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Read this essay to learn about the disorders of endocrines and metabolism. After reading this essay you will learn about: 1. Simple Goitre 2. Hyperthyroidism 3. Hypothyroidism 4. Gout 5. Diabetes Mellitus.
- Essay on Simple Goitre
- Essay on Hyperthyroidism
- Essay on Hypothyroidism
- Essay on Gout
- Essay on Diabetes Mellitus
Essay on Endocrine and Metabolism Disorder # 1. Simple Goitre:
A female patient, usually in her teens, presents with an enlargement of the thyroid gland but does not present with any uncomfortable symptoms warranting a treatment except that it is unsightly. The condition is SIMPLE GOITRE.
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Simple goitre is either endemic or sporadic or diffuse or nodular. Most of these simple goitres are due to dietary insufficiency of iodine. These are presented by people living in isolated villages and often in high mountains, for example Nepal. These people migrate in search for jobs. Change of diet and addition of iodized salt in their food greatly improves the condition.
Most of the time no treatment is required. However it is necessary to inquire into food habits of the patient and if any objectionable food being taken in large quantities is detectable then that item of food may be eliminated.
Constitutional remedies like Calcarea, Natrum muriaticum, lodium and Spongia closely resemble the pathogenesis of the simple goitre. During puberty and pregnancy goitre associated with euthyroidism rarely requires intervention. Patient should be reassured that that there will be spontaneous resolution.
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Very often Goitre is noticed as cosmetic defect. The majority of them are painless, but can produce dysphagia and difficulty in breathing implying oesophageal or tracheal compression. Clinical thyroid status of these patients must be determined..
Essay on Endocrine and Metabolism Disorder # 2. Hyperthyroidism:
A patient tall for her age and sex, reports with moderately enlarged soft and highly vascular thyroid gland with a conspicuous lobular structure: complains that the growth has been slowly developing: there is general heat and feels feverish, the appetite is increased but not sufficient to compensate the increase in energy expenditure, and hence patient complains of loss of weight, there is palpitation and breathlessness on exertion, resting pulse rate is raised often over 100/min., raised systolic pressure, and peripheral vasodilation, cardiac arrhythmia, great anxiety with fine tremors to the hands, diarrhoea, irregular menstruation. The condition is HYPERTHYROIDISM.
This is a clinical condition resulting from increased levels of free T4 and or T3, usually because of the disorder of the Thyroid gland but can also be induced by administration of excessive amounts of thyroidal hormones.
Clinical features of hyperthyroidism are seen through many systems. There is loss of weight although appetite is greatly increased. Behavioural change and increased irritability, and restlessness. There is heat intolerance, breathlessness, palpitation, loss of libido etc.
No treatment should be instituted without biochemical confirmation. TSH is suppressed, and a normal TSH usually excludes the diagnosis. If one studies the pathogenesis of Iodides of Kalium, Baryta, Natrum, Magnesium, Spongia, Bromium one will find a close resemblance to the pathogenesis of hyperthyroidism.
Kali iod:
Has strong action on the tumours of glands, tumours of the breast. Kali iod craves open air and motion. Patient has rheumatic, gouty diathesis. Pains are characteristic — crushing, stitching and sharp pains. Discharges are watery and foul. There is loss of weight. There is diffused sensitiveness over the affected parts. Goitre is sensitive to touch.
Baryta iod:
Has been used in enlarge thyroid, enlarged breasts with tumours.
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Spongia:
Has usually these tumours which develop after blows or injury. Usually the lower potencies are useful, use.30c.: action on the lymphatic and glandular system. The testes and the thyroid are indurated. The blood, heart and the veins are involved and with the protruding eyes a perfect picture of exophthalmic expression.
Thyroidinum:
An important sarcode is of great use in the cases of thyroid —both in its excessive state or reduced state. This Thyroidinum is now better known as lodothyrine. It is prepared from the dried thyroid gland of a sheep. It is interesting that Thyroidinum 3x is often found useful in hypothyroidism and Thyroidinum 6x is useful in hyperthyroidism.
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While using this sarcode remember it will have all the signs and symptoms of the disease, one will only have to match the modalities for its proper use.
ledum:
Has enlargement of glands, testes, thyroid, breast, mesenteric etc. They first get swollen, and then begin to dwindle. There is a rapid metabolism, emaciation, weight loss, and debility causing perspiration on slightest exertion. Hot patient. Ravenous appetite, yet emaciating. Goitre is hard and has sense of constriction, impending deglutition.
Essay on Endocrine and Metabolism Disorder # 3. Hypothyroidism:
A female patient in her middle life, with a puffy face, baggy eyelids, and with sparse hair on the head, falling of eyelids from the outer third eyebrows, swollen and oedematous swelling of the supraclavicular region, neck, back and hands presents for treatment. This is case of HYPOTHYROIDISM.
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This is a clinical condition resulting from decreased circulating levels of T4 and/or T3. When this hypothyroidism is of a severe degree and of long standing, it is seen as myxoedema which is characterized by deposition of mucinous material causing swelling of the skin and of subcutaneous tissue. Many complaints related to alimentary, cardiovascular and generative organs will be presented.
