Hypothyroidism is a prevalent endocrine disorder that can involve multiple organ systems, including the liver. This case report highlights the classical homeopathic management of a 33-year-old female diagnosed with hypothyroidism and concurrent hepatic dysfunction, who declined conventional levothyroxine medications.
Laboratory investigations revealed elevated TSH, SGOT, SGPT, and GGT levels. Over 12 months, the patient experienced sustained clinical improvement with classical homeopathic intervention, alongside normalization of thyroid and liver function tests. This case shows the potential of individualized classical homeopathy to holistically address endocrine disease conditions. It also illustrates how homeopathy can lead to systemic recovery even in the absence of conventional treatment. The findings recommend the need to investigate the relevance of classical homeopathy in functional thyroid disorders.
Keywords: Primary hypothyroidism, endocrine disorders, liver dysfunction, case report, classical homeopathy.
Introduction:
Hypothyroidism is defined as a clinical condition resulting from inadequate production or action of thyroid hormones, primarily thyroxine (T4) and triiodothyronine (T3).1 These hormones play a central role in regulating basal metabolic rate, thermogenesis, and essential metabolic pathways.1
A deficiency leads to a generalized physiological slowdown, affecting every organ system. Globally, hypothyroidism is estimated to affect 4% to 10% of the population, with a markedly higher prevalence among women and older individuals.2
Primary hypothyroidism results from pathology within the thyroid gland itself, and includes conditions such as Hashimoto’s thyroiditis, iodine deficiency, surgical removal, or radioiodine ablation.2 Certain medications, such as lithium, can also impair thyroid function. Secondary hypothyroidism, less commonly encountered, arises due to dysfunction of the pituitary or hypothalamus.2
Clinically, patients often present with fatigue, weight gain, cold intolerance, bradycardia, constipation, menstrual irregularities, and depressive symptoms.2 The impact extends beyond endocrine manifestations and can affect multiple organ systems, such as the cardiovascular, hematologic, and hepatic systems.2 Diagnosis of hypothyroidism is largely biochemical, with elevated serum TSH and low free T4 being hallmark findings.1 Subclinical hypothyroidism is characterized by elevated TSH with normal T4, and although often asymptomatic, it may progress to overt disease.1 Additional laboratory abnormalities may include normocytic anaemia, hyperlipidemia, and altered liver function tests.1
The interplay between thyroid function and hepatic metabolism is clinically relevant but often overlooked in routine management.3 Thyroid hormones are known to regulate bilirubin conjugation, lipid metabolism, and the activity of hepatic enzymes. In hypothyroid states, this can result in elevated serum levels of liver enzymes (SGOT, SGPT, GGT) and impaired bilirubin clearance, which may be reversible with thyroid dysfunction.4
Conventional management typically involves lifelong levothyroxine therapy, aimed at restoring euthyroidism and alleviating symptoms.2 While generally effective, some patients experience persistent symptoms or seek alternatives due to concerns about dependence on synthetic hormone replacement.2
Classical homeopathy has been effective in treating hypothyroidism in the past.5,6,7 The present case illustrates the successful homeopathic management of a young woman diagnosed with hypothyroidism and concurrent liver dysfunction, resulting in the resolution of symptoms and normalization of laboratory markers without recourse to conventional hormone therapy.
Case report:
A 33-year-old unmarried female presented on 16th May 2021 with a six-month history of hypothyroidism. She had declined allopathic treatment, citing concerns after her sister experienced side effects from synthetic thyroid hormones. Over time, she began to experience worsening symptoms, and routine blood investigations revealed elevated liver enzymes (Figure 1). on 30/03/2021, the measures were as follows:
SGOT-63 (Normal: 5-34), SGPT- 92 (Normal: 0-55), GGT-64 (Normal: 9-36), TSH- 7.25 (Normal: 0.4-4.2), Hb-11.4 (Normal: 12-16).
At this point, she sought classical homeopathic treatment.
Figure 1: Laboratory investigation findings before treatment.
