A Case of PCOD with Borderline Hypothyroidism
by Dr. Sujit Chatterjee, Dr. Manish Yadav and Dr. Sadaf Ulde
A young woman, age 29, came to us on 7th January 2012. She had swelling throughout her body, great fatigue with lethargy, mood swings and depression with a lot of gloom and negativity. With this she was gaining weight, her hair was falling out, and her skin was becoming increasingly dry. Because of these symptoms, in 2011 she underwent investigations and was diagnosed with borderline hypothyroidism (TSH – 5.47). Her doctor advised her to start Eltroxin but she refrained from it.
At around this time she also visited her doctor with complaint of very irregular menses, and she was diagnosed with polycystic ovarian disease. Her gynecologist advised hormonal treatment but she did not start the treatment.
Along with all of this she developed severe back pain. She was diagnosed as having nerve compression at L5.
Her job involves a lot of traveling which has been stressful for her. She feels “extremely drained, with no stamina to do anything – I am just very tired.”
She says that she feels unable to take decisions and has very low confidence. She used to feel confident about doing presentations at her office but now she feels shy about it. She is often in need of help at work, but she feels unable to ask for help when she needs it. She feels shy and hesitant about standing up for her rights.
She feels that her depression may be connected to the stress of coping with her father’s severe depression, “trying to pull him out of it”. There are heavy family and financial responsibilities due to her father’s disability and she feels these have dragged her down.
In her childhood her family enjoyed a lavish lifestyle, but suddenly her father had a business failure due to having been cheated by his own uncle. All of his assets, including their home, were sold. Then from their high lifestyle they “went down to the lowest possible, a complete shock for everyone.” She took it quietly but she did not understand what had happened, and it left a big impact on her as well as on the rest of her family.
As her father’s health was getting worse, responsibility for the family’s welfare fell to her. She felt there was no support from other family members, and this produced “a lot of anger and negativity within me.”
She feels that her father doesn’t care for her and that he never thinks about her, as if she did not exist for him. She said that “this situation came like a hit for me. I was completely broken down.” Sometimes she would not be able to sleep even after taking sleeping pills.
Once during a big emotional upset she took forty sleeping pills in an attempt at suicide, and was admitted into the hospital. She said, “I was extremely hurt emotionally. I seriously didn’t want to live at that time. I didn’t expect him to do anything in return or take care of me. He is old, I understand, but the whole thought that for him I don’t exist was a shock for me.”
When asked more about the experience of the shock, she says that she was completely devastated, not wanting to believe that she doesn’t exist in her father’s thoughts. She said, “His lack of interest in me and in my life was affecting me a lot, and that was building up within me. Nothing would make me happy; I couldn’t see my future; I had no vision. Something got into me and I was unable to see my future. That felt claustrophobic, like suffocation.”
When asked about the experience of ‘suffocation’, she said that she wanted to be free to do things without hesitation, wanted to breathe freely. She said, “In my thoughts and mind there is a lot of stiffness. I am holding myself back, and there is a lot of heaviness inside, as if carrying tons and kilos of weight on me…There is a lack of clarity in my thought process. A lot of thoughts are all confusing, jumbling up, messed up inside me, and then I am not able to express myself or ask anybody for help. The whole mess is like a lot of pressure and heaviness just increasing on me and I wanted to release that horrible feeling.” With this, she feels she has no stamina to do anything; there is a complete lack of energy.
When asked to describe ‘heaviness’, she says, “It feels like an inability to move the body freely, as if you are carrying a lot of weight. Then I want to lie down and don’t feel like moving. It feels as if the tons and kilos of weight are tied around my shoulders. There are a lot of strings attached to it. Lots of messed-up thoughts, making my head and shoulders very heavy, with tiredness and pain.”
I then asked her to describe the pain. She said it is a “drained out, tired feeling as if stuck somewhere, confused and don’t know what direction to move in. Which is the way forward?”
When asked about the opposite of this situation, she said, “being free”.
Asked to tell about ‘free’, she said that ‘free’ means “light as feather”. She said the experience of this is “not holding to the past or future thoughts. The feeling would be wonderful and give me freedom for movement. It would let me do things that I like. Then there will be happiness, cheerfulness, a serene feeling like music and dance. Something like salsa that is very light, comfortable and happy. It simply moves with the flow. A happy and high kind of feeling.”
She said, “I feel a lot of weight on my shoulders and I feel like pushing it away, cutting the extra baggage, extra weight.” She said she was trying to find her “intrinsic self”. When asked to visualize her intrinsic self, she said, “Confident, a happy-go-lucky person with a positive outlook. Not being bogged down with the situation, facing it and moving on. I don’t want to hold on to anything or be bogged down with things that take a toll on me. That is suffocating as heart and soul are not synchronizing with each other.” She said the sensation of that was choking and suffocating; unable to breathe freely.
