Category Archives: Metabolic Disorders

Topic related to metabolic disorders

ANAEMIA

Anaemia can be defined as decreased haemoglobin counts or reduced red blood cell counts or reduced oxygen carrying capacity of blood, due to “loss of” or “abnormality of” red blood cells or haemoglobin.

Normal Heamoglobin Counts

  • 6 months to 5 years of age > 11g/dl
  • 5 years to 12 years of age > 11.5g/dl
  • 12years to 16 years of age > 12g/dl
  • Adult Females (non-pregnant) > 12g/dl
  • Adult Females (pregnant) > 11gm/dl
  • Adult Males > 13g/dl

CAUSES OF ANAEMIA

  • Blood losss
  • Excessive Red Blood Cell destruction
  • Heamoglobinopathies
  • Hypovitaminosis B12
  • Hypoferremia
  • Anaemia of Chronic diseases
  • Autoimmune haemolytic anaemia
  • Inflamatory bowel diseases
  • Hypervolemia or water retention due to sodium or other salts.
  • Genetic hereditary conditions like Thalasemia
  • Certain cancers
  • Kidney diseases
  • Reduced erythropoetin production
  • Excessive RBC destruction
  • Impaired RBC production
  • Certain infections like malaria which causes RBC destruction.
  • Certain drugs which causes RBC destruction eg. Quinine causes chinchonism.
  • Bone Marrow lesions and pathologies
  • Etc.

CLASSIFICATION OF ANAEMIA

There are many types of anaemias. It can be broadly classified into 7 categories depending upon their causes

Anaemia due to

  1. Blood Loss
  2. Hemolysis
  3. Impaired or abnormal Erythropoesis
  4. Hypervolemia
  5. Chronic Diseases
  6. Nutritional deficiency

Based on RBC morphology it can be classified into 3 groups

  • Microcytic
  • Macrocytic
  • Normocytic

FEW COMMON and RARE TYPES OF ANAEMIA

  • Iron Deficiency Anaemia
  • Aplastic Anaemia
  • Megaloblastic Anaemia
  • Pernicious Anaemia
  • Sideroblastic Anaemia
  • Autoimmune Hemolytic Anaemia
  • Myelodysplastic Syndrome
  • Thalasemia
  • Fanconi Anaemia
  • Congenital Dyserythropoetic Anaemia
  • Daimond-Blacfan Anaemia
  • Myelopthisis
  • Anaemia of Prematurity
  • Erythroblastopenia or Pure Red Cell Aplasia
  • Hereditary Spherocytosis
  • Hereditary Elliptocytosis

SYMPTOMS

  • Weakness
  • Lethargy
  • In children it affects growth in general
  • Somnolence, Drowziness in day time
  • Disturbed sleep at night
  • Pallor, general pale appearance of skin, mucous membranes and eyes.
  • Dyspnoea on Exertion.
  • Reduced Immunity, tendency to catch infections and slow recovery and healing.
  • Bodyaches
  • Cyanosis in severe cases
  • Palpitations
  • Tachycardia
  • Low blood pressure
  • Chest pain
  • Depression
  • Craving for indigestible things , PICA
  • Cold clammy extremities
  • Oedematous swelling of extremities, dependent oedema
  • Angina or cardiac failure in severe cases
  • Will impact general growth and repair of all the vital organs and tissue of the body.

HOMEOPATHIC MEDICINES FOR ANAEMIA

Depending upon the cause of anaemia and general constitution of the patient, one of the following medicines may be called for duty by a homeopathic physician.

  • Ferrum Metallicum
  • Ferrum Phosphoricum
  • Cinchonna Officinalis
  • Natrum Muriatic um
  • Arsenicum Album
  • Abrotanum
  • Hamamelis Verginiana
  • Pulsatilla Nigricans
  • Janosia Ashoka
  • Crotalus Horridus
  • Lachesis
  • Acidum Phosphoricum

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 HYPOVITAMINOSIS D

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.

VITAMIN D DEFICIENCY HYPOVITAMINOSIS D

Vitamin D Deficiency is also called as Hypovitaminosis D and is very common form of nutritional deficiency and it is closely associated with calcium level in blood as it plays a major role in calcium regulation in body.

Vitamin D also called Cholecalciferol is a Fat Soluble Vitamin produced naturally in skin where a precursor 7-Dehydrocholestrol is converted into Pre- Cholecalciferol through conrotatory pathway when exposed to Ultra Violet B (UV-B) rays present in sunrays having wavelenght between 290nm-315nm causing electrocyclic reaction with optimal synthesis between 295nm-300nm when exposed for several minutes to form an equilibrium.

