A case of hypothyroidism treated with homoeopathy

A case of hypothyroidism treated with homoeopathy


Background: Thyroid disorders are very common, affecting 750 million people worldwide by recent World Health Organization (WHO) estimates, being possibly even more prevalent than diabetes. The drug of choice is thyroxine which the patient has to take throughout their life, this leads the patient to look for  an  alternative therapy. With the increasing reliance on alternative treatments there is need to formulate methods for the fast and reliable prescriptions. Homoeopathy has emerged as the trustworthy line of treatment in many of the chronic diseases. Many researches both clinical and preclinical have shown the plausibility of the evidence-based medicine.

Materials and Methodology: A known case of HYPOTHYROIDISM presented with the menstrual irregularities and hairfall.The pre and post thyroid profile were taken as the evidence for the case, other than that the zulewski’s score pre and the post scores were taken to assess the symptomatic relief .  

Conclusion: With the individualization of the case, Sulphur was considered as the indicated remedy and was seen quite effective in the treatment of hypothyroidism in the patient.

Keywords: Hypothyroidism, homoeopathic intervention, Sulphur.

Abbreviations:( WHO )world health organization,(LMP) last menstrual period, (TDS) thrice a day. (EMES) every morning empty stomach, (TSH) thyroid stimulating hormone, (T4) tetraiodothyroning, (T3) triiodothyronine.


Thyroid diseases are amongst the commonest endocrine disorders around the world including India. According to a projection from various studies on thyroid disease, it has been estimated that about 42 million people in India suffer from thyroid diseases. 1

Thyroid diseases are different from other diseases in terms of their ease of diagnosis,

accessibility of medical treatment, and the relative visibility that even a small swelling of the thyroid offers to the treating physician. Early diagnosis and treatment remains the cornerstone of management. Hypothyroidism is caused by inadequate function of the gland itself (primary hypothyroidism) or by not enough stimulation by thyroid-stimulating hormone (central hypothyroidism).2Primary hypothyroidism is more common than central hypothyroidism.

3.It can cause number of constitutional symptoms, such as increase weight, dry skin,

menstrual irregularities, falling of hairs, cold intolerance, constipation, hoarseness of

voice, coldness of skin, and generalised debility and fatigue. In children,hypothyroidism leads to delays in development, which is called cretinism in severe cases. The classical signs and symptoms of  various grades of hypothyroidism can be estimated with clinical scores named as zulewski’s score4,this questionnaire  helps in clinically monitoring the case.The outcome assessment is based on the  criteria that lower the score the better the results.

Homoeopathy has proved its effectiveness in various clinical conditions including endrocrinological disorders. As homoeopathy, like other sciences, is attaining the plausibility as an evidence-based science, this case report will be adding on to the evidence basis to the science.


Case profile

Presenting complaints

A 27 years old unmarried female presented the complaint of absence of menses since last 3 months, and falling of hair from scalp,

History of present complaints

Patient has been preparing for competitive examination in a coaching centre from last 4 years. There were two to three episodes of grief after declaration of results.  She had increasing body weight from last 2 years. With a continuous 4-6 hours of study in coaching and 6-8 hours at home, patient stay in a sedentary life style. She has irregular menstrual cycle from last 3-4 years. Hair falling from scalp from last 1 year.

Past history

Irregular menstrual cycle from last 3-4 years. Mostly treated with hormone therapy but after 3-4 cycles again absence of menses. In 2012, diagnosed with hypothyroidism and took thyroxin 25 mg up to 3 months.

Family history

Father-diabetic, mother- hypothyroidism.

Gynaecological & Obstetrical History

Gynaecological history:

  • Menarche: at 12 years
    • LMP: 19/01/16
    • Menstruation:
      • Duration: 3 days
      • Cycle(interval): 32-35 days

Treatment history

Hormone therapy

Physical generals:

Patients is sensitive to heat with complaints of amenorrhoea,falling of hairs,aversion of milk,hoarseness of voice,dryness of skin,constipation ,disturbed sleep.

Mental generals:

Irritable and become angry to trifle things.

Life space investigations:

Patient was born in a middle class hindu family. She was the 3rd of the three

children to her parents. Father had diabetes, mother had hypothyroidism. Patient was worried about her future.

Physical examination

Patient was found to be obese.

Systemic examination

On musculoskeletal examination, it was noted that there was hard bony overgrowth at forearm, thighs, knees,legs and ankles. There was no tenderness while examining the bones.No signs of inflammation seen.

Respiratory system: vesicular breathing with no added sounds.

Nervous system: ankle reflex took slightly more time.

