Category Archives: Endocrinology

Endocrinology

PRE MENSTRUAL SYNDROME PMS

Pre Menstrual Syndrome (PMS) and role of Homeopathy

In many traditional cultures, the time of menstrual flow is considered as a period of cleaning and regeneration.

Most women live in dread of their monthly cycle.

If menstruation is a natural event, then why is it seen that most of women have health issues with their cycles?

The menstrual flow is regulated by a complex interaction of hormones. There are 3 phases of cycle. Average cycle is of 28 days.

You probably get some signs that your periods are appearing. For most women its not a big deal, but for others, the days before periods are harder which may interfere with your daily life. Then probably you are suffering from PMS.

PMS affects 75% of women especially in thier 20’s or 30’s.

WHAT IS PRE MENSTRUAL SYNDROME?

Pre Menstrual Syndrome is a constellation of symptoms both physical, emotional and behavioral which may affect women during certain days of mentrual cycle, generally just before her menses.

It usually affect most of the menstruating women.
It starts from 5 to 10 days before menses and typically goes away once menstruation begins.

CAUSES OF PRE MENSTRUAL SYNDROME

Exactly what causes PMS is unknown, but several factors may be considered which influence Pre menstrual syndrome.

HORMONAL CHANGES
Signs and symptoms of PMS change with hormonal fluctuations and disappear during pregnancy or menopause.

DEPRESSION
Some women with severe PMS have undiagnosed depression , anxiety, stress or history of mood disorders, emotional trauma.

FAMILY HISTORY
Family history of PMS may be one of the cause.

Fluctuations of serotonin, that is thoght to play a crucial role in mood states that could trigger PMS.

SIGNS AND SYMPTOMS OF PRE MENSTRUAL SYNDROME:

Variety of symptoms have been attributed to Pre menstrual syndrome.

Women can have pre menstrual symptom of varying duration and severity from cycle to cycle.
The most frequent mood related symtoms of Pre menstrual emotional symptoms includes

  • Exaggerated mood swings
  • Anger and irritability
  • Tension
  • Depression
  • Overensitivity

Physical symptoms includes

  • Fatigue.
  • Bloating.
  • Weight gain.
  • Breast tenderness.
  • Acne.
  • Nausea, vomiting.
  • Diarrhoea.
  • Sleep disturbances.

The duration of Pre menstrual symptoms varies among women. Most women experience the symptoms for a few to several days prior to onset of their menses. PMS usually starts after ovulation, mid of the montly menstrual cycle, or jus few days before cycle.

DIAGNOSIS OF PRE MENSTRUAL SYNDROME

Pre menstrual syndrome is diagnosed based on the physical, emotional amd behavioral symptoms. If the changes occur consistently around mid menstrual cycle and persists until the menstrual flow begins, then PMS is probably the accurate diagnosis.

ROLE OF HOMOEOPATHY IN PRE MENSTRUAL SYNDROME

Homoeopathic Medicines have a very beneficial role in Pre Menstrual Syndrome PMS. They aim at correcting the underlying imbalances that lead to PMS. Homoeopathic treatment is based on detailed case study of the patient.
Few indicated Homeopathic remedies are.;

PULSATILLA NIGRICANS

Pulsatilla is indicated in pre menstrual syndrome. It is of great help for women with increased sensitivity towards pre menstrual syndrome. They have weeping tendency, tearfull eye, very sensitive and mild.
Open air makes them feel good. They have complaints of suppressed or delayed menses. Total absence of thirst. Tendency to gain weight before menses with headache, nausea and dizziness.

SEPIA

Sepia is indicated homeopathic medicine for pre menstrual syndrome. The patient presents mainly with irritability pre menstrual syndrome. There is aversion to indulge in physical or mental activity. Marked indifference. Extreme anger. Bearing down sensation, with bearing down pain in the uterus. Oily skin with acne before menses.

SILICEA

Silicea is one of the indicated remedy in pre menstrual syndrome. Indicated in case of extreme constipation before menses. They have great difficulty in passing stool. Stool receeds back after being partially expellled. She is mild, yielding with irritability and sadness before and during menstruation.

NATRUM MURIATICUM

Natrum mur is indicated in case of pre menstrual syndrome where the patient presents with depression, indifference, lack of self confidence, anxiety, suicidal tendency before or during menses. Presents with headache before menses.Tenderness and swelling of breasts with palpitation.

PHOSPHOROUS

Phosphorous is indicated in women who suffer from pre menstrual syndrome. There is great irritability, difficulty in concentrating. Indecesive, anxiety. Hot flushes on face. Swelling of face. Buring pain in vagina. Tendency to put on weight during menses. Tenderness in breast and nipples.

CALCAREA CARBONICUM

Calcarea carb is indicated in case of premenstrual syndrome. There is marked irritability, panic attacks, apprehension, anxiety. Headache and dizziness before periods,pain in the back and thighs.

LACHESIS

Indicated in pre menstrual syndrome, presents with marked irritability before menses. Suspicious, mistrustful

EASING THE SYMPTOMS OF PRE MENSTRUAL SYNDROME :

  • Eat balanced diet to improve your overall health and energy level.
  • Eat plenty of fruits and vegetables.
  • Reduce oily, fatty food, and intake of salt and sugar.
  • Drink plenty of fluids to ease abdominal bloating.
  • Good quality sleep. Sleep atleast 7 to 8 hours to reduce fatigue.
  • Reduce stress.
  • Regular excercise to decrease bloating and improve mental health as well.

MENOPAUSE

Menopause and Climacteric age related complaints and its management with Homeopathic Medicines.

Women tend to put everyone else’s need first when it comes to health concerns but sometimes the care taker needs a little care herself.
Homeopathy addresses a wide range of womens health issues, most important among them is MENOPAUSE.

WHAT IS MENOPAUSE?

Menopause can be defined as the point in time when menstrual cycles permanently cease due to natural depletion of ovarian oocytes due to aging.

The diagnosis is made retrospectively after the women has missed her periods for 12 consecutive months.
It marks the permanent end of fertility.

SIGNS AND SYMPTOMS OF MENOPAUSE

Some women may experience few or no symptoms of menopause while others experience multiple physical and psychological symptoms.
So it is imortant to remember each womens experience is highly individualistic.

