Received: 2018.09.22
Accepted: 2018.11.19
Published: 2018.12.12
1513 2 — 24
Individualized Homeopathic Therapy in a Case
of Obesity, Dysfunctional Uterine Bleeding, and
Autonomic Dystonia
ABD 1,2 Tamara G. Denisova
ABCD 2 Liudmila Ivanovna Gerasimova
ABCD 3 Nadezhda L. Pakhmutova
EF 4 Seema Mahesh
DE 5 George Vithoulkas
Corresponding Author: George Vithoulkas, e-mail: [email protected]
Conflict of interest: None declared
Patient: Female, 39
Final Diagnosis: Vegetovascular dystonia • dysfunctional uterine bleeding
Symptoms: Bleeding per vaginum • loss of consciousness • weakness
Medication: —
Clinical Procedure: Oral medication
Specialty: General and Internal Medicine
Objective: Unusual clinical course
Background: Obesity is one of the leading causes of morbidity and mortality globally and challenging to treat because of
the multifactorial etiology and presentation. Individualized homeopathy takes into account factors that led to
a patient’s health condition and hence may have a role in the treatment of obesity and related co-morbidities;
co-morbidities that may arising from the same etiology may respond as a whole to homeopathy treatment.
Case Report: A 39-year-old Russian female who developed multiple problems after severe emotional stress was treated with
individualized classical homeopathic therapy. Obesity, dysfunctional uterine bleeding, and dysautonomia were
pathologies that showed improvement.
Conclusions: The response in this patient’s case, supports the need for further investigation on the relevance of individualized homeopathy in these related conditions.
MeSH Keywords: Obesity • Primary Dysautonomias
Full-text PDF: https://www.amjcaserep.com/abstract/index/idArt/913328
Authors’ Contribution:
Study Design A
Data Collection B
Statistical Analysis C
Data Interpretation D
Manuscript Preparation E
Literature Search F
Funds Collection G
1 Department of Research and Information, Chuvash State University I N Ulyanov,
Cheboksary, Russian Federation
2 Postgraduate Doctors’ Training Institute, Health Care Ministry of the Chuvash
Republic, Cheboksary, Russian Federation
3 Department of Homeopathy, Centre of Homeopathic Medicine “Zdorovie”,
Cheboksary, Russian Federation
4 Department of Research, Centre For Classical Homeopathy, Chandra Layout
Vijayanagar, Bangalore, India
5 International Academy of Classical Homeopathy, University of the Aegean,
Alonissos, Greece
e-ISSN 1941-5923
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DOI: 10.12659/AJCR.913328
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Background
The management of obesity and its associated complications
has become a growing challenge globally in recent years, and
it has emerged as one of the leading causes of morbidity
and mortality [1–4]. Obesity has been attributed to chronic
low-grade inflammation in the body which also triggers various other inflammatory states such as metabolic syndrome,
depression, cardio vascular diseases, etc. The cause for obesity is not always as straight forward as an increase in energy
intake. Studies have shown that alteration of the hypothalamicpituitary-adrenal axis through emotional stress can also lead
to obesity [5–7]. While lifestyle and diet corrections go a long
way in making the situation better for some cases of obesity,
they are not enough in many cases, especially when a patient
has organic functions disturbed.
Autonomic dystonia (dysautonomia, vegeto-vascular, and vegeto-vagal dystonia) has been seldom mentioned in general
medical literature but finds abundant presence in the Russian
medical literature [8–11]. The condition involves sudden malfunction of the autonomic nervous system with panic attack
like episodes associated with vasodilatation and loss of consciousness. Therapeutic approaches are lacking and often involve general improvement of health [9,12]. Though unclear,
its etiology is considered mostly psychogenic and though it is
sometimes considered a completely psychological complaint,
the effect on quality of life is tremendous and real [9,12,13].
It is interesting that there exists a close link between the autonomic nervous system functioning and body mass index [14,15],
as was relevant in this patient case report.
