Hashimoto's patient setback - Q

August 25, 2010

Hey y'all,

I have a great patient, 25 yof, who came in today with a pretty major setback on

her progress thus far. She has seen me over the past 8 months for hypothyroidism

(I dx'ed Hashimoto's), and has seen some pretty terrific progress. Her setback

began 2 weeks ago, the very day after she ran out of her Multi Bs. Symptoms are

mainly neurological, including general disorientation, light-headedness and

dizzy spells. Occasionally she experiences numbness down her arms. She also

feels uncoordinated to the point where she is uncertain of her position in the

dark, and has been occasionally hitting her arm against things she normally

wouldn't. Knitting is also getting difficult. She says that she feels very

similar to how she felt when she first came to see me, which was frustrating to

hear.

Other info: she drank a glass of gluten-free wine two days in a row, and began

feeling " strange, " so she discontinued it (no specific symptoms she pinpointed).

Then a few days afterward, had a glass of regular wine and felt similarly. This

past week, she also went for 5-6 days without a single productive BM; when she

did, it was easily passed and appeared normal to her. No symptom improvement

afterward.

Tx so far:

Gluten-free diet (she has since also eliminated dairy)

BTGs

UNDAs as per pt. presentation (last time, 1, 16, 48, mainly for dysmenorrhea)

Rubus idaeus gemmo, 50 gtts bid (also for dysmenorrhea)

Beet kvass, 1/4 cup bid

I decided to address her neurological symptoms this time around, with UNDAs 9,

47, and 202. I'm concerned that the Multi B was masking many of her symptoms,

and that a lot of our progress has...well, not been progress.

Other info: she is very organized, and keeps good records of her symptoms (her

diet diary was a thing of beauty). Very intelligent, friendly, easy to smile.

She doesn't strike me as the overly meticulous Arsenicum; she also seems more

sure of herself than a Silica. Still, I'm willing to consider those. (She tried

Sepia on her own for dysmenorrhea with no benefit.)

Any advice? I don't feel like I've been giving her the world's most expensive B

vitamin for her condition, but this last setback makes me wonder.

Isaacs, ND, DC

in wonderful downtown Littleton, CO

August 25, 2010

Have you considered a CBC/anemia panel? Perhaps B12/folate anemia? Dr. Igor N. SchwartzmanWhole Family Wellness Centerwww.wholefamilywellnesscenter.comWellWirewww.wellwire.com2920 SW Dolph Court, Suite 2 Portland, Oregon 97219 T: F: This e-mail message and any attachments are intended only for the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential and exempt from disclosure

under applicable law. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution, or copy of this communication is strictly prohibited. If you have received this communication in error, please notify us immediately by telephone and destroy the original and any copies of this e-mail. Subject: Hashimoto's patient setback - QTo: Date: Wednesday, August 25, 2010, 2:16 PM

Hey y'all,

I have a great patient, 25 yof, who came in today with a pretty major setback on her progress thus far. She has seen me over the past 8 months for hypothyroidism (I dx'ed Hashimoto's), and has seen some pretty terrific progress. Her setback began 2 weeks ago, the very day after she ran out of her Multi Bs. Symptoms are mainly neurological, including general disorientation, light-headedness and dizzy spells. Occasionally she experiences numbness down her arms. She also feels uncoordinated to the point where she is uncertain of her position in the dark, and has been occasionally hitting her arm against things she normally wouldn't. Knitting is also getting difficult. She says that she feels very similar to how she felt when she first came to see me, which was frustrating to hear.

Other info: she drank a glass of gluten-free wine two days in a row, and began feeling "strange," so she discontinued it (no specific symptoms she pinpointed). Then a few days afterward, had a glass of regular wine and felt similarly. This past week, she also went for 5-6 days without a single productive BM; when she did, it was easily passed and appeared normal to her. No symptom improvement afterward.

Tx so far:

Gluten-free diet (she has since also eliminated dairy)

BTGs

UNDAs as per pt. presentation (last time, 1, 16, 48, mainly for dysmenorrhea)

Rubus idaeus gemmo, 50 gtts bid (also for dysmenorrhea)

Beet kvass, 1/4 cup bid

I decided to address her neurological symptoms this time around, with UNDAs 9, 47, and 202. I'm concerned that the Multi B was masking many of her symptoms, and that a lot of our progress has...well, not been progress.

