Unresponsive hyperthyroidism - guidance appreciated!

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Hello colleagues,

I have been treating a 49yo female patient since Oct. 21, 2011. Patient's goal

is to avoid radioactive iodine treatment.

Dx:

- Hyperthyroidism (Graves Disease) Dx in Oct 2011. Only presenting symptom is

fatigue and increased HR (frequently around 130-140bmp). Anti.thyroid and

anti.TPO are both negative. The 24hr radioactive iodine uptake test was

increased (49%).

- gas/bloating/diarrhea managed by gluten avoidance (celiac labs negative).

- liver enzymes mildly elevated, eosinophils slightly elevated, RBC and RDW

slightly elevated, MCH and MCV slightly decreased.

Possible causes of hyperthyroidism can include:

- Hx of toxicity exposure: numerous Hg amalgams, ate contaminated fish during

childhood (known later to contain high levels of heavy metals).

- poor diet

- high consumption of iodine: in various self-prescribed supplements.

- possible genetic predisposition: Mother also Dx with hyperthyroidism (treated

with radioactive iodine).

Meds started on Oct 7th: Verapamil (Ca channel blocker) 1 tablet tid, Tapazole

(a.thyroid) 1 cap qd. Verapamil has helped decrease heart rate to 85bpm. Between

Oct 4th to Oct 17th Tapazole helped lower free T4 back into high-normal range.

Note that TSH has always remained below detectable limits for all tests since

Oct 2011.

ND treatments started on Oct 21 2011:

- 250mL Liquid Herbal: 170mL Lycopus, 40mL Leonorus, 30mL Silybum; 1 tsp 3x/day

- Unda 16, 273, 1000: 5 drops of each under the tongue, 3x/day. Patient only

took Undas once daily (Note: I encouraged patient to increase dosage at Nov 30th

appointment).

- Avoid all foods and supplements that contain iodine

- Continue to avoid all gluten

- Eat more raw Brassica-genus vegetables (i.e. cruciferous vegetables)

- avoid junk foods

- reduce exposure to chemicals that affect thyroid (as listed in previous NDNR

article).

On Oct 27th, patient noticed significant improvements with energy levels. Heart

rate decreased slightly (80 bpm) even with decreased Verapramil dosage (tid to

bid).

In November, patient suffered a set-back following bronchitis infection treated

by MD with antibiotics. Heart rate increased to 100bpm, and Verapramil increased

again to tid. Free T4 increased again and therefore Tapazole increased to 1 cap

on one day and 2 caps every other day.

ND adjustments (November 30th) in addition to previously noted treatments:

- Unda 8 added to Unda Rx. 5 drops of each tid. (November 30th) - no change in

symptoms with treatment

- thyroidinum 200K: 3 pellets 2x/day. (November 30th) - no change in symptoms

with treatment

- iodum 6CH: 3 pellets 2x/day. (December 22): Note that I haven’t seen patient

yet to follow up with this additional treatment.

Thank you in advance for any guidance in this case!

Gleixner, ND

Moncton, NB