SIGNS AND SYMPTOMS DURING MENOPAUSE

HOT FLUSHES

Hot flushes are sudden feeling of heat. Hot flushes are common among women undergoing menopause. They usually last for 30 seconds to several minutes. Hot flushes are usually due to hormonal fluctuations. They experience sweating, palpitation, flushing of face.
Hot flushes start usually few months or years before your period stops and usually continues for several years after your last period.

How can one deal with Hot flushes?

  • If u feel flush coming on, spray your face with cold water.
  • Keep the room cooler.
  • Sip cold or iced drinks.
  • Have luke warm shower.

MOOD SWINGS

Changes in hormone production affect the mood of women during menopause. They present with feelings of irritability, depression, mood swings.

VAGINAL DRYNESS

The decreased production of hormones can affect the thin layer of vaginal wall, may also present with itching around the vulva.

URINARY TRACT INFECTIONS

Lower level of hormones cause changes in the urinary tract, makes them more susceptible to infections.

SKIN AND HAIR CHANGES

Due to reduced level of hormones hair may become dry brittle causing loss of hair.Due to aging there may be dryness of skin and loss of elasticity.

INSOMNIA

During menopause it might be hard to fall asleep.
It is important to try some relaxation/breathing techniques and excercise which helps the patient to overcome insomnia.

HOMEOPATHIC MANAGEMENT FOR MENOPAUSAL SYNDROME

Although menopause is a naturally occuring phase of life, this doesnt mean that you have to suffer while it lasts.
Homeopathy is a holistic system of medicine that treats the patient on the basis of individualisation where your physical as well as emotional smptoms are equally important.

HOMEOPATHIC MEDICINES THERAPEUTIC INDICATIONS FOR MENOPAUSE

PUSATILLA NIGRICANS

Pulsatilla is most often indicated in menopausal women who are very sensitive, emotionally weak, weeping tendency, mild and yielding. She feels better from reassurance. The hot flushes are worse in warm room and better out in fresh open air. Pulsatilla patient is usually hot and thirstless. History of difficult periods and pre menstrual symptoms.

SEPIA

Sepia is indicated in case of menopause. Patient presents with hot flushes that are associated with weakness increased perspiration, feeling of heat usually ascending upwards. Emotionally sensitive.

GRAPHITES

Graphitis is indicated in women who are chilly, pale, sluggish. Tendency towards weight gain during or after menopause. Hot flushes and sweats at night are often seen. Tendency towards skin problems with oozing cracked erruptions.

NATRUM MURIATICUM

Natrum muriaticum is indicated in women who seem to be very reserved. Has strong emotions which she hides. Indicated in case of hot flushes, irritability, mood swings. Craving for salt. Sun headache.

LACHESIS

Lachesis patient typically experiences flushes of heat primarily on falling asleep, throughout night or while waking. The most intense hot flushes happen without any perspiration, dry heat. One of the most common remedies used in hot flushes.

SULPHUR

Sulphur is often helpful for hot flushes during menopause. Very anxious.
Weeps and worries about her health.

IGNATIA AMARA

Ignatia is often helpful for emotional ups and downs occuring during menopause. The women is very sensitive,
Hysterical, moody. She tries to hide her feelings and becomes defensive. Tendency to sigh, outbursts of tears or laughter are strong indications of Ignatia.

STAPHYSAGRIA

Staphysagria women is usually mild, mannered , shy and accomodating and has many suppressed emotions. Women around time of menopause become very depressed or have outbursts of rage.

CALCAREA CARBONICA

Calcarea carb is indicated in women with heavy bleeding, night sweats, flushing of face despite general chilliness. Weight gain during menopause.

GLONOINUM

A women needing this remedy often has hot flushes that are sudden violent and with upward rush of blood to head causing severe headache, palpitations, cannot bear least jar of motion.

SOME USEFUL ADVICE TO BE FOLLWED DURING MENOPAUSE

There are number of ways you can ease the stress of Menopause through self care.

Keep track of when you feel discomfort whether physical or emotional. Practice Yoga or excercise which will help you to reduce the intensity of complaints.

Being kind to yourself is truly important at this point of life. Make some time for yourself, do things which intrests you.

Pay attention to your diet and water intake. Increase intake of fresh veggies and fruits which will help to strenghten your immune system and help to cope with the stress of changes in the body.

DIABETES MELLITUS

Diabetes Mellitus is a complex condition in which the blood sugar levels are raised for a long period of time either because of inadequacy of insulin production or lack of body cell responses to insulin

Causes of Diabetes

Weight-Weight is the important risk factor in type 2 diabetes.
The more the weight the more the body becomes resistant to insulin.
Age-Risk of Diabetes increases after 45 years of age.
Family history-Those having family history of Diabetes have greater risk of acquiring diabetes.
Diet-Diet high in fats, calories and cholesterol and deficient in fibre increases risk of diabetes.
Lack of exercise and sedentary lifestyle.
Hormonal imbalances.

Types of Diabetes Mellitus

1- Diabetes Mellitus (Type 1)-Also known as insulin dependent diabetes mellitus or juvenile diabetes as it is usually diagnosed in childhood.
In this type the insulin production is not enough or very less.
They require insulin on daily basis to survive
2- Diabetes Mellitus (Type 2) -In this type the body is incapable of responding to insulin.
The body becomes insulin resistant.
It is most common type of Diabetes due to sedentary lifestyle and increased obesity.
3- Gestational Diabetes -It occurs in cases where there are high blood sugar level during pregnancy.
Occurs in women who previously delivered baby weighing more than 4.5kg(10lbs).

Pathogenesis

Type1 diabetes mellitus
Type 1 diabetes is considered to be an autoimmune disorder
In autoimmune disorder body attacks it’s own tissues and organs.
T1 DM results from destruction of insulin producing pancreatic beta cells.
Beta cell autoantigen, macrophages,B and T lymphocytes are involved in pathogenesis of T1 DM.
Activated macrophages,CD4+Tcells and beta cytotoxic CD8+Tcells destroy beta cells
Insulin antibodies, Islet antigen (IA 2) antibody, glutamic acid carboxylase also paly a major role in autoimmunity.
The Human leucocyte antigen (HLA) encoding the major histocompatibility complex proteins is known to be associated with increased susceptibility to T1 DM.
The HLA complex helps the immune system to distinguish body proteins from proteins made by viruses and bacteria.
Due to insulin deficiency there is excessive secretion of glucagon.
The excess glucagon secretion and insulin deficiency imparies the expression of genes for target tissue to respond normally to insulin resulting in T1 DM.