Laboratory investigations

Previous investigations Investigations advised
23.06.2012   26.04.2016
T3- 96 ng/dl T4- 6.9 mg/dl TSH-  17.2uIU/ml T3 T4 TSH

Provisional diagnosis:

Hypothyroidism: the well-known signs and symptoms of  hypothyroidism are dry skin, cold sensitivity, fatigue, muscle cramps, voicechanges, and constipation that  results from an intrinsic disorder of the thyroid gland (primary hypothyroidism). In this situation, serum T4 is low and TSH is elevated, usually in excess of 20 mU/L.5

Miasmatic diagnosis6

Scanty menstruation, hoarseness of voice, constipation, dryness of skin , hair falling from scalp

Psoric in nature

Symptoms Intensity Common/uncommon Miasm6
Mental generals      
Anger ++ Uncommon Psora
Irritability ++ Uncommon Psora
Physical generals      
Aversion to milk ++ Uncommon Psora
Desires sweets ++ Uncommon Psora,Syphillis
Amenorrhoea ++ Common Psora
Disturbed sleep ++ Common  
Obesity ++ Common Psora
Constipation ++ Common Psora
Coarse skin + Common
Hoarseness of voice ++ Common Psora
 Dryness of skin ++ Common Psora
 Falling of hair from scalp + Common Psora,Syphillis

Table :Analysis and evaluation of the case

Totality of symptoms

  • Anger
  • Irritability
  • Menses absent
  • Aversion milk
  • Desire sweets
  • Skin dry
  • Obesity
  • Hair falling from scalp
  • Hoarseness of voice
  • Constipation

Selection of medicine

Repertorial method-Synthesis 10.0 Repertory7 has been used for repertorisation

Rubrics selection

Table 01:Repertorial totality with rubrics

Symptoms Rubrics
Anger MIND- anger
Irritability MIND- irritability
Aversion to milk APPETITE- Aversion- milk
Desire to sweets APPETITE- Desire- sweets
Menses absent FEMALE GENITAL/SEX-MENSES- absent
Dryness of skin SKIN AND EXTERIOR BODY- Dry
Hair falling from scalp HEAD- External- hair – falling out
Constipation STOOL- constipation
Hoarseness of voice VOICE AND SPEECH- Hoarse

Fig 01:Repertorial chart 7.

Top 5 suggested medicines on repertorisation

Sulphur- 10/27

Calcarea carb[Y1] onicum- 10/25 Natrummuriaticum10/25 Phosphorus – 10/25

Kalim carbonicum- 10/24

, Sulphur  covered the totality of symptoms quantitativelyas the remedy for this patient[Y2] . Selection of remedies was based on the repertorisation of totality of symptoms.

  • The constitutional remedy was selected after repertorial analysis in consultation with Materia Medica,8,9,10,11.. Though Calcarea carbonicum, Natrium muriaticum, Phosphorus and Kalium carbonicum were close in qualitative totality.Sulphur was ahead of them, corresponding to the patient with thermal reaction which is Hot patient.

First Prescription:

1. Sulphur. 200/ 1 Doses EMES + PL 30 / TDS x 14 days(every morning empty stomach)200 C potency was prescribed based on the susceptibility of the patient 12.13

General management According to a special health report by harvard medical college about the healthy eating for healthy thyroid  14

Patient was advised to-

  • Liquid and fibre rich food, diet including green vegetables and fruits intake should be more.
  • Avoid foods such as fatty, carbohydrate rich and sweet.
  • Avoid goiterogenic food like cabbage, cauliflower and broccoli.
  • Regular morning brisk walk along with yoga and meditation.
[Y3] 4

Zulewski’s score:

  Symptoms Base line 1st Followup 2nd Followup
1. Diminished sweating Sweating in the warm room or a hot summer day 1 1 1
2. Hoarseness Speaking voice, singing voice 1 1 0
3. Paraesthesia Subjective sensation 0 0 0
4. Dry skin Dryness of skin, noticed spontaneously, requiring treatment 1 1 0
5. Constipation Bowel habit, use of laxative 1 0 0
6. Impairment of hearing Progressive impairment of hearing 0 0 0
7. Weight increase Recorded weight increase, tightness of clothes 1 1 1
Physical signs
1. Slow movements Observe patient removing his clothes 0 0 0
2. Delayed ankle relaxation time Observe the relaxation of the reflex 1 1 1
3. Coarse Skin Examine hands, forearms, elbow for roughness and thickness of skin 1 1 1
4. Per orbital puffiness This should obscure the curve of the malar bone 0 0 0
5. Cold skin Compare temperature of hands with examiner’s 0 0 0
Sum of all symptoms and sign present 07 06 04

Interpretation: Hypothyroidism- hypothyroidism- intermediate hypothyroidism

Units Base line value 26.04.2016 1st follow up 26.07.2016 2nd follow up 25.10.2016
T3 ng/dl 132 134 130
T4 ug/dl 8.8 8.9 9.2
TSH uIU/ml 13.8 14.2 3.8