This case report, to the best of our knowledge, is the first of
its kind with the specific association of obesity, hypertension,
hormonal imbalances, dysfunctional uterine bleeding, and
dysautonomia treated with homeopathy. The case does have
a selection bias as the patient opted for homeopathy herself.
Case Report
The patient, a 39-year-old Russian female complained of copious bloody vaginal discharge of 10 days duration; copious
vaginal bleeding started after a 26-day delay in her menstrual
cycle. In general, her menstrual cycles were very irregular. She
also experienced general weakness, recurrent bouts of dizziness, and sickness with profuse perspiration and the loss
of consciousness of one-year duration. At presentation, she
weighed 106 kg, her blood pressure was 215/126 mm Hg. Her
mucosae were pale in appearance and her thyroid gland was
slightly enlarged; she was considered to be in an iodine deficiency endemic zone.
On gynecological examination, the uterine body appeared
slightly enlarged and was painful on displacement; there was
copious bloody discharge. An abdomino-pelvic ultrasound revealed moderate fatty liver infiltration, moderate common bile
duct dilation, moderate wall thickening and heterogeneity of
the gallbladder, moderate lipomatosis of the pancreas; the
uterus was moderately enlarged, ovaries multifollicular with
the right ovary enlarged, with a 25×16 mm cyst; there was a
small amount of fluid in the pouch of Douglas.
Blood tests showed an increased prolactin, thyroid stimulating
hormone, luteinizing hormone, and follicle stimulating hormone
level. She had mild dyslipidemia, but other biochemical values were normal (Table 1). The patient’s diagnosis was dysfunctional uterine bleeding with obesity, hypertension, and
vegeto-vascular dystonia (autonomic dystonia) with sympatho-adrenal crises.
Past history revealed that in 2008, she developed hormonal
imbalances (increased estrogen, follicle stimulating hormone,
and prolactin levels); she also underwent endometrial polyp
extraction. In 2009, she developed enlargement of the thyroid
gland. In 2011, she had cholelithiasis and in 2012 she had urolithiasis. In 2013, she delivered her second child; she developed blood pressure changes, chest pains, palpitations, and
loss of consciousness. Her first menstruation was at the age
of 11 years, initially copious with the duration of 5 to 6 days.
She had 2 childbirths, no abortions. The character of her menstruation changed after her first childbirth delivery; it became
irregular and abundant with a duration of 7 to 8 days. Her body
weight was 68 kg, she gained 28 kg during the pregnancies,
and weighed 106 kg, she did not lose any of the weight gain.
Her last pelvic examination, which was a few months prior to
the present examination, did not reveal any pathology. The
pelvic ultrasonography detected no pathology at that time.
Her mother died of stomach cancer; there was also prostate
cancer and thyroid disorders in her family history. The patient
related the beginning of her ill health to the time her mother’s
death in 2007. She reported missing her mother very much;
she was very attached and has dreams of her mother. Her first
reported hormonal changes appeared in 2008 and her health
became worse from there onwards. In 2013, she delivered
her second child and at the end of that lactation period, she
started having irregular and heavy menses.
She eventually consulted an endocrinologist and a neurologist.
Such measures as curettage of uterine cavity, prescription of
uterotonic drugs, and antibacterial therapy were planned to
stop the bleeding. She was also scheduled to start a weight loss
program. The neurologist, however, asked her to see a professional homeopath to see if an alternative solution was available.