Past medical history:
The patient had a long-standing history of recurrent right-sided otitis media beginning at the age of 15 and continuing until the age of 32. The episodes were characterized by offensive ear discharge and stitching pain. Between the ages of 15 and 25, episodes occurred every 3 to 4 months.
From age 25 to 30, the frequency increased, with episodes occurring approximately every two months. These were managed with repeated courses of antibiotic therapy. Over the past two years, the frequency and intensity of the otitis episodes gradually diminished, and the condition had completely resolved one year before her presentation.
She reported developing fevers only rarely throughout her life and did not recall having any significant acute illnesses during childhood. Her most recent episode of fever occurred a year ago and was mild (approximately 99°F), for which she took a single dose of paracetamol.
Family history:
Father was healthy, and mother had suffered from a stroke, and the older sibling suffered from psoriasis.
Diagnosis: Primary hypothyroidism (ICD 10: E03.9)8
Case analysis and prescription:
The prescription was based on the totality of symptoms as shown in the repertorisation in Figure 2. Silicea 200CH, one dose was prescribed on 16/05/2021.
Figure 2: Reportorial result on 16/05/2021 (Vithoulkas Compass)
The follow-up of the case is listed in Table 1.
Table 1 – Follow-up of the case.
| DATE | SYMPTOMS | LABORATORY FINDINGS | ANALYSIS | PRESCRIPTION |
| 17/06/2021 | Weakness after breakfast was better by 50%. Itching without eruptions was better by 30%. There was no bitter taste on waking up in the morning, and her appetite improved. | – | The remedy was the similimum, and the potency chosen was correct.
Remedy is acting. |
Nil. |
| 30/06/2021 | Itching without eruptions was completely better.
Weakness after breakfast was completely better. Perspiration of palms and soles had reduced by 50% No more dryness in the throat and bitter sensation in the mouth. Sleep and appetite were better. Patient developed a new symptom – irritability before menses. |
28/06/2021:
TSH-2.77 (N: 0.38-5.33) SGOT- 16.4 (N<35) SGPT-10.6 (N<35) GGT-18.8 (N<38) |
Very impressive changes. There is general amelioration of the case. | Nil. |
| 04/12/2021 | Patient took the COVID-19 vaccine in September 2021, following which hypothyroidism had relapsed.
New symptoms: Irritability before menses > menstrual flow ++ Left leg pain before menses > menses flow ++ Heat of palms and soles ++ The patient felt tired and unrefreshed when she woke up in the morning. Sweet desire persisted. |
30/11/2021:
TSH-8.39 (N: 0.38-5.33) SGOT- 17.1 (N<35) SGPT-9.90 (N<35) GGT-18.1 (N<38) (Figure 3) |
There is a new, clear remedy pattern (figure 4). Hence, we need to change the remedy. | Lachesis 200CH one dose. |
| 02/05/2022
|
Sleep was refreshing, no weakness on waking up.
Itching without eruptions was completely better. Weakness after breakfast was completely better. Perspiration of palms and soles had reduced by 80%. No more dryness in the throat and bitter sensation of mouth Irritability before menses was better by 70%. Heat of palms and soles got completely better. Leg pain before menses was the same. |
30/04/2022: TSH-2.72
(N: 0.38-5.33) SGOT-14.7 (N<35) SGPT-8.6 (N<35) GGT-16.9 (N<38) Hb-12.6 (N: 12-15) |
There is emotional, general, and pathological betterment. The remedy is acting. We must wait for new symptoms to appear. | Nil. |
| 21/04/2023 | Patient started getting recurring right ear discharge again since 3 months.
Ear discharge was offensive. She complained of getting negative thoughts and has always felt dissatisfied with her life. Her father gave her kitten away, and she could not forgive him for 3 months for that incident. She kept brooding over this issue. Her sleep was unrefreshing, and she got irritated if someone spoke to her in the morning. |
Thyroid profile and liver function tests have been normal. (Figure 5) | Return of old complaint with increased intensity and clear remedy pattern (Figure 6). We need to change the remedy. | Acidum nitricum 1M one dose. |
| 26/06/2023 | Ear discharge subsided after 3 days. Patient even developed a high fever of 101F after the remedy.
