Abstract –
Thyrotoxicosis is the condition more over due to the disturb function of thyroid gland however is also due to Graves’ disease that is auto immune disease.
This condition is well treated & managed homoeopathically with the holistic approach & patient not only the symptoms of the thyroid dysfunctioning but also the patient as a whole & greatly managed by dynamically.
Introduction –
Thyrotoxicosis is characterized by an excess of thyroid hormone. However, hyperthyroidism, which is due to the overactive thyroid. The main causes of thyrotoxicosis are Graves’ disease , toxic multinodular goitre (MNG), toxic adenomas, and hyperthyroidism. The symptoms are insomnia, rapid heartbeat, weight loss, increased appetite, anxiety, and heat intolerance are some of the symptoms of thyrotoxicosis; other symptoms may include sweating, tremors, and irregular menstrual periods.
Epidemiology –
Between 60 and 80 percent of thyrotoxicosis is caused by Graves’ disease.
Different groups have different prevalence, which are influenced by iodine intake and genetic variables (high iodine intake is linked to an elevated incidence of Graves’ illness. Graves’ illness is one-tenth as common in men but can affect up to 2% of women. The condition usually strikes between the ages of 20 and 50, however it can sometimes strike older people. It seldom starts before puberty.
Aetiology –
Thyrotoxicosis occurs due to various reasons . That’s are –
Graves’ Disease, Multinodular Goitre, solitary Thyroid Adenoma, Thyroiditis (Sub acute, Post partum), iodide-induced (Drugs-amiodarone, Radiographic Contrast media, Iodine Supplementation Programme), Extracurricular Source of Thyroid hormone( Fictitious Thyrotoxicosis, struma Ovaries), TSH-induced(TSH-secreting pituitary adenoma, Choriocarcinoma & Hypdatiform mole, Follicular carcinoma)
In which the major cause is Graves’ disease, the less common cause is multinodular Goitre & Other causes are not often seen.
Pathogenesis –
Thyroid-stimulating immunoglobulin (TSI), which is produced in the thyroid gland, bone marrow, and lymph nodes, is the cause of the hyperthyroidism associated with Graves’ disease. Bioassays or the more popular thyrotropin-binding inhibitory immunoglobulin (TBII) assays can be used to identify such antibodies. These tests are helpful in monitoring pregnant Graves’ patients, as elevated levels of TSI can cross the placenta and result in newborn thyrotoxicosis. The presence of TBII in a patient with thyrotoxicosis implies the occurrence of TSI.
Thyroid-associated ocular disease seems to be significantly influenced by cytokines. Activated T cells infiltrate the extraocular muscles, releasing cytokines like interleukin-1 (IL-1), tumour necrosis factor (TNF), and interferon y (IFN-Y) that activate fibroblasts and increase the production of glycosaminoglycans that trap water, causing the characteristic swelling of the muscles. The muscles develop permanent fibrosis in the later stages of the illness. There is growing evidence that TSH-R is a common autoantigen expressed in the orbit, which would account for the tight relationship with autoimmune thyroid illness, even if the pathophysiology of thyroid-associated ophthalmopathy is yet unknown. Retrobulbar tissue growth can also be caused by increased fat. Optic neuropathy, diplopia, and proptosis can result from an increase in intraorbital pressure.
Investigation –
TSH is decreased while total and unbound thyroid hormone levels are raised in Graves’ disease. Only T3 is elevated in 2–5% of patients (and more in regions with poor iodine consumption; T3 toxicosis). The opposite condition, known as T4 toxicosis, is sometimes observed when hyperthyroidism is brought on by too much iodine, which supplies too much substrate for the production of thyroid hormones. This condition is characterised by increased total and unbound T4 and normal T3 levels. Although it is not required on a regular basis, measurement of TPO antibodies or TRAb may be helpful if the clinical diagnosis is ambiguous. Associated abnormalities such as elevated ferritin, liver enzymes, and bilirubin might lead to diagnostic confusion in thyrotoxicosis. Thrombocytopenia and microcytic anaemia could happen.