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Test Status before starting treatment Status after 12.5 months of treatment
Follicle Stimulating Hormone 10.6 mU/mL (normal: up to 9.9 mU/mL) 7.6 mU/mL
Luteinizing Hormone 19.6 mU/mL (normal: up to 15 mU/mL) 7.8 mU/mL
T4 75 nmol/L (normal: 55–137 nmol/L)
Thyroid Stimulating Hormone 5.6 mIU/L (normal: 0.4–4.2 mIU/L) 3.4 mIU/L
Antibodies to Thyroperoxidase 3.6 U/mL (normal: up to 5.6 U/mL)
Testosterone 2.5 ng/mL (normal: 0.45–3.17 ng/mL)
Progesterone 3.1 nmol/L (normal: 2.3 nmol/L)
Estradiol 0.43 nmol/L (normal: 2.3 nmol/L)
Serum Prolactin 1167 mIU/L (normal: 450–650 mIU/L) 578 mIU/L
Blood pressure (24 hours average) 215/126 mm Hg 135/93 mm Hg
Serum creatinine 0.86 mg/dL (N – 0.4–1.1 mg/dL)
Blood urea 4.2 mmol/L (N – 2.5–7.1 mmol/L)
Urinalysis Light yellow color;
Specific gravity – 1,014 g/L,
Reaction (pH) is acidic;
Protein – nil;
Glucose – nil;
Bile pigments – absent;
Ketone bodies are absent;
Hemoglobin is absent.
Microscopy of urine 2-4 leukocytes per field of view
Erythrocytes – 1–3 in per field of view
Epithelial cells – 3-4 per field of view
Casts – 0 per field of view
Liver function ALS – 0.43 mmol/L (N – 0.1–0.68 mmol/L);
AST – 0.27 mmol/L (N – 0, 1–0.45 mmol/L);
SCHF – 2.1 mmol/L (N1-3 mmol/L);
GGT – 2.4 mmol/L (N-0.6–3.96 mmol/L);
Total bilirubin – 16.3 (N-8.6–20.5 mmol);
Total protein – 72.8 hl (N- 65–85 hl);
Albumins – 47.2 hl (N-40–50 hl);
Globulins – 26.4 hl (N20–30 hl).
Lipid profile Total cholesterol – 6. 81 mmol/L (N – 3.10–5.16
mmol/L)
HDL – 1.24 mmol/L
(N 1.0–2.07 mmol/L)
LDL – 4.28 mmol/L
(N 1.71–3.40 mmol/L)
VLDL – 1.29 mmol/L
(N 0.26–1.04 mmol/L)
Triglycerides – 1.34 mmol/L
(N 0.45–1.60 mmol/L)
Atherogenic coefficient – 4.5
(N 1.5–3)
Total cholesterol – 4.73 mmol/L
HDL – 1.67 mmol/L
LDL – 3.18 mmol/L
VLDL – 0.56 mmol/L
Triglycerides – 1.13 mmol/L
Atherogenic coefficient – 1.8
Hemoglobin 86.4 g/L (N 120–140 g/L) 126.7 g/L
Table 1. Health parameters before and after treatment.
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The patient sought homeopathic consultation on October 10,
2016. She did not take any other medication and continued
the same diet and routine as she had been practicing. After
taking into consideration her present condition along with
the prolonged grief that the patient was experiencing from
her mother’s demise, which probably had led to her complicated health situation, the homeopathic remedy Natrum muriaticum 15C was chosen. The follow-up and subsequent prescriptions are shown in Table 2.
The last follow-up was October 30, 2017, and at 12.5 months
after starting the homeopathic remedy, and the patient reported
that her quality of life had greatly improved, with her menstrual cycles were now regular. The sympatho-adrenal crises
were gone within 5 months of beginning the treatment; she
weighed 82 kg at the last follow-up. Her prolactin level had
returned to normal and her pelvic ultrasound scan was normal as well (Table 1).
Discussion
It has been suggested that a patient’s immune system has a
major role to play in the onset and maintenance of obesity
and its complications [2]. This means that if deep and lasting
changes for the better are to occur, then therapy must not only
help decrease weight but also change the immune status of
the patient to a healthier one. This may be seen as changes
in associated complaints.