Her sleep was much better now. Emotionally, irritability had drastically come down. Leg pain before menses persisted but much better compared to before. |
– | Patient is doing better. We must wait until any new symptoms appear. | Nil. |
| 25/04/2025 | Patient has been doing well.
All her complaints are better. Sleep has improved. |
Thyroid function test and liver function tests have been normal. | Patient is doing better. We must wait until any new symptoms appear. | Nil. |
Figure 3: Laboratory investigation findings during treatment.
Figure 4: Reportorial result on 04/12/2021 (Vithoulkas Compass)
Figure 5: Laboratory investigation findings after treatment.
Figure 6: Reportorial result on 21/04/2023 (Vithoulkas Compass)
Discussion:
Hypothyroidism continues to pose a significant global health burden, particularly among women of reproductive age.2 Although levothyroxine remains the conventional standard of care, a substantial proportion of patients report persistent symptoms or biochemical imbalances despite treatment.2 This has led many to seek integrative approaches that target systemic regulation rather than symptomatic control. In such cases, classical homeopathy may serve as an alternative.
Classical homeopathy offers a holistic approach that focuses on individualized remedy selection based on the totality of physical and emotional symptoms.9 Rather than replacing deficient hormones, homeopathy aims to stimulate the body’s innate self-regulatory mechanisms.10 In complex cases involving multiple systems, such as the coexistence of hypothyroidism and hepatic dysfunction, this integrative approach may provide both symptomatic relief and biochemical normalization.
In this case, the patient presented with both hypothyroidism and elevated liver enzymes, pointing toward hepatic dysfunction secondary to thyroid hormone deficiency. Following treatment, the patient experienced significant symptomatic relief, with normalization of thyroid and liver parameters within two months. Notably, her past complaint of right-sided otorrhoea resurfaced during treatment. According to Hering’s Law of Cure, this signifies a favourable prognosis and deeper constitutional healing.11
The patient belonged to group C, level 7 of the “levels of health theory”, and with correct treatment, her health level improved, and she started developing recurrent infections.12 A temporary relapse occurred following COVID-19 vaccination, with a rise in TSH and reappearance of fatigue and emotional instability. This aligns with homeopathic principles, which suggest that external stressors such as vaccines can destabilize the immune balance in sensitive individuals.10
By the end of one year, the patient remained symptom-free without conventional medication. Laboratory tests confirmed sustained normal thyroid function, liver enzymes, and haemoglobin levels. Importantly, the patient was followed up for a total of three years.
During this extended period, she remained entirely free from relapse. No recurrence of thyroid or liver dysfunction was observed, and she continued to live a healthy life without any need for conventional hormonal therapy.
The Modified Naranjo Criteria for Homeopathy (MONARCH) causality assessment provided a score of 11/13, suggesting a significant causal relationship between the treatment and the observed outcome (Table 2).13 This long-term stability observed in this case reflects the depth of recovery achieved and highlights the potential of homeopathy as a sustainable therapeutic option in treating chronic conditions.