Type 2 Diabetes Mellitus

Inability of insulin to produce it’s desired effect on circulating glucose levels.
Destruction of pancreatic beta cells along with insulin resistance is associated with T2 DM.
Muscle fats and level cells fail to respond to insulin.
The main mechanism involves increased breakdown of lipids with in fat cells,lack of incretin,high glucagon levels.
Inability of insulin to suppress lipolysis results in increase plasma levels of fatty acids that in turn stimulates glucose production in liver.
The elevated free fatty acids also produces low grade inflammation which is also associated with T2 DM.
Genetic factors include insulin receptor and insulin receptor substrate gene polymorphisms that affects insulin signal.
Polymorphisms of beta3 adrenergic receptor gene associated with visceral obesity promote insulin resistance.
Adipokines are also seen to be involved in insulin resistance.
Other gene associated are ABCC8,CAPN10,GLUT2,TCF7L2.

Signs and Symptoms

  • High blood level of glucose
  • Frequent and painful urination
  • More thirsty and hungry
  • Feeling tired and dizzy
  • Lethargic feeling
  • Fatigue
  • Itching skin
  • Dry mouth
  • Blurred vision
  • Nausea
  • Vomitting
  • Smell of acetone in breathe
  • Increased susceptibility to Infections
  • Weight gain or loss
  • Slow healing if wounds, cuts and sores
  • High blood pressure

Diabetic Ketoacidosis

Diabetic ketoacidosis is complex disorder characterized by hyperglycaemia, acidosis and ketonaemia.
It occurs due to insulin deficiency that causes increase in counter regulatory hormones.
Insulin deficiency along with counter regulatory hormones leads to excessive production and accumulation of glucose in the body.
Insulin deficiency causes release of fatty acids and glycerol.
Glucagon stimulates liver to oxidize fatty acids into ketone bodies.
Ketone dissociates into anion and hydrogen ions.
Acidosis develops as body tries to maintain extracellular pH by binding hydrogen ions with bicarbonate ions.
Ketonaemia develops as the ability of tissue to utilize ketone bodies exceeds.
Kidney excrete large amount of ketone and glucose into urine that causes dehydration, ischemia that further worsen acidosis.

Diagnosis

  • Random blood sugar – By this test the level of glucose can be measured at any time irrelevant of diet.
    Blood glucose level of 200mg/DL or more indicates Diabetes.
  • Fasting blood sugar test-Blood sugar level of 126mg/DL indicates Diabetes.
  • Sugar level between range of 100-125mg/DL indicates prediabetes.
    Normal range is below 100 mg/DL.
  • Oral glucose tolerance test-Blood sugar level of 200 mg/DL indicates diabetes.
  • Sugar level with in range 140-200 mg/DL indicates prediabetes.
    Below 140 mg/DL indicates normal range.

Homoeopathic Medicines For Diabetes Mellitus

  • Syzygium Jambolanum
  • Cephalandra Indica
  • Rhus Aromatica
  • Acidum Phosphoricum
  • Gymnema Sylvestre
  • Uranium Nitricum
  • Helonias
  • Abroma Augusta
  • Iodium

OSTEOPOROSIS

Osteoporosis is a disorder of bone where reduced Bone Mineral Density makes the bones fragile

Osteoporosis is a silent disease that causes thinning and weakening of bones

There is decrease in Bone Mineral Density making the bones weak and brittle

Risk Factors of Osteoporosis

  • AGE  and SEX – as age advances chances of osteoporosis increases, Bone Mineral density reached its peak at around 30 yrs of age. Then after certain years it gradually starts depleting due to depleting levels of Growth hormone and later more pronounced after 48 in women and after 60 in men, its attributed to depletion of oestrogen in females and depletion of testosterone in males. its more common and severe in females as oestrogen depletion in females affects more compared to effect of testosterone depletion in males.
  • Genetics and Familial Predesposition
  • Habitat  – in region or lifestyle with lesser exposure to sunlight.
  • Vitamin D deficiency
  • Parathyroid Dysfunctions
  • Thyroid Dysfunctions
  • Kidney diseases
  • Diabetes Mellitus
  • Acromegaly
  • Certain rheumatological conditions
  • Parkinson’s Disease
  • Sedentary lifestyle lack of exercise and physical activity
  • Excessive tobacco smoking
  • High Protein diet
  • High intake of phosphoric acid, usually its through areated soft drinks
  • Prolonged increased exposure to Cadmium.
  • Malabsorption and Malnutrition

Pathophysiology of Osteoporosis

(this part is under construction)

Bone constitutes major portion of Human Skeleton

There Are Over 206 bones in skeleton primarily it consists 270 bones at birth later they fuse together during development

Bones Differs in various size shapes and structures

Bones not only performs the functions of protection protection and support to the body but also helps in storage of minerals lipids and nutritients

Tissue that constitute bone are of two types that gives strength and rigidity to bones viz:

  1. Cortical bone – Cortical Bone forms the outer layer of most of the bones. It is stiffest and hardest. It helps in supporting and protecting the soft tissues of body and gives shape to the body. It Consists of Osteons that in turn consists of Haversion Canal that allows the blood vessels and nerves to travel through them.
  2. Cancellous Bone – It occur at the end of the Long Bones. It is less stiff and weaker compered to the Cortical Bone. They Consists of Red Bone Marrow that produce Blood Cells

The Bone tissue exibits following type of cells:

  • Osteoblast
  • Osteoclast
  • Osteocyte

They help in Synthesization, Bone Resorption as well as Maintainence and repair of bones

Osteoporosis most commonly occurs due to the imbalance in bone resorption and bone formation and insufficient mass

Low Bone Density occurs when osteoclast degrads bone matrix faster than osteoblasts.

Role of Parathyroid Gland in Calcium Metabolism and Osteoporosis

•Hyperparathyroidism-Hyperparathyroidism can be defined as a condition when one or more of the parathyroid glands become hyperactivie and increases in size.
This leads to increased PTH levels in blood
Parathyroid Hormone Vitamin D and Calcium Metabolism 
•Parathyroid hormone is secreted by parathyroid glands.
•PTH along with vit D helps in regulation of calcium level in human body.
•PTH is secreted through negative feedback mechanism of the body when the serum calcium levels are decreased.
•Vit D regulates intestinal absorption of calcium.
•Calcitrol the active form of vit D regulates calcium metabolism.
•Vit D3 is produced from 7-dehydrocholestrol when the skin is exposed to Ultraviolet rays
•Vit D3(Cholecalciferol) is then carried to liver via blood where it undergoes two hydroxylation process.
•First it goes under hydroxylation in liver forming Calcidol 25(OH) and then in kidneys forming Calcidol(1,25 dihyrdroxy vit D).
•The decreased serum calcium level stimulates PTH secretion.
•As Bones are the major store house of calcium,the secreted PTH corrects calcium level by mobilizing calcium from bone through destruction of bones by osteoclasts.
•This leads to osteoporosis where there is weakening of bone decreasing it’s density.

