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Case Report: Acupuncture Treatment in Patient With Hypothyroidism and Oligoasthenoteratozoospermia

Authors:
  • Center of Traditional Chinese Medicine "Tong Da Tang" Skopje
  • Center of Traditional Chinese Medicine "Tong Da Tang" Skopje

Abstract

Hypothyroidism has become a very common health problem worldwide. Common symptoms are: hair loss, fatigue, aversion to cold, dry skin, weight gain, muscle cramps, infertility and etc. In the Traditional Chinese Medicine (TCM) the main pathogenesis is Spleen-kidney yang deficiency. The treated patient is a 43 years old male diagnosed with hypothyroidism and oligo asthenoteratozoosperm. The patient has done 32 acupuncture treatments, once weekly in a period of two years. The patient was treated in a clinic for TCM and acupuncture by a doctor specialist in acupuncture. Points that were treated are Ashi points located on the neck (front and back). scalp and inner thigh and meridian points: DU20 (Tai Chong).Before and after the treatment were done several analysis for the thyroid hormones and sperm tests. After the treatments the results are amazing, showing normal results of the thyroid hormones and no presence of oligoasthenoteratozoosperm. Because of the hypothyroidism the patient was almost bald and after using the Ashi points on the scalp the patient now has a new grown hair Acupuncture as a treatment for hypothyroidism and secondary complications can give very satisfying results with a high percentage of efficiency and success. The treatment is long-term and careful monitoring of the patient's condition is required.
International Journal of Medical Science and Health Research
Vol. 2, No. 05; 2018
ISSN: 2581-3366
www.ijmshr.com Page 24
Case Report: Acupuncture Treatment in Patient With Hypothyroidism and
Oligoasthenoteratozoospermia
Jihe Zhu1, Blagica Arsovska2, Kristina Kozovska3
1, 2, 3 Faculty of Medical Sciences, University Goce Delchev, Shtip, Republic of Macedonia
2 Institute of Biology, Faculty of Natural Sciences and Mathematics, Skopje, Republic of
Macedonia
Corresponding author: Kristina Kozovska; ‘Orce Nikolov’ 155/5-2 1000 Skopje, Macedonia
Abstract
Hypothyroidism has become a very common health problem worldwide. Common symptoms
are: hair loss, fatigue, aversion to cold, dry skin, weight gain, muscle cramps, infertility and etc.
In the Traditional Chinese Medicine (TCM) the main pathogenesis is Spleen-kidney yang
deficiency. The treated patient is a 43 years old male diagnosed with hypothyroidism and oligo
asthenoteratozoosperm. The patient has done 32 acupuncture treatments, once weekly in a period
of two years. The patient was treated in a clinic for TCM and acupuncture by a doctor specialist
in acupuncture. Points that were treated are Ashi points located on the neck (front and back).
scalp and inner thigh and meridian points: DU20 (Bai Hui), GB20 (Feng Chi), DU14
(DaZhui), ST9 (Ren Ying), LI4 (He Gu), BL15 (XinShu), BL20 (PiShu), BL23 (Shen Shu),
DU4 (Ming Men), RN6 (Qi Hai), RN4 (Quan Yuan), SP9 (Yin Ling Quan), ST36 (Zu San
Li), SP6 (San Yin Jiao), KI3 (Tai Xi), LR2 (Tai Chong).Before and after the treatment were
done several analysis for the thyroid hormones and sperm tests. After the treatments the results
are amazing, showing normal results of the thyroid hormones and no presence of
oligoasthenoteratozoosperm. Because of the hypothyroidism the patient was almost bald and
after using the Ashi points on the scalp the patient now has a new grown hair Acupuncture as a
treatment for hypothyroidism and secondary complications can give very satisfying results with a
high percentage of efficiency and success. The treatment is long-term and careful monitoring of
the patient's condition is required.
Keywords: Acupuncture, Traditional Chinese Medicine, Treatment, Hypothyroidism,
Oligoasthenoteratozoosperm
Introduction
Hypothyroidism has become a very common health problem worldwide. Hypothyroidism is an
endocrine disorder caused by deficit of hormone production by the thyroid gland. Common
symptoms are: hair loss, fatigue, aversion to cold, dry skin, weight gain, muscle cramps and etc.
