CASE REPORT: ACUPUNCTURE TREATMENT IN MALE PATIENT WITH PRIMARY HYPOTHYROIDISM

The thyroid gland controls the metabolism in the human body. In primary hypothyroidism, the thyroid is being stimulated properly but it isn’t able to produce enough thyroid hormones for the body to function properly. This means that the thyroid itself is the source of the problem. In this research is presented a case of 39 year old male patient diagnosed with primary hypothyroidism. Before coming to the clinic the patient was feeling fatigue, had loss of energy, loss of hair, was gaining weight and other typical symptoms for hypothyroidism were present. The patient is treated with acupuncture treatment in a clinic for Traditional Chinese Medicine and acupuncture, by a doctor specialist in acupuncture. 5 treatments are made from 26th of December to 06th of February. Before the treatment the results were showing low fT4 levels and high TSH. After 5 made treatments, a control blood test analysis was made and the results show normal fT4 levels and decreased TSH levels. The patient will continue to do the treatments until the TSH levels are normal. The patient’s condition will be followed up and the upcoming results will be updated in the paper.


Introduction
The thyroid gland controls the metabolism in the human body. To stimulate the thyroid, the pituitary gland releases the hormone thyroid-stimulating hormone (TSH). The thyroid then releases two hormones, T3 and T4. These hormones control the metabolism. In hypothyroidism, the thyroid doesn't produce enough of these hormones. Hypothyroidism has three types: primary, secondary, and tertiary. In primary hypothyroidism, the thyroid is being stimulated properly but it isn't able to produce enough thyroid hormones for the body to function properly. This means that the thyroid itself is the source of the problem. The most common cause for primary hypothyroidism is autoimmune. It usually occurs as a results of Hashimoto thyroiditis and is usually associated with firm goiter or in late phase of the disease process, with reduced fibrotic thyroid with decreased or no function. In primary hypothyroidism serum TSH is always elevated and serum fT4 is low.
[1] [2] The two antibodies that cause thyroid problems are thyroid peroxidase and thyroglobulin.
Measuring the levels of these thyroid antibodies can help diagnose the cause of the thyroid problem. Positive anti-thyroglobulin or anti-thyroid peroxidase antibodies in a patient with hypothyroidism indicate that there is present Hashimoto's thyroiditis. [3] In hypothyroidism there are many metabolic, neurologic, ocular, gynecologic and other system manifestations. Symptoms of hypothyroidism are: aversion to cold, fatigue, muscle weakness, depression, constipation, weight gain, slow heart rate, menorrhagia, brittle nails and hair and etc. Hypothyroidism may occur at any age but it is most common among the elderly, as it may present subtly and be very difficult to recognize. [2] Hypothyroidism treatment involves taking hormonal medications to replace the missing thyroid hormones. Treatment starts with low doses, which then are increased gradually. The goal is to return the levels of thyroid hormones within the normal range. [

1] [4] [5]
In Traditional Chinese Medicine (TCM) hypothyroidism (hyperthyroidism as well) is considered to be a Yin/Yang imbalance. In Chinese medical theory, Yin and Yang are the essential components of the material world. The basic principle of TCM is to keep the Yin and Yang in balance, since the balance of Yin and Yang is needed for a healthy state of the body. TCM treatment options for hypothyroidism are: acupuncture, herbal medicine, and dietary therapy, which are designed to bring the Yin and Yang back in normal balance. By the terms of Western medicine, an over or underproduction of thyroid hormones changes the body's chemical balance and causes hyper or hypothyroidism. When the Yang energy is deficient, it cannot produce enough of the vital energy that is necessary to keep the function of the body well and symptoms of hypothyroidism occur. [6] The aim of the TCM treatment is to strengthen the affected organs, increase the energy in the Heart, Spleen and Kidney, remove the symptoms, improve the general health condition, balance and regulate the thyroid hormones , improve the endocrine function and so on. [7]

Case Report
In this research is presented a case of 39 year old male patient diagnosed with primary hypothyroidism. Before coming to the clinic the patient was feeling fatigued, had loss of energy, loss of hair, was gaining weight and other typical symptoms for hypothyroidism were present. The patient is treated with acupuncture treatment in a clinic for Traditional Chinese Medicine and acupuncture, by a doctor specialist in acupuncture. (TaiXi) and LR2 (TaiChong). Also in the treatment were included Ashi points located on the neck (front and back). In the treatment were used fine sterile disposable needles with dimensions 0.25x25mm manufactured by Wuijuiang City Medical & Health Material Co., LTD. Before the treatment the results were showing low fT4 levels and high TSH. After 5 made treatments, the patient confirmed that he's feeling better. A control blood test analysis was also made after 5 treatments and the results show normal fT4 levels and decreased TSH levels. The results are shown on table 1. The main causes of hypothyroidism are deficiency of Qi, Yin and Yang in the Spleen, Heart and Kidney. When the Yang energy is deficient, the necessary vital energy is not produced for the body to function properly, therefore the hypothyroidism symptoms occur. By the terms of TCM, the main pathogenesis is deficiency of Spleen/Kidney Yang. The two primary organ systems included are the Kidney and the Spleen. The Heart organ system is more involved in the advanced stage of the disease [7] [8] The aim of the TCM treatment is to awaken the body's natural ability to heal itself. The most common TCM treatment used for hypothyroidism is acupuncture. Acupuncture is used to regulate the energy levels in the body, to restore hormonal balance, to smooth and help manage the emotions, the sleep and the reproductive problems.
[8] [9] The acupuncture points in the treatment were chosen with aim to help the patient to remove the blockages from the meridians, warm the meridians, improve the thyroid and the reproductive function, recharge the Yang Qi, tonify the Kidney and Spleen, remove the phlegm and the Liver Qi stagnation, warm the Kidney Yang, lift up the clear Yang energy and balance the Yin and Yang in the body. [7]

Conclusion
In less than 2 months with only 5 treatment made, the treatment with acupuncture gave an amazing and astounding results in the treated patient. The patient will continue to do the treatments until the TSH levels are normalized. The patient's condition will be followed up and the upcoming results will be updated in the paper.