Signs and Symptoms of Osteoporosis

  • Osteoporosis itself may stay silent and show no symptom untill bone becomes weak and break down.
  • Acute and chronic pain in bones and muscles.
  • May precipitate or trigger osteoarthritis
  • Deformities and anomalies to carry out normal daily activities.
  • Stooped posture, loss of height, collapse (loss of consciousness).
  • Fractures are most dangerous aspect of osteoporosis. Fractures most commonly occurs in spine, hip, rib, shoulder, wrist.

Diagnosis of Osteoporosis

The normal Bone Density is within +/-1 SD(+1 or-1)(Standard Deviation) in young adults.

The Score Between -1 and -2.5 is indication of low bone mass.

The score of -2.5 or lower indicates osteoporosis.

  • X rays to an extent helps in detecting reduced Bone Mass also in detecting the complications of osteoporosis like fractures.
  • CT Scan and MRI helps in detecting complications of reduced bone mass, preosteoporosis or follow up examination.
  • Dual Energy X ray Absorptiometry(DEXA) is mostly used for evaluating Bone Mineral Density and its grading for diagnosis of Osteoporosis.
  • Quantitave Ultrasound is a non-invasive method of estimating bone density and risk of bone fracture.
  • Certain Biomarkers are also useful in detecting bone degradation.

Homoeopathic Medicines for Osteoporosis

  • CALCAREA PHOSPHORICA 

    It affects the nutrition of bones and glands indicated in it Homoeopathic form when bones becomes soft brittle and thin, promotes ossification of bones in non union of fractures, pain and burning along the sutures, shifting pain, malassimilation.

  • CALCAREA CARBONICA

    Improper assimilation of calcium gives rise to defective nutrition of bones glands and skin. Swelling of the joints especially knee weakness and trembling of limbs.

  • SYMPHYTUM OFFICINALE 

    injuries to cartilage, periosteum, comminuted fractures, non union of fractures, deficient callus, arthralgia of knees, carries of vertebrae.

  • RUTA GRAVEOLENS 

    Sore tendons, injured or bruised bones, formation of deposit or nodes in periosteum and tendons, ill effects of bruise, fractured bones, brittle paralytic rigidity of injured or affected part.

  • FLOURICUM ACIDUM

    This remedy should be thought of when osteoporosis secondary to some chronic metabolic digestive or autommune condition or post chronic debilitating deep seated  infections  produces slow deeply destructive effects carries of long bones ulceration varicose veins bedsores calcareous degeneration tissues are puffy indurated and fistulus.

  • Ammonium Muriaticum 

    A good remedy to combat secondary effects and complications of osteoporosis especially those due to nerve compression due to degenerative changes of spine as a complication of osteoporosis. Patient has tension and tightness as if muscles or tendons are too short neuralgic pain in stumpsof amputed limbs sciatica pain in heels.

 

VITAMIN D DEFICIENCY Homeopathic Medicines and Homeopathic Treatment Methodology

OBESITY

Obesity has reached at pandemic levels and has become a subject of concern as it is directly related to many diseases.

As obesity is directly associated with many diseases, so it needs to be studied properly in all its dimensions so as to prevent it, treat it and also to understand all the underlying factors related.

Diagnostic Measurements and Evaluation Methods for Level of Obesity

To measure fat ratio in our body there are many highly technical ways but clinically feasible and practical are the following 3 ways which are widely used.

  1. BMI – Body Mass Index, where the body weight is related with height BMI=Body Mass/ (Body Height)². It is measured as kg/m². BMI of 18.5 to 25kg/m² is considered to be normal, below 18.5kg/m² underweight, 27-30kg/m² overweight, above 30kg/m² Obese. In general a subject having BMI above  27kg/m² and below 18.5 kg/m² is considered to be at health risk.
  2. Various Circumferences of body and their relation and ratio with each other, especially waist to hip circumference ratio. Distribution of fat also determines the risk factor as it is observed that central or visceral obesity where fat accumulates in belly around abdominal organs and on trunk is observed to have more health risk compared to diffused subcutaneous fat accumulation.
  3. Skin Fold Measurement is also one of the ways to measure fat proportion. This method which gives us better idea about subcutaneous fats. Skinfold measurement when taken along with the other two above mentioned methods gives us a better comparative ratios and evaluation of body fat measurements.

Risk Factors of Obesity

Not only genetics but also environment plays a major role e.g. Its observed that Asian shifting to USA (the obesity capital of world), ratio wise more tend to become obese compared to their counterparts in their country.

Few of the risk factors are mentioned below

  • Genetics and familial predesposition
  • Enviroment and staple food of the region
  • Sedentary lifestyle
  • Irregular sleep pattern
  • lrregular meal pattern
  • Low protein intake
  • High carbohydrate and sugar intake
  • Certain Metabolic Disorders
  • Hypothyroidism
  • Diabetes Mellitus
  • PCOS polycystic ovarian disease
  • Certain Medications
  • Certain Psychiatric Eating Disorders
  • Bigorexia/muscle dysmorphia
  • Body Dismorphic Disorder
  • Anorexia Nervosa
  • Orthoxia nervosa
  • Depression
  • Anxiety
  • Night Eating Syndrome
  • Certain injuries deformities and disabilities that makes patient immobile which causes weight gain.

Pathophysiology of Obesity

To simplyfy the understanding of causation of obesity; which otherwise is too complicated to comprehend with a single article; I have explained it in a broader sense and summarised its essense as follows:

“Obesity is the disease of low energy utilisation compared to intake!”

“When the intake of energy exceeds its utilisation, it then get converted into triglycerides and is stored in adipose tissues causing obesity”

There are many factors that are responsible for obesity but the recent research has come up with an interesting mind boggling study of one of such factor that is the molecule Leptin.