The treatment will depend mostly on how the case is presented. In general practice we see replacement therapy is instituted by using thyroxine as remedy of choice. The homoeopathic treatment will be mostly on the constitution and the totality of the case. The choice of remedies will fall with Bromium, Calcarea Iodide, Graphites, Kali Iodide, Natrum mur. Sepia, Spongia and Thyroidinum.
Bromium:
Is useful in scrofulous children, with enlarged glands. And is mostly prescribed on the general expression, swollen and indurated glands, with much anxiety, fear of ghosts and vision in the dark. Useful in sailors who come ashore and are better at seaside.
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Graphites:
Is useful in those who have a tendency to put on weight, unhealthy fat, defective animal heat from defective oxygenation, always cold whether indoors or outdoors. Nodulated goitre choking while swallowing, worse on empty swallowing.
Kali iodatum:
Has glandular swellings with loss of weight.
Essay on Endocrine and Metabolism Disorder # 4. Gout:
Patient may present with a sudden acute excruciating pain in the great toe, having started the pain in the early hours of the morning, the joint is red and swollen, and very tender. This condition is GOUT. Gout is caused by monosodium urate monohydrate or uric acid crystals, deposition from hyperuricaemic body fluids.
There are two stages in which this disorder presents: firstly, recurrent attacks of arthritis, and secondly, when these attacks finally do not resolve they leave behind deposition of urates in and around the joints.
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An acute gouty arthritis affects the metatarsophalangeal joints of big toe initially and later feet, ankles, knees and hands, wrist, elbow. The excruciating pains are usual at night.
Gout is a disease as obstinate as it is painful. It owes its origin usually to high living, although heredity has much to do with its development.
The treatment of Gout may be divided into that of the acute paroxysm and that of the general symptoms. In the acute attacks these have been successfully used.
Colchicum:
Toe joints become inflamed, dark red and hot, and intensely painful, the foot becomes oedematous; urine scanty and dark red. The smell of the food makes him sick at the stomach. Cannot tolerate any noise and external impressions.
Ledum pal:
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Is useful after abuse of alcoholic drinks. Hot tensive swelling of the toe, foot with tearing, grinding and shooting pains, cannot bear the least covering or the warmth of the bed. Although there is oedema of the foot there is copious and frequent urine and the nodes of the frequent attacks turn very painful and sore, better by ice application.
Arinca:
The pains are unbearable during the night and the bed feels too hard. The inflamed joint is shining, red, and hard. He dreads the proximity of anyone.
Bryonia:
Has swollen joint, tense and not very red. Feels deathly sick and has a white-coated tongue; and is unbearably cross.
Benzoic acid:
Usually has a very offensive urine and deposits a reddish cloudy sediment but with attack the urine becomes more or less clear, and there is tearing sensation in the joints, old nodes become painful, and the pain abates with the palpitation in the heart and ceases only when they increase.
Belladonna:
Has swelling, redness of the joint with excruciating, throbbing pain and very sensitive to touch, and are worse from hanging down of the parts, and at night these attacks are often precipitated by taking cold. When fever is present other symptoms of Belladonna will also be present.
Mag phos:
Has similar pains, redness and swelling but they are better with hot fomentation.
Lycopodium:
Will be very useful in sub-acute and chronic cases. It has a weak digestion. There is a lot of flatulence, with bloated abdomen. Aversion to bread, desire for sweets, delicacies and pastries, cannot eat oysters and onions, beans, eating them causes severe swelling of joints due to precipitation of uric acid.
Prefers hot food and drink. There is frequent urging to urinate. Pain in the back starts before passing the urine and that is better after urinating. Red sand in urine offensive. Usually there is relief in joint pain after offensive loaded urine freely passes.
Causticum:
Has painful nodes on the joint, stiff joints and the pains are relieved by the warmth of the bed.
Graphites:
Has tearing in toes, the pains drives him of the bed at night, and the gastralgia is relieved by eating.
Lithium carb:
Has gouty constitution and uric acid diathesis. Soreness is the keynote of lithium carb. Violent sharp pains, as from red hot needles. Diet is very important for these patients. Foods containing high purine material needs to be totally avoided. Foods like cauliflowers, beans, mushrooms need to be totally discarded. Alcohol to be stopped. Fish of crustaceous origin should also be avoided.
Essay on Endocrine and Metabolism Disorder # 5. Diabetes Mellitus:
An adult complains of gradual development of polyuria, intense thirst, with perhaps nocturia, weight loss, weakness and lassitude, pruritus, cramps in the legs, crops of boils and loss of libido. He claims that it has been happening over some period. This condition is DIABETES MELLITUS.
Hahnemann has classified Diabetes Meilitus on the basis of his Miasmatic Theory. Present-day classification based on the WHO Classification does not differ from what Hahnemann had thought of. Hahnemann’s Psoric diabetics are those who are called Pre And Potential Diabetics of modern classification of WHO.
Sycotic Diabetics are those who are Non-Insulin Dependent Diabetic (NIDDM). Grouped under Tubercular or Syphilitic type are those which are Insulin dependent (IDDM) cases.
