Hypothyroidism
1. PRELIMINARY DATA
- No.: 209/2026
- Patient's Name: BCD
- Address: Flat 1203, Crystal Palace, Pune.
- Occupation: Homemaker (previously bank clerk, now mostly home due to fatigue)
- Religion: Hindu
- Date: 10/04/2026
- Age: 44 Years
- Sex: Female
- Education: B.Com
- Status: Married
2. CHIEF COMPLAINTS AND ASSOCIATED TROUBLES
| LOCATION | SENSATION & PATHOLOGY | A/F & MODALITIES | CONCOMITANTS |
|---|
| General & Endocrine | Profound fatigue, weight gain (15 kg in 3 years despite diet), cold intolerance, dry skin/hair loss, constipation | < Cold weather, < Morning, < After sleep, < Mental exertion, > Warm environment, since 5 years (diagnosed 4 years ago, TSH 8-12 despite levothyroxine) | Puffy face/eyelids, hoarse voice, depression, slow thinking |
| Neck | Goitre (diffuse, non-tender) | < Pressure collars | Anxiety about weight & appearance, low mood |
3. PERSONAL PAST & FAMILY HISTORY
- Past History: Post-partum thyroiditis after second child; recurrent weight gain attempts with dieting; suppressed menstrual irregularities with hormones; frequent colds & hair fall; iron deficiency anaemia in 30s.
- Family History: Mother has hypothyroidism & goitre. Maternal grandmother had myxoedema. Sister has PCOS.
- Developmental Landmarks: All milestones were reached at the appropriate age.
4. PATIENT AS A PERSON (PHYSICAL CHARACTERISTICS)
A. Physical Characteristics
- Appetite: Diminished, feels full quickly
- Desires: Warm food/drinks (+++), Sweets (+)
- Aversions: Cold food, fatty food
- Thirst: Scanty
- Elimination:
- Urine: Normal
- Stool: Hard, infrequent (constipation)
- Perspiration: Scanty, dry skin
- Sleep: Excessive, unrefreshing; daytime drowsiness
- Thermal State: Very chilly patient (needs multiple blankets, warm clothes)
B. Reactions - Physical Factors
- Weather: Aggravation in winter/cold
- Position: Better wrapped up warmly
5. MENTAL STATE (Psychodynamic & Life-Space)
- Nature: Dull, slow, weepy, forgetful
- Anxiety: About family responsibilities, weight gain
- Fear: Fear of becoming dependent, fear of illness progression
- Dreams: Being late, failing duties, suffocation
- Other: Depression, low self-esteem, feels sluggish mentally
6. PHYSICAL GENERAL EXAMINATION
- Wt: 82 kg | Ht: 155 cm | Temp: 97.8°F (subnormal)
- RR: 16/min | Pulse: 68 bpm (bradycardia) | B.P.: 130/80 mmHg
- Face: Puffy, pale, expressionless
- Tongue: Thick, coated
- Nails: Brittle
- Skin: Dry, rough, cool to touch
7. SYSTEMIC EXAMINATION
- Endocrine: Diffuse goitre, delayed ankle jerk reflex
- CVS: Bradycardia, distant heart sounds
- Respiratory: Clear
- GIT: Abdomen soft, sluggish bowel sounds
8. ANALYSIS AND EVALUATION OF SYMPTOMS
- Mental General: Sluggishness, depression, weepiness, anxiety about dependency (Grade 3)
- Physical General: Very chilly, scanty thirst/perspiration, constipation, desire warm food/drinks (Grade 3)
- Particular: Chronic hypothyroidism with goitre, fatigue, weight gain, dry skin/hair loss, < cold (Grade 2)
9. SELECTION OF REPERTORY WITH REASON
- Repertory: Kent’s Repertory of Homoeopathic Materia Medica
- Reason: Chronic endocrine disorder with prominent Mental Generals (sluggishness, depression) and Physical Generals (extreme chilliness, scanty secretions) dominating; Kent suits psoric/sycotic rubrics for hypothyroidism.
10. TOTALITY OF SYMPTOMS FOR REPERTORISATION
- Mental dullness/sluggishness
- Depression and weepiness
- Anxiety about dependency
- Extreme chilliness
- Desire warm food/drinks
- Scanty perspiration/thirst
- Dry rough skin/hair loss
- Constipation hard stool
- Puffy face/goitre
- Fatigue & bradycardia
- Family thyroid issues
11. CONVERSION INTO REPERTORIAL RUBRICS
| SR. NO. | SYMPTOMS | RUBRICS WITH SUB-RUBRICS | PAGE NO. (Kent) |
|---|
| 1 | Dullness mind | Mind; DULLNESS | 37 |
| 2 | Weeping tendency | Mind; WEEPING; tendency | 92 |
| 3 | Chilly extreme | Generalities; COLD; agg. | 1348 |
| 4 | Perspiration scanty | Perspiration; SCANTY | 1297 |
| 5 | Skin dry | Skin; DRY | 1307 |
| 6 | Stool hard | Rectum; CONSTIPATION; hard stool | 607 |
| 7 | Face puffy | Face; SWELLING; puffy | 392 |
12. SELECTION OF REPERTORIZATION (NUMERICAL ORDER)
| SR. NO. | REMEDIES | RUBRICS COVERED | TOTAL MARKS |
|---|
| 1 | Calcarea Carbonica | 7/7 | 22 |
| 2 | Sepia | 6/7 | 18 |
| 3 | Natrum Muriaticum | 5/7 | 14 |
13. MIASMATIC INTERPRETATION
| PSORA | SYCOSIS | TUBERCULAR | SYPHILIS |
|---|
| Chilliness, sluggishness, dry skin | Goitre, weight gain, suppression history | Family endocrine issues | Destructive fear dependency |
Dominant Miasm: Psora
14. FINAL STEPS
- Provisional Diagnosis: Hypothyroidism
- Differentiation of Remedies: Compared Calcarea carb with Sepia. Sepia has more indifference, bearing-down, chilly but aversion to family; Calcarea carb matches classic hypothyroidism with chilliness, sluggish mind/body, desire warm food, puffy face/goitre, anxiety about duties, family thyroid history. Nat mur more thirstless, grief.
- Selection of Remedy (Materia Medica): Calcarea Carbonica matches chronic hypothyroidism with profound chilliness, sluggishness, weight gain, dry skin, constipation, puffy face, goitre, anxiety about responsibilities (Ref: Allen’s Keynotes, Boericke).
- Selection of Potency: 200C (Chronic endocrine miasmatic case, sensitive constitution)
- Actual Prescription:
- Calcarea Carbonica 200 — single dose (one dose only, wait & watch)
- Placebo — 4 pills twice a day for 8 weeks
15. FOLLOW-UP'S TABLE
| DATE | COMPLAINTS | REMEDY | ADVICE |
|---|
| 05/06/2026 | Energy improved 50%, cold intolerance less, constipation better, TSH down to 5.8 | Placebo | Warm clothing, iodine-rich diet (seaweed/fish), regular thyroid tests |
| 05/10/2026 | Weight stable, no hair fall, skin softer, fatigue minimal, TSH 3.2 (normal range) | Placebo | Balanced diet, light exercise, avoid suppression with allopathy if possible |