I then asked about the feeling of ‘choking and suffocating, unable to breathe freely’. She said, “There is a lot of constricting. They put pressure on me.” At this point she made a gesture of squeezing her hands together. When asked to describe the gesture, she said, “There is a lot of pressure, a need to be free, open up. The feeling is of being closed and stiff… Stiffness is like compacting – that is not allowing me to be free. Stiffness feels like tight and rigid.”
When asked about the opposite of this she said, “Relaxed and calm, ease of movement, a comfortable feeling.” She said that the experience of this is “relaxed, giving me a sense of freedom and space. There is a need to move. It’s like there is a fight within yourself – you want to move and be free. The constant feeling of fight drains me completely, sucking all the energy from my body. Then there is tiredness, making me drowsy, completely drained out.” When asked about ‘drained out’, she said “The energy comes out. Completely dead from fighting, succumbing to the fight.”
She recalled a recurrent dream from childhood in which she was walking for a long distance, through mountains, through parks, just walking alone. She said in the dream the experience was, “I am lost. I don’t know right path.” ‘Lost’ means “I don’t know what direction I am walking in. I don’t know which is right and wrong.”
She said that in her dreams she tends to see different people who have no connection with each other, from her personal life and from her professional life. “Everybody comes together in my dream, and if you come back and think about it, there is no connection between them. I don’t know how they know each other, or how they land up there.” When asked about the experience of this she said, “I am just having some sort of flow happening.”
She described another dream in which she has a house with a big gate and a path. “On the left side there is a temple on the property, and on the right side is a two-storey building where the ground floor is like a big hall or dining area, a place where people can sit and meet, with a kitchen also on the ground level.” She says, “I have always seen myself as a married person in this house, so on the first floor there is this one section for my parents, another section for my husband’s parents, and on the second floor is my room where from one end I can see the sea, and from the other end I can see a big garden and a lawn, which is also part of the property.”
When asked about this experience she said, “It is beautiful, relaxed, happy, calm and serene. The feeling is of freedom – nothing negative is taking control of me. It is a safe feeling, secure.”
She said the experience of ‘freedom’ is “basically movement, and nothing is holding me back, nothing is putting pressure on me, which makes me feel happy and light, like a feather, no extra baggage. No heaviness.”
When asked about the worst situation in life she said that a man had molested her. At the time she did not realize what had happened, but when she reached the 7th standard she shared it with her mother. Her mother then told everything to her father. In that same year her father met the man who had done it, and her father behaved very normally towards him, as if nothing had happened. That surprised her and she felt very hurt and angry, that her father could be so normal with him. She said the experience of that hurt was “as if someone is drowning or sinking, and when you drown you lose your breath. You want to cry but you are numb, no sensation, dead. You want to breathe but you are suffocated, you want to die.”
When asked about her hobbies and interests she said that she likes painting, listening to music, watching movies, and going out with friends. In drawing, she especially draws houses. She feels that may be due to dealing with the loss of her house in childhood, as then she would draw “hearts pierced with an arrow, to indicate hurt, pain and bloodshed with tears.” Asked more about this, she said, “The tears signify pain. Emotionally hurt, helpless, not knowing what to do in a specific situation. I felt lost, lonely, with no one to help, neglected.”
- Food and drink: she is not fussy; she likes all foods. She mentions that she likes chicken and seafood.
- Sleep Position: on her side, with her hand under the pillow.
- Menstrual History: it used to be regular, but at present irregular due to PCOD.
When asked about her experience of the case-taking, she said, “I feel lighter than before.”
Themes of the case:
- serene, calm
- heavy versus light
- carrying of the baggage of the past
- suffocating, choking, not able to breathe freely.
- dreams: walking alone, lost
- neglected, forsaken
I was looking for a remedy from plant kingdom, as we see sensitivity and the opposite polarities of a sensation. The miasm is something from tubercular to leprous, which we see from the feeling of no support, of being abandoned by her father, attempted suicide, loneliness, claustrophobia and suffocation. The experience of feeling that for her father she does not exist for her is like a shock. This again helps us verify that the remedy belong to plant kingdom and is not hydrogen. Then we hear that her experience of shock is heaviness, like baggage, suffocating, and the opposite of it being light, serene, and calm. This leads us to Hamamelidae.
I was looking for a remedy with main themes of suffocation, unable to breathe, ‘lost’, and strong issues with the father or family members.