This Pre-cholecalciferol finally undergoes (1,7) antarafacial sigmatropic rearrangement to finally isomerize into cholecalciferol, which an inactive form of Vitamin D.

Cholecalciferol further undergoes Hydroxylation in Liver whith help of 25-Hydroxylase in Hepatocytes and is converted to 25-Hydroxycholecalciferol(Calcifediol) which is an inactive form.

Calcifediol further undergoes Hydroxylation in kidney with help of 1-α-Hydroxylase to form (1,25)dihydroxycholecalciferol(Calcitriol) which is an active form of Vitamin D. Parathyroid hormone tightly regulates amount of active Vitamin D circulating in blood by controlled activation of 1-α-hydroxylase.

Vitamin D Deficiency is usually caused due to

  • Insufficient exposure to Ultra Violet B radiation from Sun. Person with  dark skin colour are more prone to its deficiency as melanin pigment absorbs UVB and doesnt let it penetrate in skin sufficient enough to activation Vitamin D synthesis. also use of sunscreen peeparations doesnt let sufficient penetration of UVB. Also time and period of exposure, altitude, longitude presence of clouds type of clothing worn by person etc determines its amount of absorption and penetration in skin.
  • Insufficient dietary in take of Vitamin D.
  • Cholecalciferol(Vitamin D) is converted into 25-Hydroxycholecalciferol in liver. In certain liver diseases this step of metabolism is disturbed and vitamin D is not converted into 25-Hydroxycholecalciferol(Calcifediol).
  • 25-Hydroxycholecalciferol(Calcifediol) is further converted into active form that is 1,25-Dihydroxycholecalciferol(Calcitriol) in kidney, certain kidney disease hampers this conversion.

Vitamin D deficiency Symptoms

Vitamin D Deficiency shows not only shows symptoms of its deficiency but also symptoms of calcium deficiency in most cases.

  • Osteomalacia
  • Osteoporosis
  • Triggers Osteoarthritis
  • Rickets
  • Periodontitis
  • Paraesthesia
  • Myalgia
  • Tetany
  • Pre-eclampsia
  • Light-Headedness
  • Depression

Vitamin D Deficiency Diagnosis 

Vitamin D Deficiency is diagnosed by measuring level of 25-hydroxycholecalciferol in blood.

Normal level of Vitamin D in blood should range between 30-100ng/ml below this upto 20ng is considered as insufficiency and level below 20 ng is considered as Vitamin D Deficiency.

Sources of Vitamin D

  • Exposure of Skin to Sunlight
  • Fish
  • Eggs
  • Mushrooms
  • Fortified Milk and other food products like oats bread Fortified with Vitamin D.
  • Suppliments are available in both oral and injectible forms.

Excess intake of Vitamin D causes Nausea, Vomitting, Constipation , Confussion, Weakness, Kidney stones(urolithiasis).

Also read following related articles

CALCIUM DEFICIENCY

OSTEOPOROSIS

RICKETS

CALCIUM DEFICIENCY

Calcium Deficiency as commonly used  is an ambiguous and misleading term as it may refer to two conditions Dietary Insufficiency without evident Hyopcalcaemia or Hypocalcaemia without Dietary Insufficiency of Calcium both have different Causes and Implications.

Hypocalceamia means reduced calcium level in blood serum below average range of 8.8-10.7 mg/dl.

Calcium is very essential element in human body and is required for maintaining proper anatomical structure and physiological functions in human body, at cellular level of almost all tissue/ organ.

Serum Calcium levels are not indicative of general chornic calcium deficiency/insufficiency, as per body’s requirements,  as  Blood Serum Calcium levels are very tightly maintained in human body within a narrow range. If there is dietary insufficiency then it may not reflect in Blood Serum Levels as the body comprimises Bone Mineral Density to maintain normal Blood Serum Calcium levels as it is more important so as to maintain proper function of other organs and cells especially heart and nerves and other cellular processes as any disturbance in this due to low blood serum calcium level may cause severe acute life threatenig conditions.

Regular intake of calcium is necessary for proper functioning of the body, If there is dietary insufficiency of calcium then the body starts consuming it from bones to maintain normal Blood Serum Calcium level, this depletes the Bone Mineral Density which if prolonged may result into conditions like

  • Osteomalacia
  • Osteoporosis
  • May trigger or contribute to Osteoarthritis.
  • Rickets with pigeon chest open sutures and fontanalles and other anomalies in growing children.