Other info: she is very organized, and keeps good records of her symptoms (her diet diary was a thing of beauty). Very intelligent, friendly, easy to smile. She doesn't strike me as the overly meticulous Arsenicum; she also seems more sure of herself than a Silica. Still, I'm willing to consider those. (She tried Sepia on her own for dysmenorrhea with no benefit.)

Any advice? I don't feel like I've been giving her the world's most expensive B vitamin for her condition, but this last setback makes me wonder.

Isaacs, ND, DC

in wonderful downtown Littleton, CO

August 25, 2010

Good idea of considering an anemia. But also thinking that B vitamins play a role in liver detoxification by way of acting as cofactors for some of the metabolic pathways as well as are important in nervous system functioning. I wonder if her program with Unda 1, 16 and 48 is starting to move metals out but not all the way and they are migrating around her system; not making it all the way out of the thyroid and brain/neurological tissues. (Maybe metals have contributed to her Hashimotos.) The bowels not moving could also be liver related or a return of sluggish bowel due to thyroid. Liver is participatory as you know in converting free t4 to t3 -- maybe you want to add some more liver drainage which will move things which might be circulating all the way out, like 2, 20, 258 and maybe some lipoic acid to assist this metal movement as well as Gammadyn Zn or rotating other gammadyns (and yes, bringing back in the b vitamins of course).I wonder if it is a bit of auto-intoxication in the sense of metals not clearing and producing all that aberrant nervous system information (dizziness, numbness, etc.)?Let us know how it goes? Have you considered a CBC/anemia panel? Perhaps B12/folate anemia? Dr. Igor N. SchwartzmanWhole Family Wellness Centerwww.wholefamilywellnesscenter.comWellWirewww.wellwire.com2920 SW Dolph Court, Suite 2 Portland, Oregon 97219 T: F: This e-mail message and any attachments are intended only for the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution, or copy of this communication is strictly prohibited. If you have received this communication in error, please notify us immediately by telephone and destroy the original and any copies of this e-mail. Subject: Hashimoto's patient setback - QTo: Date: Wednesday, August 25, 2010, 2:16 PM Hey y'all, I have a great patient, 25 yof, who came in today with a pretty major setback on her progress thus far. She has seen me over the past 8 months for hypothyroidism (I dx'ed Hashimoto's), and has seen some pretty terrific progress. Her setback began 2 weeks ago, the very day after she ran out of her Multi Bs. Symptoms are mainly neurological, including general disorientation, light-headedness and dizzy spells. Occasionally she experiences numbness down her arms. She also feels uncoordinated to the point where she is uncertain of her position in the dark, and has been occasionally hitting her arm against things she normally wouldn't. Knitting is also getting difficult. She says that she feels very similar to how she felt when she first came to see me, which was frustrating to hear. Other info: she drank a glass of gluten-free wine two days in a row, and began feeling "strange," so she discontinued it (no specific symptoms she pinpointed). Then a few days afterward, had a glass of regular wine and felt similarly. This past week, she also went for 5-6 days without a single productive BM; when she did, it was easily passed and appeared normal to her. No symptom improvement afterward. Tx so far: Gluten-free diet (she has since also eliminated dairy) BTGs UNDAs as per pt. presentation (last time, 1, 16, 48, mainly for dysmenorrhea) Rubus idaeus gemmo, 50 gtts bid (also for dysmenorrhea) Beet kvass, 1/4 cup bid I decided to address her neurological symptoms this time around, with UNDAs 9, 47, and 202. I'm concerned that the Multi B was masking many of her symptoms, and that a lot of our progress has...well, not been progress. Other info: she is very organized, and keeps good records of her symptoms (her diet diary was a thing of beauty). Very intelligent, friendly, easy to smile. She doesn't strike me as the overly meticulous Arsenicum; she also seems more sure of herself than a Silica. Still, I'm willing to consider those. (She tried Sepia on her own for dysmenorrhea with no benefit.) Any advice? I don't feel like I've been giving her the world's most expensive B vitamin for her condition, but this last setback makes me wonder. Isaacs, ND, DC in wonderful downtown Littleton, CO