Clinical Features –
Common sign & symptoms
- Weight loss despite normal or
- Increased appetite
- Heat intolerance, sweating
- Palpitations, tremor
- Dyspnoea, fatigue
- Irritability, emotional lability
- Weight loss,Tremor
- Palmar erythema, Sinus tachycardia
- Lid retraction, lid lag
Less common Sign & Symptoms
- Osteoporosis (fracture, loss of height)
- Diarrhoea, steatorrhoea
- Angina,Anxiety, psychosis
- Muscle weakness
- Amenorrhoea/oligomenorrhoea
- Infertility, spontaneous abortion
- Loss of libido, impotence
- Excessive lacrimation, Goitre with bruit
- Atrial fibrillation, Systolic hypertension/increased
- Pulse pressure, Cardiac failure2
- Hyper-reflexia, III-sustained clonus
- Proximal myopathy, Bulbar myopathy
Rare Sign & Symptoms
- Vomiting, Apathy
- Anorexia, Exacerbation of asthma
- Gynaecomastia, Spider naevi
- Onycholysis, Pigmentation
Homoeopathic Approach –
The condition of thyrotoxicosis is very well treated by Homoeopathic treatment . We treat not only Thyrotoxicosis but treat the patient as a whole with the holistic approach.
Raptorial Approach –
Kents Repertory
GOITRE : Ail., aloe., am-c., ambr., apis., aur-i., aur., bad., bell., brom., calc-f., calc-i., calc-s., Calc.., carb-s., caust., cist., con., crot-c., ferr-i., fl-ac., form., hep., Iod., kali-c., kali-i., lach., lap-a., lyc., lycps., mag-c., merc-i-f., merc-i-r., nat-c., nat-m., nat-p., nat-s., phos., plat., podo., sep., Spong., stram., tab., tarent., tub., .
Constriction : Calc-s., Crot-c., iod., lyc., spong.
Exophthalmic : Aur-i., aur., bad., cact., calc., con., crot-h., ferr-i., ferr., Iod., nat-m., phos., sec., spong.
Indurated : Iod., spong.
Painful : Iod., plat., spong…
PAIN : Bar-c., caps., fago., kreos., merc., nat-m., op., phos., puls., sul-ac.
Thyroid gland : Am-c., carb-v., cupr., spig.
SWELLING, thyroid gland
Thyroid gland : Ail., ars., aur-s., carb-an., caust., clem., kali-i., nat-c., nit-ac., ol-j., thuj.
Boger Boenninghausen Characteristic Repertory
Gland (goitre) :- Am-c., Am-m., Ambr., Apis (cyst), Ars. (r.), Ars-i., Aur. (pulsation of), Bad., Bar-c. (children), Bell., Brom., CALC., Calc-f., Calc-i., Caust., Con., Dig., Ferr-i., Fl-ac. (hard), Ham., Hep., IOD., Kali-c. (r.), Kali-i., Lap-a., LYC., Mag-c., Merc., Merc-i-f., Merc-i-r., Nat-c., Nat-m., Nit-ac. (r.) (children), Petr., Phos., Plat., Sep., Sil., SPONG., Staph., Sul-i., Sulph., Thyr.
Boericks Repertory
Thyroid (Goiter, bronchocele) — Adren., Am. C., Am. M., Apis, Aur. Sul., Bad., Bar. Iod., Bell., Brom., Calc. c., Calc. fl., Calc. iod., Caust., Chrom. S., Cistus, casc., Ferr. M., Fluor. Ac., Fucus,, Hep., Hydr., Hydroc. Ac., Iod., Iodothyr., Iris, Kali c., Kali iod., Lapis alb., Mag. P., Merc. i. fl., Nat. m., Phos. Spong., Sul., Thyr.
Thyroid-(EXOPHTHALMIC GOITRE
Amyl, Ars., Ars. Iod., Aur., Bad., Bar. C., Bell., Brom., Cact., Calc. c., Can. Ind., Chrom. S., Colch., Con., Echin., Ephedra, Ferr. Iod., Ferr. M., Ferr. P., Fluor. Ac., Fucus., Glon., Iod., Jabor., Lycop., Nat. m., Piloc ,Stram.,Spongia., Thyr.
