This Hashimoto’s case report presents a 38-year-old woman with elevated anti-TPO levels without previous thyroid issues. The patient received ten acupuncture treatments every two weeks for six months. These treatments restored normal TPO levels and relieved all her symptoms, effectively curing her condition.
Hashimoto’s and Acupuncture
Slightly elevated levels of TSH, normal T3/T4 levels, and high Anti-TPO levels are signs of subclinical hypothyroidism. More than 90% of thyroid disease cases result from autoimmune diseases. Hashimoto’s thyroiditis is a progressive and lifelong autoimmune disease. It starts quietly, typically long before the patient’s diagnosis, and develops slowly over time.
Before treatment, the patient’s anti-TPO level was 91.2 U/ml (<60.0 U/ml). After receiving acupuncture, her level normalized to 54.8 U/ml. Similarly, she had a slightly elevated TSH level before treatment of – 4.39 pIU/ml (0.55-4.75 pIU/ml). After treatment, the TSH level normalized to 2.08 pIU/ml.
Acupuncture points used in the treatment included: RN4 (QuanYuan), RN6 (QiHai), DU20 (BaiHui), GB20 (FengChi), DU14 (DaZhui), LI4 (HeGu), DU4 (MingMen), BL15 (XinShu), ST9 (RenYing), BL20 (PiShu), BL23 (ShenShu), LR2 (TaiChong), SP9 (YinLingQuan), SP6 (SanYinJiao), ST36 (ZuSanLi), KI3 (TaiXi) and Ashi (trigger) points located on the neck (front and back).
Acupuncture is most effective at the onset of disease and delivers good results in such pre-conditions. Therefore, the authors recommend acupuncture to prevent more severe and advanced conditions.
Understanding Hashimoto’s Disease
Subclinical hypothyroidism is an early and mild form of hypothyroidism, indicating that the body is not producing enough thyroid hormones. The condition is subclinical because thyroid-stimulating hormone (TSH) is slightly above normal. However, the thyroid hormones (T3 and T4) are still within the normal range. In addition, positive anti-TPO antibodies confirm that the condition is autoimmune, meaning antibodies actively attack thyroid cells, leading to hypothyroidism.
Hashimoto’s is most often progressive. More than 90% of thyroid disease cases are autoimmune. Hashimoto’s thyroiditis is a progressive and lifelong autoimmune condition, typically starting long before a doctor makes a diagnosis.
Common symptoms of hypothyroidism include fatigue, depression, hair loss, weight gain, intolerance to cold, goiter, and constipation. In addition, some studies indicate that patients with hypothyroidism have twice the risk of developing heart disease, high cholesterol, or high blood pressure.
Five Stages of Hashimoto’s Disease
There are five stages of Hashimoto’s disease:
- Stage 1 – There is a genetic predisposition without any current symptoms or changes in the thyroid hormones.
- Stage 2 – Immune cells appear in the thyroid gland. 90% of Hashimoto’s patients have elevated thyroid antibodies and normal thyroid hormone levels in this stage. They may be experiencing anxiety, mood swings, or fatigue. Unfortunately, doctors often misdiagnose patients at this stage as having mood-related disorders and prescribe SSRIs, which do not address their underlying condition. This stage is the ideal time to start preventive measures to slow the progression of the disease.
- Stage 3 – Subclinical hypothyroidism – T3/T4 levels are normal at this stage, and the TSH levels are slightly elevated (3-10 mU/L).
- Stage 4 – Overt hypothyroidism – Patients in stage 4 present with elevated TSH levels, and fT3/fT4 levels are low. This timeframe is when doctors typically diagnose patients with Hashimoto’s and begin prescribing medications.
- Stage 5 – Progression to Other Autoimmune Disorders – At this stage, the patient may develop another autoimmune disorder like celiac disease, multiple sclerosis, lupus, or rheumatoid arthritis. The immune system is out of balance and overacting on other organs in the body. One should not conventionally approach these conditions, focusing only on one organ. Instead, healthcare providers should treat the body as an integrated whole.
Treating Hashimoto’s Disease
Proper treatment can reverse early-stage autoimmune conditions. For example, traditional Chinese Medicine (TCM) is a treatment that effectively treats hypothyroidism. From a TCM perspective, Hashimoto arises due to chronic deficiency of one or more vital substances of the body: Blood, Qi, Yin, Yang, and Essence. The disease may start with general Qi deficiency and then progress to affect all organ systems over time.