Leptin and Ghrelin with other endocrinal molecules controls Appetite and Satiety centers through hypothalamus. Is a complex Hypothalamo-pitutary-endocrinal axis that is inovolved in the mechanism.

Of all the other various factors, Leptin needs a special reference and attention when it comes to obesity. As Leptin not only controls Apetite but also controls Thermogenesis and other Catabolic processes.

Role of Leptin in Apetite Control

Adipocytes communicate with satiety centers present in hypothalamus by secreting a polypeptide called Leptin. The levels of Leptin are determined by the amount of fat stores in the body. Leptin interacts with the hypothalamus by attaching to Leptin receptors.

When Lateral Hypothalamus(LH) is stimulated it increases appetite and vice a versa.

When Venteromedial Hypothalamus(VMH) is stimulated it creates satiety and vice a versa.

Level of Leptin and its relation with certain appetite controling molecules through Stimulation or inhibition of LH and VMH is as follows:

  • Inversely proportional to a powerful appetite stimulators like Neuropeptide Y(NPY) and Agouti Related Peptide(AgRP). Resultant Stimulating LH and Inhibiting VMH
  • Directly proportional to powerful appetite inhibitors like Glucagon Like Peptide-1(GLP-1), Pro-opiomelanocortin(POMT) and Cocaine and Amphetamine Regulated Transcript(CART). Resultant Stimulating VMH and inhibiting LH

Role of Leptin in Catabolic Processes.

Leptin receptor stimulation increases

  • Energy expenditure
  • Physical activity
  • Thermogenesis(heat production)

Role of leptin in Energy Expenditure, Physical Activity and Thermogenesis

  • Stimulation of leptin receptors in hypothalamus stimulates secretion of Norepinephrine from sympathetic nerve endings in adipose tissue.
  • This stimulates β3-adrenergic receptors expressed by fat cells which results into hydrolysis of fatty acids.
  • This results into release of energy which is dissipated in the form of heat.

Also there are other catabolic effects of leptin which are mediated through Hypothalamo-Pitutary axis which goes through the channel of endocrinal system by stimulating endocrinal glands.

Deletion or SNP of Leptin producing gene causes leptin deficiency resulting into extreme obesity.

Complications and Diseases Associated with Obesity

Obesity complicates almost all the diseases and precipitates many life threatening chronic diseases.

Few of them which needs special reference are

  • Hypertension
  • Diabetes Mellitus
  • Osteoarthritis
  • Gout
  • Lumbar spondylodis
  • Sciatica
  • Meralgia Paraesthetica
  • Artherosclerosis
  • Hypertriglyceridemia
  • Hypercholestrolemia
  • Low HDL
  • Cardiomegaly
  • Congestive Cardiac Failure
  • Ischemic Heart Diseases
  • Deep Vein Thrombosis
  • Pulmonary Embolism
  • Fatty Liver
  • Cholelithiasis
  • Hypoventilation syndrome
  • PCOS
  • Infertility
  • Erectile Dysfunction
  • Hypogonadism
  • Burried male genitals
  • Depression
  • Certain Cancers

HOMEOPATHIC MEDICNES AND MANAGEMENT FOR OBESITY

To Lose Weight in obese patient who wants to reduce weight it is necessary to rule out all the pathological factors which may be responsible for obesity and if any found then first the underlying abnormalities needs to be treated first.

Each case preferably needs to be individualised properly as per homoeopathic principles for medicine selection, to yield best results of homoeopathic medicines.

Though , there are some generally used common homoeopathic medicines to lose weight which I have simplified to select by providing basic guidelines which are hard to fail in most of the cases,

  1. Phytolacca Berry well proven homoeopathic medicine for weightloss in general.
  2. Fucus Vesiculosus compliments well to phytolacca berry and when both given intermittently during weightloss treatment works wonders.
  3. Calcarea Carbonica Generalised obesity, for fair, fat and flabby women especially in their forties, mentally and physically sluggish , well suited to women with thyroid disorders.
  4. Thuja Occidentalis obesity due to excessive hunger and abnormally high appetite.
  5. Ignetia Amara obesity in females due to depressing emotion and PCOS.
  6. Thyroidinum obesity due to thyroid disorder
  7. Sepia obesity in female do to Polycystic Ovarian Syndrome (PCOS)
  8. Iodium obesity due to disorder in thyroid glands
  9. Bromium obesity due to disorder in thyroid gland
  10.  Nux Vomica for weight gain due to sedentary lifestyle, irregular dietary habbits, irregular routine, lack of sleep, typical central obesity.

Weight Management

  • To lose weight a person needs to keep strict control on his diet and need to do exercise on regular basis along with medicines for faster and better results.
  • One needs to keep check that he doesnt lose muscle mass in the process
  • I recomend to completely stop sugar and jaggery
  • Oil and Ghee not more than 1-2 tsp throughout the day
  • Increase protien intake as per intensity of workout
  • Increase fiber intake in form of salads and fruits that are not too sweet
  • 4-5 small meals throughout the day
  • Ample of water throughout the day
  • 1 hour yoga or brisk walk
  • Intense workout under professional guidance for those wants to achieve subnormal so called ripoed and defined body.
  • Atleast 7 hours of continious sleep at a stretch is recomended.

THYROID LESION Cured With Homeopathy

Thyroid Lesion – DrDEEPAN P. SHAH cured 17mm*12mm*13mm hypoechoec lesion in thyriod glands with internal vascularity

Thyroid lesion

DrShah cured 17mm*12mm*13 mm hypoechoec lesion with internal vascularity Presenting complaints pain deglutition , malaise , recurring pharyngitis , mild visible swelling in cervical region and lateral cervical lymph node enlargement, trembling of limbs , frequent cramps , loss of appetite , wt loss, anxiety, insomnia with somnolence in daytime.USG thyroid showed this vascular noduleTFT showed elevated TSH

Most of the homoeopaths would have thought here of constitutional treatment based on totality of symptoms but I prefered pathological prescribing based on the organ involved, to start with and then if required constitutional.I avoided FNAC as the tumours in glands are usually encapsulated and if this capsule integrity is breached in anyways or physically intervened it may facilitate malignant cells to escape and form new vegetations (metastasis).