Table 2: Modified Naranjo Criteria for Homeopathy (MONARCH) – for causality assessment
| Criteria | Y | N | Not sure/NA | Score in case |
| 1. Was there an improvement in the main symptom or condition for which the homeopathic medicine was prescribed? | 2 | -1 | 0 | 2 |
| 2. Did the clinical improvement occur within a plausible time frame relative to the drug intake? | 1 | -2 | 0 | 1 |
| 3. Was there an initial aggravation of symptoms? | 1 | 0 | 0 | 0 |
| 4. Did the effect encompass more than the main symptom or condition, i.e., were other symptoms ultimately improved or changed? | 1 | 0 | 0 | 1 |
| 5. Did overall well-being improve? | 1 | 0 | 0 | 1 |
| 6 (A) Direction of cure: did some symptoms improve in the opposite order of the development of symptoms of the disease? | 1 | 0 | 0 | 1 |
| 6 (B) Direction of cure: did at least two of the following aspects apply to the order of improvement of symptoms:- from organs of more importance to those of less importance, from deeper to more superficial aspects of the individual, from the top downwards | 1 | 0 | 0 | 1 |
| 7. Did “old symptoms” (defined as non-seasonal and non-cyclical symptoms that were previously thought to have resolved) reappear temporarily during the course of improvement? | 1 | 0 | 0 | 1 |
| 8. Are there alternate causes (other than the medicine) that with a high probability could have caused the improvement? (consider known course of disease, other forms of treatment, and other clinically relevant interventions) | -3 | 1 | 0 | 1 |
| 9. Was the health improvement confirmed by any objective evidence? (photos before and after treatment) | 2 | 0 | 0 | 2 |
| 10. Did repeat dosing, if conducted, create similar clinical improvement? | 1 | 0 | 0 | 0 |
| Total | 11 |
Conclusion:
While this is a single case, the clinical picture, progression of symptoms, and objective laboratory findings support the integrative management of endocrine and hepatic disorders through individualized homeopathy. Therefore, the use of classical homeopathy in multi-systemic disorders must be investigated further in this light.
References:
- Zamwar UM, Muneshwar KN. Epidemiology, Types, Causes, Clinical Presentation, Diagnosis, and Treatment of Hypothyroidism. Cureus. 2023;15(9):e46241. doi:10.7759/CUREUS.46241
- Patil N, Rehman A, Anastasopoulou C, Jialal I. Hypothyroidism. StatPearls. Published online February 18, 2024. Accessed June 4, 2025. https://www.ncbi.nlm.nih.gov/books/NBK519536/
- Piantanida E, Ippolito S, Gallo D, et al. The interplay between thyroid and liver: implications for clinical practice. J Endocrinol Invest. 2020;43(7):885-899. doi:10.1007/S40618-020-01208-6,
- Yorke E. Co-Morbid Hypothyroidism and Liver Dysfunction: A Review. Clin Med Insights Endocrinol Diabetes. 2024;17:11795514241231532. doi:10.1177/11795514241231533
- Nair DG. Constitutional approach in Homoeopathy cured hypothyroidism: A case report. ~ 208 ~ Int J Homoeopath Sci. 2020;4(4):208-211. Accessed June 4, 2025. www.homoeopathicjournal.com
- Raj A, Hemapriya R, Amma CRKK. A case report on hypothyroidism treated constitutionally with homoeopathic medicine causticum 1M. Int J Health Sci (Qassim). 2025;9(S1):15-24. doi:10.53730/IJHS.V9NS1.15521
- Wadhwa B, Rastogi DP, Singh A. Management of overt hypothyroidism with homoeopathic Management of overt hypothyroidism with homoeopathic medicine Iodium-An evidence-based case report medicine Iodium-An evidence-based case report. Indian J Res Homoeopath. 2023;17:28-34. doi:10.53945/2320-7094.1189
- 2025 ICD-10-CM Diagnosis Code E03.9: Hypothyroidism, unspecified. Accessed June 3, 2025. https://www.icd10data.com/ICD10CM/Codes/E00-E89/E00-E07/E03-/E03.9
- Hanhemann S. Organon of Medicine. B.Jain publishers; 1994.
- Vithoulkas G and Tiller.w. The Science of Homeopathy. 7th Edition.; 2014.
- Kent JT. Kent’S Lectures on Homoeopathic Philosophy. B.Jain publishers; 2002. https://www.naturopathicmedicineinstitute.org/wp-content/uploads/2016/09/Lectures-on-Homeopathic-Philosophy.pdf
- Vithoulkas G. Levels of Health.; 2017.
- Lamba CD, Gupta VK, Van Haselen R, et al. Evaluation of the Modified Naranjo Criteria for Assessing Causal Attribution of Clinical Outcome to Homeopathic Intervention as Presented in Case Reports. Homeopathy. 2020;109(4):191-197. doi:10.1055/s-0040-1701251