[1] Hypothyroidism can be divided into primary and secondary. Primary hypothyroidism is most
common and mostly occurs in women. The disease is induced by chronic inflammation of the
thyroid gland. Very high levels of TSH (thyroid stimulating hormone) indicate presence of
primary hypothyroidism and low levels of TSH are indication for secondary hypothyroidism.
The presence of primary hypothyroidism may not be detectable except by blood analysis. [2]
International Journal of Medical Science and Health Research
Vol. 2, No. 05; 2018
ISSN: 2581-3366
www.ijmshr.com Page 25
The main problem is thought to be caused by deficiency of Qi, Yin and Yang in the Heart,
Spleen and Kidney. When there is deficiency of Yang energy, the necessary vital energy cannot
be produced for the body to function properly and thus the hypothyroidism symptoms result. [1]
[2] [3] In the Traditional Chinese Medicine (TCM) the main pathogenesis is Spleen-Kidney
Yang deficiency. Spleen-Kidney Yang deficiency can lead to edema, pain and visceral
dysfunction. [4]
Lack of both Yin and Yang causes hypothyroidism, with symptoms as dry skin, dizziness,
constipation, pale complexion and lethargy.[1] In the pattern of Spleen-Kidney Yang deficiency
the main symptoms are: poor memory, lassitude, dizziness, sleepiness, tinnitus, aversion to cold,
dry skin and hair, edema, constipation, irregular periods in women, impotence in men, pale
tongue with tooth marks on the edges, white and sticky tongue coating and a deep/thin or
deep/slow pulse. In the pattern of Heart-Kidney Yang deficiency the main symptoms are:
sleepiness, palpitations, chest pain and congestion, feeling cold, pale tongue with white and
slippery coating and deep and slow pulse. [3]
TCM offers acupuncture, Chinese herbs, moxibustion and cupping as treatment methods for
hypothyroidism, which have proven their efficacy through the years. The aim of the treatment is
to strengthen the affected organs, boost the Kidney Yang energy, increase the Yin and Yang
energy in the Kidney, Spleen and Heart, improve the general health condition, remove the
symptoms, regulate and balance the thyroid hormones and improve the endocrine function. [1]
[4]
Case Report
The treated patient is a 43 years old male diagnosed with hypothyroidism and
oligoasthenoteratozoosperm. The patient was diagnosed 4 months before starting the
acupuncture treatment. He was prescribed to take 100mg Eutirox from Monday to Friday and
75mg for the weekend. The patient and his partner was also trying to conceive for some time.
The patient was treated with acupuncture at the same time for the both diagnoses. The patient has
done 32 treatments, once weekly in a period of one year (12.10.2017-12.07.2018). The patient
was treated in a clinic for TCM and acupuncture by a doctor specialist in acupuncture. In the
treatment were used fine sterile disposable needles with dimensions 0.25 x 25 mm manufactured
by Wuijuiang City Medical & Health Material Co., LTD. Points that were treated are Ashi points
located on the neck (front and back), scalp and inner thigh and meridian points: DU20 (Bai
Hui), GB20 (Feng Chi), DU14 (Da Zhui), ST9 (Ren Ying), LI4 (He Gu), BL15 (XinShu),
BL20 (Pi Shu), BL23 (Shen Shu), DU4 (Ming Men), RN6 (QiHai), RN4 (Quan Yuan), SP9
(Yin Ling Quan), ST36 (Zu San Li), SP6 (San Yin Jiao), KI3 (Tai Xi), LR2 (Tai Chong).
Before and after the treatment were done several analysis for the thyroid hormones and sperm
tests. After the treatments the results are amazing, showing normal results of the thyroid
hormones and no presence of oligoasthenoteratozoosperm. Because of the hypothyroidism the
patient was almost bald and after using the Ashi points on the scalp the patient now have a new
grown hair. The dose of the Eutirox tablets for hypothyroidism was gradually reduced too.