Hypocalcaemia is a severe acute condition usually caused due to deficient calcium metabolism which is regulated by Parathyroid hormone , vitaminD and also healthy functioning of organs like liver and kidney are required for proper calcium metabolism.

Symptoms of Hyopcalceamia

Positive Bathmotropic Effect

As calcium blocks sodium channel which maintains the threshold level of depolarisation of nerve and muscle So, decreased level of calcium will decrease the threshold level for depolarisation which will result in to Positive Bathmotive Effect

Petechea

Recurrent Petechial Heamorrhages which if persists, it tends to overlace and merge with each other appearing like purpura , it appears espescially on weight bearing and dependent parts.

Paraesthesia

Tingling and numb sensation on face especially in perioral region and in limbs on extremities like fingers spreading to hands and toes spreading to feet

Myalgia

Muscular pain especially in lower limbs, its may also accompany paraesthesia.

Tetany

Painful and violent muscular cramps and contractions generalised or may be redtricted to carpopedal region.Positive Trousseau’s  and or Chvostek’s sign for Latent Tetany

Cardiac Symptoms

  • Decreased Chronotropic and Inotropic effect that is reduced heart rate and Myocardial Cantractibility.
  • Which causes decreased cardiac output.
  • ECG shows associated changes like intermittent QT prolongation, typical Ventricular Tachycardia.

Causes

  • Hypoparathyroidism
  • Low Vit D
  • Low dietary intake of calcium
  • Other pathological conditions like kidney or pancrease disease etc.

Homoeopathic Medicines for Calcium Deficiency or Hypocalcaemia

  • Calcarea Carbonica
  • Calcarea Phosphorica
  • Calcarea Fluorica
  • Silicea
  • Magnesia Carbonica
  • Magnesia Muriaticum
  • Magnesia Phosphorica
  • Zincum Metallicum
  • Natrum Mur
  • Natrum Phos
  • Kalium phos

RICKETS

VITAMIN D DEFICIENCY HYPOVITAMINOSIS D

 

OSTEOPOROSIS

IRON DEFICIENCY HYPOFERREMIA SIDEROPAENIA

Iron Defciency also called Sideropaenia or Hypoferremia means lack of supply of sufficient quantity of iron required for various eventual physiological needs of human bady, it is one of the most common form of nutritional deficiency.

It is more common in females compared to males. More than 50% of Indian women suffer from iron deficiency. Severe form of iron deficiencies also causes deaths not only in under-developed countries(350 per million) but also in developed countries like USA(8 per million). Its prevalence in European nations is surprisingly low.

On an average there is 4-5 gms of total iron in human body of which approximately 2.5gms is in RBC and almost 2 gms in bone-marrow liver and spleen. Where liver is primary physiologic source of iron reserves in body. Around 3-4 mg of iron in body circulates through plasma which is bound to transferrin as free iron is toxic to body. Also Reticulo-Endothelial system hoards and recycles iron from ageing RBC, macrophages store iron from engulfed RBC and is stored in form of hemosiderin they create in times of excessive RBC destruction and increased requirement of iron which gradually they reabsorb and destroy one requirement is normalised.

Within cells iron that been designated for cellular processes is stored in myoglobin and in cytochromes for energy producing redox reactions these type of designated iron amount is around 400gm in whole body.

Iron deficiency first relfects in iron reserves, reduced reserves usually doesent show any symptoms initially in most of the cases. As more than 60% of iron is in form of heamoglobin within RBC the very first sign iron deficiency will be seen as anaemia, this type of anaemia is called iron deficiency anaemia. and its usually its found that people with iron deficiency die of organ failure due to lack of oxygen carrying capacity of RBC that will be well before cells runs out of iron for intracellular processes like electron transport.

For production of new RBC humans use 20mg of iron/day most of which is salvaged and recycled from old RBC

Basic Role of Iron in Human Body

  • Iron is Present in all the cells.
  • Especially in Red Blood Cell where its a key component of Heamoglobin molecule.
  • Required for transportation of Oxygen from lungs to all tissues and its cells.
  • In the form of Cytochromes it helps electron transfer within the cells.
  • Facilitating Oxygen Enzyme Reaction in various tissues

Iron Absorption

Iron is absorbed in form of Heme protein or in Ferrous Fe²+ form  in duodenum by special molecules present in entrocytes of duodenal lining.