Classical homeopathy regards an individual’s immunological
make up and medical history along with familial tendencies
Date Symptoms Prescription
10/10/2016 Copious vaginal bleeding; irregular menstrual cycles; prolonged
bleeding weight gain; high blood pressure with fluctuations;
episodes of sudden onset of profuse sweating and loss of
consciousness; general weakness and dizziness; palpitations;
distracted, unable to concentrate before menses; grief over her
mother’s death 9 years ago, not recovered yet
Natrum muriaticum 15C one dose
alternate days.
Later increased to 21C and 30C as
required
19/12/2016 Patients mood better
Symptoms of pre-menstrual syndrome better appearance of a
boil with pus discharge on the forehead and right thigh which
disappeared on its own
Sleep better
Natrum muriaticum 60C
27/03/2017 Weight loss – 4 kg
Had stress at work which caused an increase in blood pressure
and exhaustion, but the patient was able to cope with it without
any medicine. There was a change in the symptom indication for
homeopathic remedy
Ignatia 200C
30/10/2017 Patient feels better on all levels, i.e., mental, emotional, and physical.
Her blood pressure is normal, menses regular and painless.
No PMS.
Sleep is refreshing and good.
No dizziness, loss of consciousness or palpitations; no profuse
sweating.
Body weight 82 kg
Nil
Table 2. Follow-up of the patient case.
Table 1 continued. Health parameters before and after treatment.
Test Status before starting treatment Status after 12.5 months of treatment
Pelvic ultrasound The uterus was moderately enlarged, ovaries
multifollicular with the right ovary enlarged – with a
25×16 mm cyst; there was small amount of fluid in
the Pouch of Douglas
Small pelvis shows no obvious
pathology; the endometrium
corresponds to the phase of the
menstrual cycle.
Body weight 106 kg 82 kg
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Individualized homeopathic therapy in a case of obesity…
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in order to determine the stress that triggered the chronic inflammatory state. With this in consideration the therapeutic
approach is tailored to that particular individual and the result
is resolution of the inflammatory state by the person’s own immune system [16,17] seen as overall betterment of the patient
and not just one of the pathological conditions. Such general
improvement in the co morbidities along with betterment in
the main severe pathology by classical homeopathic therapy
has been recorded before now [18–21]. This is evidenced in
the present case as well. The mechanism of action of the biologically active potentized remedies is not quite known. So
far there are some hypotheses as may be seen in the Science
of Homeopathy [22].
In our patient case, the autonomic nervous system dysfunction
seemed to be central to all of the patient’s suffering. The severe stress experienced by the patient seems to have upset the
sympatho-vagal balance which resulted in obesity, hormonal
imbalance, hypertension, and vegeto-vascular dystonia. The
initial disruption of our patient’s health was caused by her severe grief. The remedies selected were those known to help
bring about balance in conditions that result from grief and
bereavement [23]. The specific way in which the pathology develops and symptoms appear in response to deep seated grief
has been recorded for this particular remedy provings and they
have been of service where people have suffered from very
long-standing depression and its co-morbidities [24]. The repetition of low potencies therapies such as 15C must be made
over a long period of time in order to see positive changes,
as was seen in this case where the patient’s autonomic dysfunction responded within 5 months of the start of treatment, and the patient’s hormonal state improved. Her weight
reduced from 106 kg to 82 kg and her lipid levels improved
even in the absence of a special diet or regimen (Table 1) and
her menses regularized.
There is question regarding the mechanism of the applied remedy’s action, and the evidence is not strong enough to clearly
support results for this homeopathic remedy. However, such
overall improvement from a therapy, especially without changes
in any other parameter that may have caused the improvements, is encouraging and suggests a need to further investigation into whether this case represents an exception or a
rule. Controlled randomized trials are needed to establish the
relevance of classical homeopathy in obesity and its co-morbidities and in autonomic dystonia as well.
Conclusions
This case of a female with dysfunctional uterine bleeding,
obesity, and vegeto-vascular dystonia showed a benefit from
classical homeopathy. It suggests the need to further evaluate,
through larger studies, if any or all of these diagnoses may
individually or collectively be amenable to classical homeopathic therapy.
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