A Case of PostpartumThyroiditis –Struma Nodosa Thyrotoxica And Leukopenia

The patient was a 34-year old woman, thin, with exophthalmos and anxious expression; blond, and with very rapid speech. She came for the first time on 18.03.2015. After delivery she used multivitamins with iodine. After 2 weeks of delivery, she felt very bad palpitations, trembling extremities, desire to weep, irritability and anxiety. In the last month she was often shouting at her husband and her young daughter but then would regret it immediately. She felt thermally hot. Appetite had lately increased. On blood tests, her thyrotoxicosis state was revealed (TSH <0.008).  An endocrinologist prescribed Thyrozol 15 mg. Patient used it for 3 weeks and after that there appeared leukopenia ( 2,10 t.N =4.0-9.8) with agranulocytosis.

Personal/Family medical history

This woman was born healthy. The grandparents were healthy and lived till 94 and 90 years.  Her father had Ca duodenum at the age of 70 years. There was no history of thyroid dysfunction in her family. Till her pregnancy patient did not have any health problems. Last acute was 1 year ago; flu with temperature of 39⁰C.

Presentation

The patient spoke in a rapid and jerky manner. She had increased perspiration during the last month. She was very anxious about the future. She had stopped therapy with Thyrozol in just 2 weeks. She could not hold a cup because of trembling hands. She also complained about dry skin.

On 04.01. 2017 – The Ultrasound of thyroid showed:

Chronic Autoimmune Thyroiditis. Struma nodosa. Tirads 4.

 Analysis and Prescription

Symptoms for Repertorisation (With RADAR software)

1. CHEST – HEART; complaints of the – thyroid glands; after overactivity of
2. CHEST – PALPITATION of heart
3. MIND – ANXIETY
4. MIND – WEEPING
5. MIND – ANGER
6. STOMACH – APPETITE – increased
7. EXTREMITIES – TREMBLING
8. GENERALS – HEAT – sensation of
9. HEAD – HAIR – falling
10. EXTERNAL THROAT – SWELLING – Thyroid gland

Vithoulkas Expert System – large remedies: Ars i., Carbn-s., Iod., Calc s., Kal s.,Kal i., Con.

I chose IODUM in this case because of heat sensation, palpitation, rapid speech, anxiety, increased appetite with weight loss.

Prescription on 18/03/2015  –Iodum 200CH one dose

F.U.1  20.04.15.

Next 3 days perspiration was less by 80 %. Patient noticed she had become calmer and the hair fall had reduced. The external throat swelling was reduced visibly

Prescription: Placebo       F.U.2  17.06.15.Patient was gradually doing well also with thyroid hormones and antibodies. Her menses were absolutely regular and normal. Her speech was still rapid. Extremities trembling had disappeared. Sometimes she had heat flushes before menses Prescription: Placebo F.U. 3   01.12.16.The patient experienced some stress a few days ago. Patient came with great fear of death and palpitation because she learned that her father had Ca duodenum.Also, she mentioned craving for salt and lack of heat.Prescription Natrum muriaticm 200CH one dose  F.U.4   05. 12.16.There was no change, only desire for salt disappeared. There was palpitation with  fear of death and to stay alone, and she had desire for cold water.Prescription Aconitum 200CH one dose

F.U.5   28.12.16.Blood analysis again showed thyrotoxicosis. There was no change in the emotional and physical symptoms. Fear that something bad will happen with health; weeping and anxiety to stay alone remains. Palpitation and flushes of heat still persisted. Prescription  Iodum 200CH one dose F.U. 6   06.01.17.In a few days all symptoms disappeared!!! It was like a miracle. Till – 06.01.19 patient was in a very good emotional and physical state. Thyroid hormones in the blood tests were normal, but the struma nodosa persisted in ultrasound. She had no other complaints now! Prescription: Placebo ConclusionThis patient was a group A person Level of Health wise. She came from a healthy genetic background with hardly any health issues,until her health was upset from taking the vitamins with iodine in them. Being sensitive to iodine it probably triggered the problem. The clarity of the remedy picture and the miraculous response to just one remedy also confirms that she was of the higher health level. Even during the acute stress that she suffered she still required her chronic remedy. This is the classic way a Group A case will present. Whenever their health is stressed, they tend to vibrate to the same remedy.  In retrospect, the prescription of Natrum muriaticum and Aconitum were wrong. This would be different if the group was lower. I thank prof GeorgeVithoulkas for my knowledge and inspiration in homeopathy!

Table 1: Laboratory diagnostics: Thyroid profile