Sensation of the Hamamelidae, as given in Sankaran’s Schema:
- Closed, shut in, confined
- Pressed, compressed
- Dragged down, heavy
- Expanded, enlarged
- Flying , floating
- Light, free
- Dullness of mind, dullness of senses
- Grounded, all movement ceases
- Inclination to lie down, rest; repose ameliorates
- Motion, averse to
 Sankaran, Rajan. “Plant Sensations Chart.” Sankaran’s schema. 2005 ed. Mumbai, India: Homoeopathic Medical Publishers, 2006. p.17.
- Desire to move, motion ameliorates
- Desire to be in open air, open air ameliorates
- Fantasizing and imagination
- Adapting to living within a confined, limited space
- Balanced (neither high nor low)
I had conducted a proving of Ficus religiosa which belongs to the family Moraceae, which is within the subclass Hamamelidae. Now if we compare some of the main characteristics of the case to the themes that emerged in this proving, we can see striking similarity.
Characteristics of the case:
- carrying tons and kilos of weight
- holding baggage that I don’t want
- lost; no contact
- a lot of anger towards her dad.
Themes of the proving which match those of the case
- doing something for others, and the opposite, feeling useless
- helping and serving others
- losing contact
- friendship versus feeling alone
Some direct proving extracts
- Prover B – Calm feeling.
- Prover D – Brush or touch of a man made her abusive.
- Prover E – Breathless feeling, > open air.
- Prover G – I do not have friends; I am all alone in this world. Strong need for Company. I want to go back to my friends (in another city). There was a feeling of being alone, that I don’t have anybody with me.
- Prover D/E/F – Indifference towards mother though she was sick. Had quarrels with mother.
- Prover K – Wanted to be alone
- Prover L – My friends are avoiding me.
- Prover E – I had gone to Brabourne Stadium; I wanted to return I was not able to find way home. A friend showed the way.
Themes common to both case and proving:
- Losing contacts
- Losing someone forever
- Separating from family and friends
- Opposite polarity: meeting friends
Remedy: Ficus religiosa 1M, twice a day for two days, and Sac lac, twice a day for one month. The 1M potency was given as the case themes were matching beautifully with proving as well as with the system understanding of the remedy source.
Follow-up on 05/04/12
Overall the patient is much better. Regarding her issues with her father she said, “Now I don’t hold on to any of the grudges and just move on, as I don’t want to carry any unnecessary thoughts or, you know, any negative baggage with me. I just want to drop everything.” (Resolving issues of the past was also an important theme in the proving.)
Repeated Ficus religosa 1M
Second follow-up, 14/5/12
The patient brings a recent report showing a TSH level of 3.81. She says, “I am doing much better than before. There has been a lot of improvement. I am very happy that my thyroid is normal now and I am not taking any allopathic medication for that. In the PCOD also, there’s a lot of improvement and my menses are regular. I have lost 4-5 kilograms of weight and I’m feeling very energetic. So overall I am very happy with the result. I am feeling happier and lighter.”
She reports that her mood is much better; now she feels happy with the challenges she faces at work. This is in spite of the fact that stress is very high at her job and she is waiting to see if she will be let go or not. She says, “From that point of view, earlier I would have been very, very depressed, which is not the case right now. I am quite normal. I am facing it well, taking it well.”
She mentions that there are some minor things which need attention, including constipation and occasional shooting headaches. But she feels much less tired and her eating habits have improved. Also, she reports that before the remedy she had a problem with bloating, and that is now much better.
Remedy: Sac lac, twice a day for one month
We saw the patient again on 21st January 2013. She has been doing fine, and her improvement has continued.
Remedy: Sac lac, pills twice a day for one month
Third follow-up: 5/7/12
The patient’s menses are regular now. Her mood is good; she feels generally cheerful. She says she is feeling much lighter and more energetic. She has been more active.
She recently got engaged to be married.
She reports that she has a few new pimples. Some constipation remains.
Remedy: Sac lac
She is much better overall. Her menses are normal now. She has no complaints related to thyroid. She no longer has depression. Her moods are very good, as are her energy levels.
Her engagement was broken off but she was able to cope very well with the situation.
She had a dream that she was alone and lost (this again confirms her miasm).
I would have missed the remedy completely had I not recognized the Hamamelidae family sensation of dragged down, heavy, enlarged, dull, open, free, etc. But this case is instructive on a critical point in prescribing: when you come to a specific family from the system understanding in a case, it is important to read all of the available remedies of the family to look for the peculiar symptoms matching the case. In this case the peculiarities that stood out were the dream of losing ones way, feeling alone and lost; a feeling of indifference toward family members; and the feeling that she was stuck in her relationship with her father, so that until that was resolved, she could not proceed.
Dr. Sujit Chatterjee
Senior Consultant and Faculty, ‘the other song’ – International Academy of Advanced Homoeopathy
Dr. Manish Yadav & Dr. Sadaf Ulde
Resident Doctors, ‘the other song’ – International Academy of Advanced Homoeopathy