August 25, 2010

Hi , In addition to the anemia, heavy metals, liver advice you have received I would consider the possibility of "another" auto-immune disease, especially MS. Her symptoms and age are typical. vit D status? family history? (especially of auto-immune disease) And of course her personal history as a child, especially between 2-7 years. Does she have any memory of a viral illness that was quite ill for a week or so? It is the auto-immune process that needs to be addressed. Hope that helps. Dick Thom Bambu clinic Portland, ORI have a great patient, 25 yof, who came in today with a pretty major setback on her progress thus far. She has seen me over the past 8 months for hypothyroidism (I dx'ed Hashimoto's), and has seen some pretty terrific progress. Her setback began 2 weeks ago, the very day after she ran out of her Multi Bs. Symptoms are mainly neurological, including general disorientation, light-headedness and dizzy spells. Occasionally she experiences numbness down her arms. She also feels uncoordinated to the point where she is uncertain of her position in the dark, and has been occasionally hitting her arm against things she normally wouldn't. Knitting is also getting difficult. She says that she feels very similar to how she felt when she first came to see me, which was frustrating to hear.Other info: she drank a glass of gluten-free wine two days in a row, and began feeling "strange," so she discontinued it (no specific symptoms she pinpointed). Then a few days afterward, had a glass of regular wine and felt similarly. This past week, she also went for 5-6 days without a single productive BM; when she did, it was easily passed and appeared normal to her. No symptom improvement afterward.Tx so far:Gluten-free diet (she has since also eliminated dairy)BTGsUNDAs as per pt. presentation (last time, 1, 16, 48, mainly for dysmenorrhea)Rubus idaeus gemmo, 50 gtts bid (also for dysmenorrhea)Beet kvass, 1/4 cup bidI decided to address her neurological symptoms this time around, with UNDAs 9, 47, and 202. I'm concerned that the Multi B was masking many of her symptoms, and that a lot of our progress has...well, not been progress.Other info: she is very organized, and keeps good records of her symptoms (her diet diary was a thing of beauty). Very intelligent, friendly, easy to smile. She doesn't strike me as the overly meticulous Arsenicum; she also seems more sure of herself than a Silica. Still, I'm willing to consider those. (She tried Sepia on her own for dysmenorrhea with no benefit.)Any advice? I don't feel like I've been giving her the world's most expensive B vitamin for her condition, but this last setback makes me wonder.

August 26, 2010

Hi ,

It sounds like she might have anti-cerebellar antibodies, an

uncommon but unfortuntaely linked sequelae of Hashimoto's. I agree you

should rule out other less serious stuff, and also with DT that the

auto-immunity is the most important aspect. Is she 100% compliant with

the gluten avoidance? Have you checked her

medications/supplements/spices/bodycare (lipstick, etc.) to ensure it is

gluten-free? Have you considered one of the gluten-digesting enzymes

for back-up? The HMF neuro? Do you have immune modulation in place?

If you think it is auto-immunity and progressing and you need to do

something fast, I would consider the use of low dose naltrexone if you

can prescribe it as it's looking like the most gentle allopathic

(semi-naturopathic/homeopathic) treatment for autoimmunity.

Just a few thoughts.

Regards,

Tim Gerstmar, ND

Redmond, WA

August 26, 2010

Wow...lots of great ideas. I'll address them as I can. Not sure that pernicious

anemia is a culprit, since she has been on the Multi B religiously from the

beginning, and her CBC in the beginning was unremarkable. Metals are a definite

possibility. Not set up currently to check for heavy metal issues, and chelation

is a dodgy issue in unlicensed Colorado, even oral chelation. Vitamin D status

should be fine; I started her on D when she first came in in December, and

discontinued it over the summer since she was getting outside plenty. I told her

we'd start it back again in the fall.

Significant history of meningitis at 1 yo, and she has significant hearing loss

as a result; she has a noticeable speech impediment and wears hearing aids.

If indeed MS is an issue, do I do further PE and treat presumptively? I don't

think an MRI is warranted right now.

Lyme is also a good possibility. What's the best way to test for it? And then

beyond that...treatment? Again, keep in mind this is unlicensed Colorado, so no

pharmaceuticals.

Isaacs, ND, DC

Littleton, CO

>

> Hi ,

> In addition to the anemia, heavy metals, liver advice you have

> received I would consider the possibility of " another " auto-immune

> disease, especially MS. Her symptoms and age are typical.

>

> vit D status?

>

> family history? (especially of auto-immune disease)

>

> And of course her personal history as a child, especially between 2-7

> years. Does she have any memory of a viral illness that was quite ill

> for a week or so?

>

> It is the auto-immune process that needs to be addressed.

>

> Hope that helps.

