoeopathic Medical College and Hospital. Based on the totality of symptoms Ignatia amara 30C was prescribed, following which, after three months of treatment, patient felt better in all aspects with normal value of  Thyroid stimulating hormone  ranges.
Keywords: Hypothyroidism,IndividualizedHomoeopathic medicine,Repertorization,Case report,Ignatia amara
Introduction
Hypothyroidism is a common health issue1 which is arise from hormone deficiency. It is divided in different backgrounds as: On basis of the time of onset; It is divided in Congenital and Acquired Hypothyroidism. On basis of endocrine dysfunction level; It is divided in Primary and Secondary Hypothyroidism. On basis of severity; It is divided in severe or clinical and mild or subclinical Hypothyroidism.2  The annual incidence rate of hypothyroidism is up to 4 per 1000 women and 1 per 1000 men.3 The common clinical features associated with hypothyroidism are tiredness, weight gain (despite a poor appetite) ,constipation, muscle weakness, puffiness around the eyes, hoarse voice, dry skin, cold intolerance, slow physical and mental activity, poor memory, hair fall, slow pulse and shortness of breath. 2,4,5
Case Report
A 40 years old female, Mrs TD reported to Motiwala Homoeopathic Medical College and Hospital OPD on 5/05/2018 with the presenting complaints of weight gain inspite of loss of appetite since 8 months along with hair fall and her menses bacame irregular, started delaying. Her menses were black and scanty duration of menses was only one day
History of presenting complaints
Patient was apparently well 8 months back. Later she observed weight gain inspite of loss of appetite from 8 months along with hair fall and her menses bacame irregular, black, scanty  and started delaying. Her normal menstrual cycle of 28 days changed to 40-45 days. LMP was on 25/03/2018. Duration of menses only one day. She had conservative treatment without significant results.
Patient as a whole
Patient was a housewife belonging to middle class family. During history taking she informedthat herhusband died before one year back after that she observed thatshe had difficulty in concentration even when recall something. She had brooding and don’t want to talk anyone most of  the time. Consolation aggravates. She had sour taste of mouth and sleeplessness due to grief.
Analysis of case
The case was analysed as per the characteristic mentals, physical generals and particular symptoms for the totality. Evaluation of symptoms are listed in Table 1 and repertorization was done by Synthesis Repertory using RADAR 10.06 (Figure-1).
Table 1-  Evaluation of symptoms

                     Category                             Symptoms
             Mentals Grief History
Difficulty in concentration
Brooding
Consolation aggravates
                     Physicals Sour taste of mouth
Sleeplessness due to grief
                     Particulars Menses – irregular, black and scanty, duration only 1 day

Seletion of remedy and it’s potency with justification

The reportorial result of this case showed that the most of the symptoms of this case covered by Ignatia amara . After considering Homoeopathic materia medica, mental, physical and particular symptoms of the patient were similar to Ignatia amara. 7 The 30C potency was selected and prescribed in the case  as per Hahnemann’s guidelines.8

Prescription with general management

Ignatia amara 30/1dose prescribed on first visit which was followed by placebo (Thyroid profile advised). Avoid stress. Regular physical exercise with general dietary advise like fruits, vegetables, whole grains and dairy product. Follow-ups listed in Table -2.

                                                Table -2 Follow-ups chart

Date           Symptoms Prescription
12/5/2018 Satisfactory stool, No flatulence.
Sour taste of moth and hair fall S.Q.
LMP – 08/05/2018.
Menses last for one day with satisfactory flow.
THYROID PROFILE reported elevated TSH value suggestive of Hypothyroidism on 11/05/2018 (Figure-2)
  Rx    
Placebo 30/tds- 15 days
26/05/2018 Sour taste of mouth much better. Hair fall better.
Satisfactory stool with no flatulence.
Rx     
Placebo 30/tds- 15             days
11/06/2018 Hair fall relapses. Unsatisfactory stool with no flatulence.
Sour taste of mouth also relapses.
LMP – 9/06/2018.
Menses last for one day with satisfactory flow.
Rx  
Ignatia 30/ 1 dose
Placebo 30/tds- 15 days
25/06/2018 Sour taste of mouth much better. Hair fall better. Satisfactory stool with no flatulence. Rx     
Placebo 30/tds- 15 days
10/07/2018 All Complaints better.
LMP – 10/07/2018.
Menses last for one day with satisfactory flow.
Rx     
Placebo 30/tds- 15 days
24/07/2018 All Complaints better.
LMP – 12/07/2018.
Menses last for one day with satisfactory flow.
THYROID PROFILE advised (Figure-3)
Rx     
Placebo 30/tds- 15 days
8/8/2018 All Complaints better.
Thyroid Profile report suggestive TSH level within range. Patient was euthyroid. (Figure-3)  
Rx     
Placebo 30/tds- 15 days