Paroxysm — Cact., Dig., Glon., Samb
Homoeopathic Therapeutic –
- Thyrodinum
Thyroid generates anćmia, emaciation, muscular weakness, perspiration, headache, nervous tremor of face and limbs, tingling feelings, paralysis. Elevated heart rate, exophthalmus, and pupil dilatation. Its effects on cretinism and myxedema are remarkable. The thyroid has a broad regulatory effect on how the growth, development, and nutrition organs function. A strong desire for sweets is a result of thyroid insufficiency. Extremely hungry and feeble, but loses flesh. Tachycardia. Children’s arrested development. Enhances memory. Goitre. Excessive fatness. Behaves better among patients who are pale. Palpitations, fainting, easy exhaustion, and a weak pulse The throat Burning, raw, swollen, and dry; left side is worse
- Throat -Dry, congested, raw, burning; worse left side. As of a splinter stuck across the throat. Exophthalmic, Cured- Goître reduced.
- Eyes – Exophthalmic goitre, Progressive loss of sight with central scotoma.
- Iodinum
Fast metabolism: High appetite, loss of flesh. Extremely thirsty and hungry. Better after consuming food. Extremely weak; even the little exertion causes sweating. An Iod person has a ravenous appetite but is extremely skinny, dark-skinned, and has swollen lymphatic glands. Tubercular kind. In patients with scrofulous disease and many other wasting diseases, glandular atrophy and rapid emaciation despite a healthy appetite necessitate this treatment.
- Throat: enlarged thyroid. Goitre, accompanied with tightness.Constriction, impeding deglutition, Burning and scraping in throat, Goitre; hard, with sensation of constriction, Uvulva swollen
- Spongia
The thyroid glands have enlarged. The feeling of tightness in the throat. Dyspnoea and fast, intense palpitations; inability to lie down; prefers to rest horizontally. Hot, overheated, and terrified to death, woke up abruptly after midnight with a sense of suffocation and torture. Gland induration and swelling; furthermore, exophthalmic Anxiety-related heat attacks, facial redness, and sweating
- Throat – Thyroid gland swollen. Stitches and dryness. Burning and stinging. Sore throat; worse after eating sweet things. Tickling causes coughing. Clears throat constantly. Soreness of the throat agg. Eating sweet things. Goitre; with suffocative spells; agg. Touching neck, or pressure
- Ferrum iodatum
This treatment is necessary for tumours, glandular enlargements, and scrofulous diseases. Emaciated body Anćmia exophthalmic goitre during menstrual suppression. Vital powers are drained by debilitation. It feels like food is pushing up into your throat instead of being swallowed .This is a useful remedy for glandular enlargements; new growths and uterine displacements esp.
- Throat – Violent tickling and scraping in throat, with sensation as though he would suffocate; hawking of mucus and cough. Rattling of mucus. Food seems to push up to the throat as if it had not been swallowed.
- Kalium Iodatum
Glandular tumours are strongly affected by kalium iodatum. Atrophied glands are indurated and swollen. Kalium iodatum is drawn to movement and the outdoors. The patient suffers gouty diathesis and rheumatism. Sharp, sewing, and crushing pains are typical. The discharges are unpleasant and watery. Weight loss is occurring. Sensitivity that is dispersed throughout the affected area of Goitre is touch-sensitive.
- Throat- Sore of speakers , Goitre sensitive to contact, Dry, Tonsils enlarged.
- Baryta Iodata
Thyroid enlargement has been treated with baryta iodata. It is particularly recommended for glandular enlargement, new growths, and tumours, particularly following trauma or injury. Enlarged breasts following trauma that have tumours.
Reference –
1.Harrison’s Principle of Internal Medicine -20th edition
2.Davidson’s Principle & Practice Of Medicine – 21th edition
3.API Textbook Of Medicine – 11th edition
4.Repertory of the Homeopathic Materia Medica By Dr. J.T. Kent
5.Boger Boenninghausen’s Characteristics & Repertory
6.Boericke’s New Manual of Homeopathic Materia Medica with Repertory
7.Materia Medica of Homoeopathic Medicines By Dr. S.R. Phatak
8.A Dictionary of Practical Materia Medica. By John Henry CLARKE
- Homeopathy: Its Fundamentals and Treatment By Dr. K.P. Muzumdar