>

> Dick Thom

> Bambu clinic

> Portland, OR

>

> I have a great patient, 25 yof, who came in today with a pretty major

> setback on her progress thus far. She has seen me over the past 8

> months for hypothyroidism (I dx'ed Hashimoto's), and has seen some

> pretty terrific progress. Her setback began 2 weeks ago, the very day

> after she ran out of her Multi Bs. Symptoms are mainly neurological,

> including general disorientation, light-headedness and dizzy spells.

> Occasionally she experiences numbness down her arms. She also feels

> uncoordinated to the point where she is uncertain of her position in

> the dark, and has been occasionally hitting her arm against things she

> normally wouldn't. Knitting is also getting difficult. She says that

> she feels very similar to how she felt when she first came to see me,

> which was frustrating to hear.

> Other info: she drank a glass of gluten-free wine two days in a row,

> and began feeling " strange, " so she discontinued it (no specific

> symptoms she pinpointed). Then a few days afterward, had a glass of

> regular wine and felt similarly. This past week, she also went for 5-6

> days without a single productive BM; when she did, it was easily

> passed and appeared normal to her. No symptom improvement afterward.

>

> Tx so far:

> Gluten-free diet (she has since also eliminated dairy)

> BTGs

> UNDAs as per pt. presentation (last time, 1, 16, 48, mainly for

> dysmenorrhea)

> Rubus idaeus gemmo, 50 gtts bid (also for dysmenorrhea)

> Beet kvass, 1/4 cup bid

>

> I decided to address her neurological symptoms this time around, with

> UNDAs 9, 47, and 202. I'm concerned that the Multi B was masking many

> of her symptoms, and that a lot of our progress has...well, not been

> progress.

>

> Other info: she is very organized, and keeps good records of her

> symptoms (her diet diary was a thing of beauty). Very intelligent,

> friendly, easy to smile. She doesn't strike me as the overly

> meticulous Arsenicum; she also seems more sure of herself than a

> Silica. Still, I'm willing to consider those. (She tried Sepia on her

> own for dysmenorrhea with no benefit.)

>

> Any advice? I don't feel like I've been giving her the world's most

> expensive B vitamin for her condition, but this last setback makes me

> wonder.

>

September 23, 2010

Hey everyone...

I saw my Hashimoto's patient yesterday. Thankfully, all her neurological

symptoms (!) had resolved within one week of her last visit, and her energy,

though not 100%, was significantly better. Hurray for UNDAs!

Having said that, I still decided to run a CD-57 panel, as per Kim Saxe's

recommendation. I still think there's something else going on. Also, it was

interesting to note that although her main tendon reflexes were normal, her left

triceps reflex was noticeably less brisk than all others. (And moderate to

severe dysmenorrhea persists, despite Rubus gemmo supplementation. May have to

dwell on that one.)

Finally, she mentioned for the first time yesterday that she experienced

neonatal jaundice that resolved with treatment and without any apparent

complications. This after a birth a few weeks post-term and a low birth weight

(4 lbs 11 oz). Curiouser and curiouser!

Thank you all for your advice. It has been very helpful. I may keep you apprised

as things go forward.

Isaacs, ND, DC

Littleton, CO

>

> , I totally agree with DT here. The autoimmunity could certainly be

triggered by a chronic infection of course but probably multiple factors. I find

with neurological disorders that a combination of our great drainage work this

group does with Klinghardt's neurological detox principles and infection tx is a

winning combination. Look into it perhaps. Or contact me or, better yet, Cory

Tichauer is much more seasoned than myself at this stuff.

> Sent on the Sprint® Now Network from my BlackBerry®

>

> Re: Re: Hashimoto's patient setback - Q

>

> ,

> With the history of meningitis, it rule's in (for me anyway) the

possibiilty of a residual microbe (virus? Lyme?) in the brain.

>

> Only " accepted " diagnosis is MRI and presence of plaques and analysis of

CSF and presence of oligoclonal bands of IgG on electrophoresis.

>

> So it seems likely one way or the other you will have to treat some type

of intra-cellular " microbe " . As Tim said, you have to try and stop the

auto-immune process.

>

> Dick Thom

> Bambu clinic

> Portland, OR

> Significant history of meningitis at 1 yo, and she has significant hearing

loss as a result; she has a noticeable speech impediment and wears hearing aids.

> If indeed MS is an issue, do I do further PE and treat presumptively? I don't

think an MRI is warranted right now.

>

September 23, 2010