Date Sign and symptoms Prescription
26.04.2016 Amenorrhea since 3 months  
  Falling of hairs from scalp Sulphur 200 / 1 Dose EMES
  Anger & irritability marked  
  Aversion to milk PL 30/TDS          X 14 DAYS
  Hoarseness in voice  
  Scanty perspiration  
  Dry & coarse skin  
  Continue increasing body weight  
  Serum TSH- 13.8 uIU/ml, Zulewski’s Score- 7  
10.05.2016 All the sign & symptoms are same except PL 30/TDS          X 14 DAYS
  mild improvement in constipation,  
24.05.2016   All the sign & symptoms are same  
  except moderate improvement in constipation, PL 30/TDS          X 14 DAYS
  Menstrual cycle started on 02.06.2016  
  Marked improvement in constipation , PL 30/TDS          X 28 DAYS
  weight increase slight slow, mild improvement  
  in falling of hairs & in irritability, all other sign  
  & symptoms are SQ,  
  Menses does not appear at regular time,  
  mild improvement in falling of hairs, PL 30/TDS          X 14 DAYS
  all other sign & symptoms are SQ,  
19.07.2016   Menses does not appear at regular time,   PL 30/TDS          X 7 DAYS
  Moderate improvement in falling of hairs,  
  all other sign & symptoms are SQ,  
  Menses does not appear at regular time,  
26.07.2016 Moderate improvement in Falling of hairs  
  from scalp, speed of weight increase slightly Sulphur 200 / 1 Dose EMES
  slow, moderate change observed in irritability,  
  all other sign & symptoms were in  SQ PL 30/TDS          X 14 DAYS
  Serum TSH- 14.2 uIU/ml, Zulewski’s Score- 6  
Date Sign and symptoms Prescription
  09.08.2016   LMP-30.07.2016     PL 30/TDS           X 28 DAYS
  Menstrual flow remains for 2 days,  
  Moderate improvement in Falling of hairs from  
  scalp, speed of weight increase slightly slow,  
  moderate  change  observed     in irritability, mild  
  improvement in hoarseness of voice & dryness of  
  skin, all other sign & symptoms were in  SQ  
  06.09.2016   Menses does not appear at regular time, Marked improvement in Falling of hairs from scalp     PL 30/TDS           X 14 DAYS
  and in irritability, speed of weight increase slightly  
  slow,      moderate improvement in hoarseness of  
  voice& dryness of skin, all other sign & symptoms were in  
   Status quo  
20.09.2016   PL 30/TDS           X 28 DAYS
  Menstrual flow for 2 days,  
  Marked  improvement  in     Falling of hairs from  
  scalp, hoarseness of voice, dryness of skin & in  
  irritability, speed of weight increase slightly slow,  
  all other sign & symptoms were in  Status quoQ  
  LMP-17.10.2016 PL 30/TDS           X 7 DAYS
  Menstrual flow for 2 days,  
  25.10.2016     Sulphur 1M / 1 Dose EMES
  In general, patient improved. According to i. Symptoms came to status quo so the potency have been raised based on susceptibility.
  zulewski’s scoring (7 to 4), ii. Serum TSH Level  
  (13.8     to     3.8),      but      still     patient      having PL 30/TDS           X 28 DAYS
  irregularities in menstrual cycle, increase in  
  weight, diminished sweating.  
  Patient on treatment continued.  
Baseline-26.04.2016 TSH level 13.8 uIU/ml Zulewski’s Score- 07  
26.07.2016 TSH level 14.2 uIU/ml Zulewski’s Score- 06
25.10.2016 TSH level 3.8 uIU/ml Zulewski’s Score- 04


As evident from this case, Sulphur showed improvement in the evidences as evident in the thyroid profile and the zulewski’s score.

Calcarea carbonica, Graphites, Lachesis, Lycopodium, Natrum muriaticum,

Pulsatilla, Sepia officinalis, and Sulphur are few of the frequently prescribed constitutional

homeopathic remedies for hypothyroidism. Many stalwarts have mentioned in their Materia medica ,8,9,10,11,,and Repertory books 15,16,17about the action of Sulphur ,According to Materia medicas Sulphur covers most of symptoms like anger and irritability,hairfall,hoarseness in voice,dryness of skin,aversion to milk ,desires sweets,constipation,Amenorrhoea .

In the Synthesis Repertory16 and Kent17Repertory under the rubric- EXTERNAL THROAT – PAIN – stitching – Thyroid Gland; EXTERNAL THROAT – SWELLING – Thyroid gland;mentions Sulphur as a remedy.


This case is one of the evidence-based documented research studies, that shows effectiveness of homoeopathic treatment not only in relieving the symptoms of hypothyroidism, but also in bringing favourable changes in pathology as evident in the investigations. Thus, this study is the classical example of the holistic approach of homoeopathy.


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therapeutic challenges”. The Journal of Clinical endocrinology and Metabolism

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 [Y1] Write complete names of all remedies in italics

 [Y2] Cite the reference from authentic source

 [Y3] Explain this questionnaire with cited reference in the above article (under introduction)

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