Disposition to Diabetes is determined by the hereditary characters and the individual susceptibilities in the presence of Hostile Environment. In clinical practice we receive three categories of cases of DM, one where there is increase in blood sugar on stress and the sugar falls down when the stress is withdrawn.
These are Pre and Potential Diabetics (Psoric). These patients need counseling, exercise, proper diet, and change in life-style that would keep the stress at bay. Such patients often do not-need any medical regimen. In the second group of Diabetics are confirmed cases on oral hypoglycemic agents. Here it may be necessary to determine the cause of Diabetes.
It is either untreated Psoric Diabetes or may have defective pancreatic metabolism, where there is less production of Insulin or less utilization of Insulin causing disturbance in the carbohydrate metabolism. Patient should continue the oral hypoglycaemic agent that he has been taking, and observe the same rules for his exercise and diet.
In addition he can be started with Homoeopathic remedy based on his totality. It is observed that with the passage of time the need for the oral hypoglycaemic agent will become less.
It may be that at the end he can withdraw the hypoglycaemic drug and, finally, he may be able to do without the homoeopathic remedy also. Only exercise and diet will be his treatment. In the third group we find the patients fully dependent on insulin.
It is our observation that the continuous insulin therapy causes fall in the production of bodily insulin and then cannot do without it. Homoeopathic therapy may help for some time but not all the time. Reversal of these cases may not be fully achieved.
Let us study the first group where stress is an important factor that causes this imbalance of hormones. In the chapter of Mind (Kent) there is a rubric “Ailments from “: Disappointment from Love, Bad News, Despair, Emotions, Fear, Fright, Grief, Mortification, Depression, Sadness.
All these factors are capable of altering the hormonal physiology in hypersensitive or hyper-reactive individual. Remedies listed under these rubrics are Aconite, Nat mur, Ignatia, Phosphorus, Calcarea, Sulphur in Bold Type and Argentum nil, Graphites, Psorinum etc. in italics.
We all know that these are all deep acting, strong Psoric/Tubercular remedies. These drugs have action on the overall economy of the patient, and the blood examinations may show the labile nature of their blood sugar levels when under stress. Similarly, remedies like Pulsatilla, Sepia, Natrum mur, Calcarea are listed under physical stress, exertion, or pregnancy. Severe infection can also cause elevation of Blood Sugar and once the infection goes away there is fall in sugar level.
These remedies will act both as inter-current and constitutional remedies. These drugs when prescribed on the basis of the totality take care of both emotional and the subsequent physical characteristics and reduce the emotional effects and the physiological/biochemical values. These remedies ultimately help in improving your emotional states and subsequent physical changes.
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If these labile state of blood sugar levels are not controlled in time the condition may proceed to produce some structural changes in the organs which may transform the whole process to sycotic state. Apart from short period of blood sugar elevation more viable changes in the system such as polyurea, intense thirst with occasional nocturia, excessive appetite with weight loss, weakness and lassitude, loss of libido.
In female patients there will be pruritus vulvae, and in males balanitis will be found.
Physiognomy of sycotic patients are different from that of Psoric or Tubercular. The whole mechanism is slow and sluggish to develop or to react. Obesity is marked in these patients and the reasons for the partial failure of the bio-chemic mechanism is genetic trait. Any benign or malignant tumour of the pancreas can cause damage to the pancreatic function and disturb the normal mechanism.
Sycotic remedies indicated in this condition are Thuja, Medorrhinum, Natrum sulph, Colchicum, Pulsatilla, etc. All these are polychrest remedies and have a deep sycotic action on the human economy. In the third group. Insulin Dependent Diabetes Mellitus, there is nearly total failure of the pancreatic metabolism and reversibility is not often possible and there is total dependence on the external Insulin.
In this the symptoms of polyuria, polydipsia, and polyphagia becoming very prominent, ketoacidosis follows with nausea, vomiting and headache. This, therefore, included in the tubercular or syphilitic dimensions. Weight loss due to fluid depletion and the accelerated break-down of the fat and muscle secondary to insulin deficiency is seen.
Phosphoric acid:
Is suited to persons of originally strong constitution, weakened by loss of fluids, acute diseases, chagrin or succession of moral emotions, or persons of mild disposition, or children or adults who have grown rapidly with pain in the back, with profuse watery urination, more at night, sometimes the urine—though clear on passing—turns milky and is offensive. Testes are tender and swollen with weakness of sexual power.
Uranium nit.:
Has excessive thirst, polyuria, and dry tongue. Uranium nit in lower potency 3x and 30 gives relief faster than any other potency. There is frequent desire to urinate — large quantities of urine with pain in the kidneys and any attempt to retain this urine causes excessive pain.
Lactic acid:
Both lower and higher potencies are useful.
Rhus aromaticus:
There is large quantity, low specific gravity urination and there is bladder atony causing incontinence. Severe pain at the beginning of urination.
A good diabetic care comprises of organized training programme involving nurse, physician and dietician.
There cannot be set diet for all diabetic patients and, therefore, the caloric requirements are tailored to the need of the individual patient.