Medicines I used were THYROIDINUM 3X and IODIUM 30 given TDS for period of 1 weekfollow up:Pt showed improvement in all other symptoms except for aggravation in trembling malaise and sleep disturbances which i attribute to thyroidinum 3xI stopped thyroidinum 3x as it had delivered expected homoeopathic aggravation continued iodium 30After 15 days pt showed improvement in all his symptoms ,patient was kept on placebo thenAfter approx 3 mnths, USG and TFT were repeated and pt showed complete resolution of the vascular nodule but his TSH levels were still elevated with mild increase in the gland size which again I attribute it to the homoeopathic medicines administered and will resolve soon, Pt is under observation for that and will be for few months or year and treated accordingly.

NOTE:

Echogenicity:-When the lesion is hypoechoiec the chances of cancer are higher it typically appears solid and hypoechoic when compared with normal thyroid parenchyma. When a thyroid nodule is markedly hypoechoic, with a darker appearance than that of the infrahyoid or strap muscles of the neck(termed as marked hypogenicity), the specificity for detection of malignancy is increased to 94 per cent. Marked hypoechogenicity is very suggestive of malignancy(cancer). No hypoechoeic halois visualised in periphery, also its taller than wider in dimension.Vascularity:-Marked vascularity within the nodule(marked intrinsic vascularity) again add up to the probability of malignancy (cancer).

Lymph nodes:-Enlarged lateral cervical lymph nodes again add up to the probability of malignancy (cancer).

TFT:-Elevated TSH shows its not a hot nodule. Again a cold nodule has increased probality of malignancy (cancer).

733806_275943122536519_1641164196_n BEFORE

Note the Size and Vasuclarity in Hypoechoeic Lesion

734367_275950532535778_1204352364_n   AFTER

Note No Lesion Found

165942_275950669202431_1336311596_nAFTER

Note LESION CURED

11654_275952045868960_593183895_n

OVARIAN CYST Cure in Homoeopathy

OVARIAN CYST

A fluid filled sac within the ovary is called Ovarian Cyst.

There can be a single cyst or multiple cyst in one or both ovaries

Usually in majority of cases these cysts are fromed due to ovulating follicle in women of reproductive age.

Types of Ovarian Cysts

All the cysts can be broadly classified into two major cayegories viz. functional ovarian cysts and non functional ovarian cysts

1. Functional Ovarian Cysts

  • Follicular Cysts
  • Corpus Leuteum Cysts
  • Theca Leutein cysts

2. Non-Functional Cysts

  • Dermoid Csyts
  • Endometriotic Cysts also called Choclate
  • Ovarian Serous Cystadenoma
  • Ovarian Mucinous Cystadenoma
  • Ovarian Cystic Adenofibroma
  • Heamorrhagic Cyst
  • Paraovarian Cysts
  • Multiple cysts or follicles in both ovaries are suggestive of a condition due to hormonal imbalance called Polycystic ovarian disease PCOD/Polycystic Ovarian Syndrome PCOS
  • Borderline tumoural Cyst
  • Few Cysts may originate due to Ovarian cancer. If ovarian cyst appears in a post menopausal women then the probability of it being cancerous are high.
  • The cyst may be a complex of one or more type which may have bleeding internally and internal space may also have developed septums and other abnormal features.
  • Rarely the cyst can also be due to vegetation of micro-organismthat is of infective origin.

Symptoms of Ovarian Cyst

Many a times there are no symptoms what so ever and its an incidental finding. But majority of cases presents with following symptoms.

  • Pain in pelvis
  • Pain in abdomen
  • Pain in lower back
  • Uterine Bleeding
  • Irregular periods
  • General Symptoms like Malaise Fatigue Lethargy
  • Gastrointestinal symptoms like Difficulty in bowel movement due to large cyst causing pressure symptoms, NauseaFlatulence and gasueos distention may also be present in many cases.
  • Symptoms of PCOS/PCOD  are different like Hirsutism, weight gain, acne For information about Polycystic Ovarian Disease or Polycystic Ovarian Syndrome visit PCOS

Complications of Ovarian Cyst

  • Ovarian Torsion is usually caused due to large cysts above 4cm in diameter causing the ovaries to change its location due to pressure alsonit might obliterate artery causing obstruction in blood flow resulting into infarction.
  • Cyst Rupture  may cause pain in abdomen lasting from few days to weeks in some cases due toncyst rupture there can be severe internal bleeding which in some cases may be severe to cause heamorrhagic shock.

Diagnosis of Ovarian Cysts

Ultrasonography

Case A

Ovarian Cyst Cured – Dr DEEPAN P. SHAH resolved 5cm*5cm*5cm haemorrhage oravian cyst in 45dys

Ovarian Cyst Cured – Haemorrhagic ovarian complex cyst measuring 5.1cm*4.9cm*4.9cm with internal septae, volume 65.36ml, COMPLETELY RESOLVED with homoeopathy by Dr.DEEPAN P SHAH, allopaths had no medicines to cure this so they had recommended urgent surgery.

BEFORE :- Haemorrhagic ovarian complex cyst measuring 5.1cm*4.9cm*4.9cm with internal septae, volume 65.36ml,

Before Treatment; Ovarian Cyst
BEFORE TREATMENT; Ovarian Cyst

AFTER :- read the last line which quotes “ATTN- previously noted right adnexal complex cyst has COMPLETELY RESOLVED “.
IMPRESSION – NO OBVIOUS ABNORMALITY DETECTED

Ovarian Cyst Cured with Homoeopathy By Dr Deepan P Shah
Ovarian Cyst Cured with Homoeopathy By Dr Deepan P Shah

MENORRHAGIA

Menorrhagia is one of the most common gynaecologic complaint seen in most of women and young girls. Almost every women experiences such episode of bleeding at some point of time in their life.

Menorrhagia may start anytime from menarche through reproductive years to menopause.

WHAT IS MENORRHAGIA?

Menorrhagia is defined as a cyclic bleeding at normal intervals, the bleeding is either excessive in amount or duration or both.

The term menorrhagia is derived from the greek word

MEN meaning Menses
RRHAGIA meaning burst forth.

Menorrhagia interferes with a womens physical, emotional and social quality of life.

LETS US NOW FIRST UNDERSTAND THE NORMAL MENSTRUAL BLEEDING

A normal menstrual blood loss is 50 to 80 ml and usually does not exceed more than 100 ml.
In menorrhagia, the menstrual cycle is unaltered but the duration and quantity of menstrual bleed are increased.
Menorrhagia is essentially a symptom and not a disease in itself.

