hypothyroidism case

[Guest guest]

http://www.sagecrossroads.net/public/news/

 

this article says the treatment of borderline hypothyroidism shortens

the patient's life. this is no surprise. every patient I have ever

seen on synthroid has a red peeled tongue. there is no doubt this drug

stimulates yang and burns yin. It should be avoided in any case

without damp accumulation, IMO.

 

I had a case recently that may be borderline hypothyroid

 

1 month ago a female, age 28 presented with mild fatigue, severe

longstanding constipation worsened by stress, frequent, dark urine,

heat effusion alternating with aversion to cold and most strikingly

orange-yellow skin for the past 2 months. She was worried about

hepatitis, thinking she had jaundice, though she claimed no high risk

activities. I wasn't convinced about the jaundice as the sclera and

oral cavity were clear, plus she lacked any sx of liver or gallbladder

disease (RUQ pain, light colored stools, etc.). It was mostly soles

and palms, though she had ruled out carotenemia because she didn't eat

that many carrots. Her pulse was weak and wiry on the left, weak and

slippery on the right. Her tongue was puffy, with a thick greasy

yellow coat.

 

Not being convinced on the jaundice, I prescribed for her based upon

her pattern, which appeared to be liver depression qi stagnation, damp

heat in the lower burner and spleen qi vacuity. I think she may have

had chills and fever due to an incipient UTI, not jaundice. Her chief

complaints were actually the frequent urination and the constipation.

I prescribed primarily with the constipation in mind as she seemed most

plagued by this sx. Most of the ingredients are froma modified Liu Mo

Tang. I added huang bai for damp heat plus zhi zi and yin chen hao,

the latter two also doing double duty if there was any jaundice.

 

1 pack dose for 2 days

 

mu xiang 12

zhi shi 12

bing lang 12

wu yao 9

he huan pi 12

bai shao 12

huang bai 18

yin chen hao 18

zhi zi 12

gan cao 6

 

The patient had 75% relief from her urinary symptoms after 2 packs.

But the constipation persisted with no change (no coffee, no BM,

another thing that made me thing GB). And the " jaundice " had not

dissipated. In addition, she now reported her fatigue was more

substantial than she had realized. I had also ordered tests for liver

enzymes which came back clean. So having ruled out jaundice, I was

still convinced that qi stagnation was the type of constipation she was

experiencing, but my intern insisted that I consider qi vacuity. I

examined the patient closely and agreed, prescribing a large dose of

huang qi this time.

 

huang qi 18

mu xiang 12

zhi shi 18

bing lang 18

wu yao 9

he huan pi 12

bai shao 12

huang bai 12

yin chen hao 12

zhi zi 9

gan cao 6

 

It was also determined that hypothyroidism is the main cause of

carotenemia and that was likely what she had, not jaundice. We ordered

a thyroid panel at the patient's request. she had apparently tested

borderline in the past She took the herbs while waiting for the

results. After the first dose, her bowels were normal and continued

that way when I saw her after 2 full packs. Her energy was up, but

most interestingly, her skin discoloration was gone. This was quite

sudden after 10 weeks of the " jaundice " . We still await her lab tests,

but it appears the huang qi may have made a big difference. Huang qi

is often used in hypothyyroidism and in a borderline case, it is

feasible that this herb alone in sufficient dosage could give enough

stimulation to the thyroid to clear the carotenoid deposits. It was

quite striking, though. More as I learn more.

 

 

Chinese Herbs