Fe³+ is first converted to Fe²+ with the help of 2 enzymes:

  1. Ferric Reductase Enzyme  present on erythrocyte brushed border and
  2. Duodenal Cytochrome B(Dcytb)

Then Divalent Metal Transporter 1(DMT1) transports this extracellular iron through the cell’s plasma membrane into the Entrocyte.

Its then either stored in enterocytes as ferritin or cell can release it into body by transfering it through basolateral end of enterocytes of small intestine with help of only known iron exporter in mamals called Ferroportin with help of a Ferroxidase called Hephaestin that converts Fe²+ to Fe³+.

Hepcidin is a hormone that post-transitionally inhibits ferroportin which acts as negative feedback in iron level balance

Body uses all these factor to increase or decrease the iron level in body by increasing or decreasing the production of these enzymes and hormone.

Rate of Absorption of Iron is dependent on following factors

  • Total Iron stores
  • Rate of RBC production by Bone Marrow
  • Concentration of Heamoglobin in RBC
  • Oxygen Content of Blood
  • any chronic inflamatory process or infection in body reduces iron absorption to deprive bacteria from iron
  • Hepcidin level

Absorption of iron if taken orally from dietary source or in form of salts as in suppliments is significantly low and also its highly variable, Body can absorb only 5-35% of total ingested dietary iron and it depends on type of iron source and other circumstances. Best absorbed form of iron in which it get absorbed by 20-15% is heme iron and it usually comes in animal products and in few plant products, most of the iron from digested food or suppliment is absorbed in body  from deudenum a part of small intestine.

Human Body steadily lose iron on daily basis through stools, sweating, shedding dead cells of skin and intestinal mucosa, minor blood from intestinal linning , in females menstrual bleeding etc. on an average normal physiologic loss of iron in male is 1 mg/day and in females it is 1.5-2mg/day who has regular menstrual function and regular healthy physiology.

Recommended Dietary Allowances for Iron

AgeMaleFemalePregnancyLactation
0-6months0.27mg0.27mg
7-12 months11mg11mg
1-3 years7mg7mg
4-8 years10mg10mg
9-13 years8mg8mg27mg10mg
14-18 years11mg15mg27mg9mg
19-50years8mg18mg
50 years above8mg8mg

Causes of Iron Deficiency

Blood loss due to

  • Excessive menstrual bleeding
  • Bleeding through ulcers benign and malignant tumours heamorrhoids.

Insufficient dietary intake of iron compared to physiological needs as mentioned in RDA table above

Improper absorption of iron due to

  • Vitamin B12 or Vit C or co-enzyme deficiencies
  • Intestinal disease
  • In patients who have surgically removed part of stomach or intestine.
  • Excess of Calcium Zinc and Manganese

Iron Deficiency Symptoms

  • Pallor – patient look pale and anaemic
  • Weakness
  • Dullness
  • Dizziness
  • Irritable
  • Lethargic
  • Tiredness
  • Frequent headaches
  • Breathlessness – dyspnoea on exertion
  • Lack of concerntration
  • Child’s growth slows down and milestones walking talking dentition etc delayed mental and behavioral problems.

Diagnosis of iron deficiency

Iron deficinecy will result into reduction in following parameters on blood test:

  • Red blood cells quantity, size and colour
  • Heamoglobin level
  • Hematocrit
  • Ferritin
  • Serrum iron
  • Transferrin

Additional test may be required to rule out other causative factors like USG, endoscopy, to rule out bleeding tumours or ulcers, hormonal essay for women with menorrhagia, etc.

Dietary Sources of Iron

Nonvegetarian has best source of iron especially in

  • Red meat
  • Shell fish
  • Liver
  • Egg yolk
  • Turkey

Vegetarian sources rich in iron

  • Spinach
  • Brocolli
  • Peas
  • Chick Peas
  • Beans
  • Lentils
  • Tofu
  • Amla
  • Quinoa
  • Almond
  • Cashewnuts
  • Flax seeds
  • Sesame seeds

Iron requires Vitamin C and Vit B12 for its absorption. Amla and Spinach have blend of both iron and vitamin C, so they are regarded as good source of iron since ages in ayurveda.

When iron deficiency is chronic and severe pt may require oral or injectable iron suppliments and in cases with severe iron deficiency anaemia  blood transfussion or RBC transfussion may be required.

Homoeopathic Medicines for Iron Deficiency

  • Cinchonna Officinalis
  • Ferrum Metallicum
  • Ferrum Phos
  • Bio Combination No1

Any underlying causes needs to be ruled out and treated, especially menorrhagia in females.

MENORRHAGIA

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

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