NORMAL CONTROL OF MENSTRUAL BLEED

Once the menstrual bleeding starts the platelet forms clots in the opened vessels. Prostaglandins causes myometrial contractions and constricts the endometrial vessels. The repair of endothelial regeneration begins on 3rd and 4th day of period, by growth of epithelial cells from the open endometrial glands aided by vasculal endothelial epidermal and fibroblastic growth factor.
In menorrhagia or excessive bleeding with regular menstrual cycles, the Hypothalamopituitary ovarian axis is intact but endometrial changes get altered.

What are Ovulatory and Anovulatory Cycles?

A more logical approach is to divide the abnormal uterine bleeding into those patterns associated with ovulatory and anovulatory cycles.

Ovulatory Cycles

Normal menstrual bleeding with ovulatory cycle ia spontaneous, regular, cyclic, predictable and frequently associated with discomfort that is dysmenorrhoea.

Anovulatory Cycles

Uterine bleeding that is unpredictable with respect to the amount, onset and duration and is usually painless, as in dysfunctional uterine bleeding like menorrhagia.

CAUSES OF MENORRHAGIA

The most common cause lies in Disturbed Hypothalamo-Pitutary-Ovarian axis resulting in condition like polycystic ovaries PCOS, Immature development of organs results in anovulation in the earlier years, unapposed oestrogen causing endometrial hyperplasia. As the girl matures the normal menstrual cycle are established.

General Causes – Blood dyscrasia, coagulation disorders, thrombocytopenic purpura, severe anaemia, leukamia, Von willebrand disease.

Uterine Causes –  Uterine fibroids, fibroidal polyps, adenomyosis, endometrial hyperplasia, endometriosis etc.

Pelvic inflammatory diseases can cause menorrhagia.

Use of Intrauterine devices, it is seen that 5 to 10% of women using intra uterine devices suffer from menorrhagia in 1st few months.

Pregnancy complications include Single, heavy, late period may be due to miscarriage. Another cause of heavy bleeding during pregnancy includes location of placenta , low lying placenta or placenta previa.

Malignancies – Uterine cancer or cervical cancer can cause heavy bleeding.

Medications– Certain medications can cause heavy menstrual bleeding.

Thyroid dysfunctions can also be one of the cause for menorhhagia.

SYMPTOMATIC REPRESENTATION OF MENORRHAGIA

  • Heavy vaginal bleeding resulting in saturation of one ore more sanitary pad, requring double protection, and need to sanitary pad more frequently.
  • Bleeding along with passage of clots and usually lasts for more than a week affecting the routine of a women.
  • Pelvic pain though not present in all cases of menorrhagia is frequently encountered symptom of menorrhagia. This may be seen in menorrhagia due to infections and conditions like endometriosis, adenomyosis and pregnancy related complications.
  • If the patient presents with pelvic infections there may be other symptoms like fever, chills, copious vaginal discharge.
  • Excessive and prolonged menorrhagia leads to anaemia. Usually the patient manifests in the form of excessive weakness, easy fatigue, pale skin, shortness of breath.
  • Menorrhagia caused due to hormonal imbalance in diseases like polycystic ovarian disease, patient may present with hirusitism, acne etc.
  • Delayed appearance of menstrual bleeding phase with Heavy bleeding is due to anovulatory dysfunction of ovary with prolonged influence of Oestrogen
  • Frequent / Early appearance of menstrual bleeding phase i.e. interval less than 21days with:
  1. Normal bleeding – is always an anovulatory cycle.
  2. Heavy Bleeding – is due to ovarian dysfunction

DIAGNOSIS

Diagnosis of menorrhagia can be done based on the complete medical history of the patient and conducting a complete physical examination including a pelvic examination.

Other diagnostic procedures for menorrhagia may include

  • Routine blood examination
  • Pelvic ultra sound scan is the first line of diagnostic tool for identifying structural abnormalities.
  • Hysteroscopy, includes visual examination of canal of cervix and interior of uterus using an instrument inserted in the vagina.
  • Pap test to rule out neoplasia.

ASSESSMENT OF MENORRHAGIA

  • We should note the total duration of bleeding and how much time it is heavy bleed.
  • Assess the length and duration of cycle.
  • How often or how frequently the patient has to change her sanitary pad.
  • Enquire about the passage of clots. Clots represent heavy flow and are painful as they pass through the cervix.
  • Look for any symptoms suggestive of anemia like easy fatigue, shortness of breath, weakness etc.
  • Enquire whether menorrhagia has an impact on her personal life and is hampering her day to day activities.
  • Enquire about any past medical illness including clotting disorders, thyroid dysfunctions or any other gynaecological history.

MANAGEMENT OF MENORRHAGIA

Some useful measures like general measures to improve the health status of patient.

Maintain a menstrual calender noting duration and extent of blood loss.

Adequate rest during menses.

Advise for proper diet with a healthy and balanced diet to regulate the menstrual cycle. Choose a diet that includes fresh fruits, vegetables, whole grains, meat, fish, food ricch in protein vitamins, iron, calcium.

Excercise regularly – Besides emproving blood circulation, excercise also helps to maintain weight. As fat cells release excessive oestrogen from body, excercise helps to maintain an optimum hormone balance.

HOMEOPATHIC MEDICINES COMMONLY USED FOR MENORRHAGIA

  1. HAMAMELIS VIRGINIANA

    Very useful homeopathic remedy for passive dark bleeding very useful medicines in inter-menstrual pain and bleeding; Vicarious menstruation dark profuse bleeding with much clots and membranous discharge; passive bleeding; in patients with heamorrhagic cyst ovarian cyst; vulva feels sore with much pruritus and severe pain in lumbar region; good remedy for post partum bleeding.

  2. LACHESIS

    Hemorrhagic tendency typically suited during climacteric age when patient has hormonal changes which causes mood swings and other menstrual abnormality especially menorrhagia. This remedy is called in when patient shows peculiar mental symptoms like mentally too restless, jealous, pt is too jealous too harm someone but her benevolent side stops her doing so,  loquacious jumps from one topic to other with no head or tail in talks, abusive ill-humored , too much of suppressed sexual desires causing nymphomania, too suspicious keeps doubting everyone around her that they all are conspiring against her, she develops a religious mania and also feels as if she is under some supernatural powers.

  3. HELONIAS DIOICA

    Too frequent and too profuse menses, with swollen sensitive breast and nipples swollen red congested burning with pruritus in vulva and severe pain in back.