Three primary organs integral to the pathogenesis of hypothyroidism are the Spleen, Kidneys, and Heart. Other organs that may be involved include the Lungs and Liver, although in an indirect manner. The initial stage of the condition, equivalent to subclinical hypothyroidism, involves many symptoms of Spleen Qi deficiency, including fatigue, muscle weakness, foggy thinking, poor concentration, constipation, and poor digestion.
Hashimoto’s Case Report
In this Hashimoto’s case report, a 38-year-old woman presented with elevated anti-TPO levels without previous thyroid issues. She did not take medications before, during, or after receiving acupuncture. Before treatment, the patient experienced fatigue and palpitations, especially at night. She received ten acupuncture treatments, once every two weeks, over six months. Acupuncturists performed the treatments at a clinic for acupuncture and TCM in Skopje, Macedonia.
Treatments lasted 30-45 minutes, using sterile, single-use acupuncture needles. Acupuncture points included: RN4 (QuanYuan), RN6 (QiHai), DU20 (BaiHui), GB20 (FengChi), DU14 (DaZhui), LI4 (HeGu), DU4 (MingMen), BL15 (XinShu), ST9 (RenYing), BL20 (PiShu), BL23 (ShenShu), LR2 (TaiChong), SP9 (YinLingQuan), SP6 (SanYinJiao), ST36 (ZuSanLi), KI3 (TaiXi) and Ashi (trigger) points located on the neck (front and back).
Blood Tests Confirming Results
Table 1 displays blood test results before and after the acupuncture treatments. Before the treatment, the anti-TPO level was 91.2 U/ml (<60.0 U/ml). After treatment, levels normalized to 54.8 U/ml. The TSH level before the treatment was also slightly elevated to the upper range of – 4.39 pIU/ml (0.55-4.75 pIU/ml). After the treatment, it normalized to 2.08 pIU/ml. The FT4 level was in a normal range before and after the treatment.
Table 1: Blood test results done before and after the treatment
Normal Ranges
TSH (0.55-4.75 pIU/ml)
FT4 (0.89-1.76 ng/dl)
Anti-TPO (<60.0 U/ml)
Before treatment:
TSH – 4.39 pIU/ml
FT4 – 1.03 ng/dl
Anti-TPO – 91.2 U/ml
After treatment:
TSH – 2.08 pIU/ml
FT4 – 1.01 ng/dl
Anti-TPO – 54.8 U/ml
Case Report Discussion
This patient’s stage of disease reflected subclinical hypothyroidism. At this stage, TSH blood tests are not sensitive enough to reveal Hashimoto’s. And while there is no significant elevation of thyroid levels, the patient will test positive for thyroid antibodies (TPO or TG). At this stage, an increase in TSH levels can reflect an increase in thyroid gland inflammation.
For an autoimmune disease to develop, three factors must be present:
- A genetic predisposition
- Intestinal permeability
- Triggers
At the stage of subclinical hypothyroidism, it is possible to reverse the condition without using medications. But first, it is essential to find the root cause of the disease. Every patient has a different root cause, as everyone has unique genes and lifestyles.
Possible triggers include stress, toxins, food sensitivities, or infections. Unfortunately, thyroid hormone replacement medication will not address the root cause of this disease. Acupuncture treatment aims to help the body naturally restore balance to the immune system without using drugs. The goal is to balance the Qi energy in the affected organs – Spleen and Kidney, revitalize stagnated energy, tonify the organs, warm the Kidney Yang, and eliminate excessive dampness and phlegm if present.
Hashimoto’s Case Report Conclusion
Acupuncture is always most effective at the onset of disease and provides practical, long-lasting results in such early-stage conditions. Acupuncture treatment is an excellent choice for prevention, as well as for more severe and advanced illnesses. The patient in this Hashimoto’s case report found complete relief and healing with acupuncture.
Next Steps
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Reference
Blagica Arsovska, Jihe Zhu, and Kristina Kozovska. (2020). CASE REPORT – ACUPUNCTURE TREATMENT IN FEMALE PATIENTS WITH ELEVATED ANTI-TPO LEVELS. International Journal of Research – GRANTHAALAYAH, 8(12), 1-4. https://doi.org/10.29121/granthaa layah.v8.i12.2020.2520, December 2020
Focus keyphrase: Hashimoto’s Case Report
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