                                         Assessment by Modified Naranjo  Score:

                                                  Criteria   Yes No   Not SureN/A know
Was there an improvement in the main symptom or condition for which the homoeopathic medicine was prescribed?    +2      
Did the clinical improvement occur within a plausible time frame relative to the drug intake?    +1    
Was there an initial aggravation of symptom?     0  
Did the effect encompass more than the main symptom or condition, i.e. were other symptoms ultimately improved or changed?   +1    
Did overall wellbeing improve? +1    
Did the course of improvement follow Hering’s Rule? +1    
Did old symptoms (non-seasonal and non-cyclical symptoms that were previously thought to have resolved) reappear temporarily during the course of improvement?              0
Are there alternate causes (other than the medicine) that-with a high probability could have caused the improvement? (e.g. known course of disease, other forms of treatment and other clinically relevant intervention)?   +1  
Was the effect confirmed by objective evidence as measured by external observation(s)?   +2  
Did repeat dosing, if conducted, create similar clinical improvement?                             0

The final score in this case was obtained using the Naranjo Criteria, as proposed by the HPUS Clinical data Working Group, March 15 2018.9  The total score was 9 and this score suggesting a definite association between the medicine and outcome [definite: ≥ 9; probable 5-8; possible 1-4; and doubtful ≤ 0]. Reporting of this case according to Hom-CASE-CARE guideline.10

Conclusion
Homoeopathy is a system of medicine which treats the patients as a whole not a disease. Most of the patients of this disorder are treated by allopathic medicine which gives only symptomatological relief but In Homoeopathy, the constitutional medicine is considered the best approach to treat a person. In this article, Individualized homoeopathic medicine was prescribed selected after repertorization with the help of synthesis repertory. This result that individualized Homoeopathic medicines not only relieved the symptoms but also bring the TSH value within normals range (Laboratory Investigation).

References

  1. Kalra S, Sahay R, Ganapathi B. Prevalence of hypothyroidism in adult: An epidemiology study in eight cites of india. Indian Journal of Endocrinology and Metabolism. 2013;17(4):647-652. [Accessed 30th  Jan 2020]
  2. Praveen A, Mathew G. Medicine. 3rd ed. New Delhi: Elsevier India: 2010.
  3. Walker BR. Davidson’s Principles and Practice of Medicine, 22nd ed. London: Elsevier Limited; 2014.
  4. M. Drake W. Hutchison’s Clinical Methods An integrated approach to clinical practice. 24th ed. London: Elsevier Limited; 2018.
  5.  F Golwala AF. Golwala’s Medicine for Students. 25th ed. New Delhi: The Health Science Publisher; 2016.
  6. RADAR 10. Archibel Homoeopathic Software. Belgium: 2009.
  7. Boericke OE, Boericke W. Pocket manual of Homoeopathic Materia  Medica and Repertory. 9th edition,  New Delhi: B. Jain publishers; 2008.
  8. Sarkar BK. Organon of Medicine by Samuel Hahnemann, 9th reprient ed. New Delhi: Birla Publications Pvt. Ltd; 2005
  9. The Homoeopathic Pharmacopoeia of the United States. Draft HPCUS Clinical Data Guidelines. Available from: http:www.hpus.com/HPUS-Clinical-Data-GUIDELINES-Draft-08 2018.pdf [Accessed 5th Feb 2020]
  10. Van Haselen RA. Development of supplement (HOM-CASE) to the CARE clinical case reporting  guidelines. Complement Ther  Med. 2016; 25:78-85.

Investigations
Pre-treatment report:

Post treatment report:

REPERTORIAL SHEET Repertorization from synthesis repertory using RADAR software 6

Leave a Comment