  4. USTILAGO MAYDIS

    Excessive menses during at climacteric age blood dark with much coagulation forming long black strings and much clotting, uterine bleeding after delivery or miscarriage, uterus much enlarged in size. headaches due to menstrual irregularities.

  5. MILLEFOLIUM

    heamorrhagic diathesis; menorrhagia with bright red blood, profuse, prolonged and starts too early. bad effects due to lifting weights or due to pregnancy which causes varicose veins that bleed easily.

  6. CARICA PAPAYA

    if given in excess dosing unhomoeopathically, this remedy will promote uterine bleeding and also aborts fetus and if administered homoeopathically in similimum dosing it will stop uterine bleeding

  7. JANOSIA ASHOKA

    very good remedy in lower potency and in crude mother tincture form, in women with menorrhagia and infertility due to hormonal ovarian or uterine imbalances. Its a very good tonic for female reproductive system used since ancient times in india in ayurveda now its homoeopathic tincture is showing promising results in homoeopathy as well

  8. FRAXINUS AMERICANA

    I have found this medicine wonderfully effective in curing menorrhagia especially due to thickeneng of endometrium in mother tincture form in frequent repetitions. also menorrhagia due to fibroids and polyps prolapse of uterus is well tackled with this medicine not only stopping the bleeding but also regressing its cause.

  9. TRILLIUM PENDULUM

    A wonderful remedy for Uterine Heamorrhages uterine bleeding aggravates on slightest movement with bright red blood gushing out accompanied with sensation os if lumbar region and gluteal region was breaking into pieces and wants it to tie it with a bandage. menorrhagia during climecteric age; menorrhagia with prolapse of uterus.

  10. GERANIUM METALLICUM

    a very good remedy for non specific bleeding from any organ also has a very good action on uterine bleeding too profuse menorrhagia.

10 Best Weight gain Medicines in Homoeopathy

WEIGHT GAIN – 10 BEST HOMOEOPATHIC MEDICINES

Weight gain with homoeopathic medicines

Homoeopathic medicines helps regularise weight of a person as per constitution and requirements of an individual.

For optimal realisation of Homoeopathic medinical effects the medicines needs to be selected as per the constitution with special emphasis on physiological imbalances and any other underlying pathological factors needs to be ruled out.

If not selected in accordance with the homoeopathic principles, the medicine might not yield desired result.

Similarly if selected in accordance with Homoeopathic principles it will not only help in weight gain but also resolve any other underlying abnormalities found in proper physiological functioning of body. As the medicines work via improving constitution of a person.

Below are simplified guidelines to select few of the generally used common medicines which are easy to select that most of the instances are hard to fail and can help gain weight in individuals with below normal weight.

  1. Abrotanum especially suited to person with Protein Energy Malnutrition, in ascending type of Marasmus, pot belly with lean thin arms and limbs, in person who eats well but still loses flesh Kwashiorker Protein Energy Malnutrition PEM , in person with Gouty Diathesis who lose muscles, in person who lose weight due to chronic Diarrhoea dysentery, linteric stool with visible undigested food particles in stools.
  2. Alfa Alfa general homoeopathic tonic to improve digestion promote protien absorption and metabolism.
  3. Ashwagandha / Withania promotes testosterone secretion thus promoting protien metabolism improving muscle mass and reducing fats
  4. Natrum Mur weak lean malnourushed  emaciated person with unhealthy skin and earthy complexion, irritability and depressive temperament causing weight loss.
  5. Tuberculinum weightloss due to past or present tuberculosis
  6. Phosphorus lean thin pale person with history of tuberculosis and sensitive to cold.
  7. Arsenicum Album typically suited in patients with Obsessive Compulsive Disorders, bulemia nervosa, person stops eating due to fear fright and anxiety of death, disease or obesity.
  8. Chelidonium Majus weight loss due to sluggish liver function
  9. Lycopodium low body weight or weightloss due to liver disease or sluggish liver function.
  10. Pulsatilla in women with depressing emotion weeping desposition pale fair complexion with tendency towards hyperacidity and tendency to catch cold easily.

LOSE WEIGHT – 10 Best Homoeopathic Medicines

Lose Weight  (Fat Loss) – 10 Best Homoeopathic Medicines

To Lose Weight in obese patient who wants to reduce weight it is necessary to rule out all the pathological factors which may be responsible for obesity and if any found then first the underlying abnormalities needs to be treated first.

Each case preferably needs to be individualised properly as per homoeopathic principles for medicine selection, to yield best results of homoeopathic medicines.

Though , there are some generally used common homoeopathic medicines to lose weight which I have simplified to select by providing basic guidelines which are hard to fail in most of the cases,

  1. Phytolacca Berry well proven homoeopathic medicine for weightloss in general.
  2. Fucus Vesiculosus compliments well to phytolacca berry and when both given intermittently during weightloss treatment works wonders.
  3. Calcarea Carbonica Generalised obesity, for fair, fat and flabby women especially in their forties, mentally and physically sluggish , well suited to women with thyroid disorders.
  4. Thuja Occidentalis obesity due to excessive hunger and abnormally high appetite.
  5. Ignetia Amara obesity in females due to depressing emotion and PCOS.
  6. Thyroidinum obesity due to thyroid disorder
  7. Sepia obesity in female do to Polycystic Ovarian Syndrome (PCOS)
  8. Iodium obesity due to disorder in thyroid glands
  9. Bromium obesity due to disorder in thyroid gland
  10.  Nux Vomica for weight gain due to sedentary lifestyle, irregular dietary habbits, irregular routine, lack of sleep, typical central obesity.
  • To lose weight a person needs to keep strict control on his diet and need to do exercise on regular basis along with medicines for faster and better results.
  • One needs to keep check that he doesnt lose muscle mass in the process
  • I recomend to completely stop sugar and jaggery
  • Oil and Ghee not more than 1-2 tsp throughout the day
  • Increase protien intake as per intensity of workout
  • Increase fiber intake in form of salads and fruits that are not too sweet
  • 4-5 small meals throughout the day
  • Ample of water throughout the day
  • 1 hour yoga or brisk walk
  • Intense workout under professional guidance for those wants to achieve subnormal so called ripoed and defined body.
  • Atleast 7 hours of continious sleep at a stretch is recomended.

Basically this article emphasises more on medicines so diet and regime will be discussed in detail in other article.

To Understand Obesity click the following link

OBESITY