International Journal of Medical Science and Health Research
Vol. 2, No. 05; 2018
ISSN: 2581-3366
www.ijmshr.com Page 26
On table 1 are shown the results from the analysis done for the thyroid hormones before, during
and after the treatments. The patient has done 7 thyroid tests. The results are showing normalized
levels of TSH, fT4, Anti-TPO and Anti-TG.
Table 1. Thyroid hormone levels before and after the treatment
Date
19.04.17
09.05.17
22.06.17
13.09.17
10.01.18
30.03.18
18.06.18
TSH
(0.3-3.6)
16.9
14.3
7.07
5.42
4.76
8.88
4.11
T3
(76.3-
220.8)
124
/
/
/
/
82.5
/
T4
(4.5-12.6)
7.03
/
/
/
/
/
/
fT4
(0.8-1.7)
0.70
/
0.767
0.873
0.78
/
1.16
Anti-TPO
(1-16)
/
180
/
139.1
363.8
113
75.4
Anti-TG
(5-100)
/
871.4
/
563.9
315.2
202
86.9
On table 2 shown the results from the sperm tests done before and after the treatment.
The results from the test done before the treatment are showing sperms with a thick and cut
middle part and elongated perform amorphous heads; Reduced sperm binding, low level of
maturity and decreased physiological function of sperms; Low chance of fertilization. The
conclusion of the sample is: oligoasthenoteratozoosperm, moderate degree of oligo zoosperm
and leukocyte to sperm.
Results that is not included in table 2:
Anti-sperm bodies in seminal plasma 168.56 U/ml (normal <60)
International Journal of Medical Science and Health Research
Vol. 2, No. 05; 2018
ISSN: 2581-3366
www.ijmshr.com Page 27
Hyaluronan Binding Assay (HBA) 42.00 (good bonding >80%, middle-bound 60-80%,
reduced bonding <60%).
Chlamydia Trachoma is IgG 5.6 U/ml (N<20)
Chlamydia Trachoma is Ig A 2.3 U/ml (N<20)
Table 2. Sperm test results done before and after the treatment
Date
22.06.18
Ref. Value
Appearance
Light gray opalescent
viscose material
Light gray
opalescent viscose
material
Volume
1.6
> 1.5 ml
pH
8.0
> 7.2
Concentration
45.0
> 15x106 ml
Total sperm count
72.0
> 39x106 ml
Mobility
65% fast mobile
15% slow mobile
10% mobile in place
10% immobile
>32% fast and slow
moving
>40% total mobile
Morphology
90% with normal
construction
5% with change of the
morphology of the
head
5% with angular
flagella
With normal
construction:
>14 with normal
finding
5-14 with good
prognosis
<4 with bad
prognosis
Vitality
95% with intact
membranes
>58% with intact
membranes
International Journal of Medical Science and Health Research
Vol. 2, No. 05; 2018
ISSN: 2581-3366
www.ijmshr.com Page 28
Leukocytes
0.5
<2.0x106 ml
Liquefaction
complete without
presence of mucous
filaments
Agglutination
moderate degree
Viscosity
normal
The results from the test done after the treatment are showing ejaculate with complete
liquefaction without the presence of mucous filaments, oligo zoosperm or as the no sperm is not
detected (only moderate degree of agglutination of the sperm). The ejaculate is of a boundary
volume and of a normal viscosity. No increased presence of leucocytes is observed.
Hypothyroidism has a big impact on the male infertility and affects the sperm parameters and the
erectile function. Men with hypothyroidism have lower amount of morphologically normal
sperms. This abnormality might be effect of the thyroid hormones on the sperm cytoskeleton.
The sperms may have deformed heads and greatly reduced potential for fertilization. Also the
motility is decreased and the levels of estradiol and testosterone are reduced. [5-8]
By the terms of TCM, in men with hypothyroidism with chronic Kidney Yang Qi deficiency
infertility and impotence may manifest. [9] Therefore the a cupoints in the treatment are chosen
with aim to help the patient to improve the thyroid and reproductive function, warm the
meridians, remove the blockages, replenish the Yang Qi, tonify the Spleen and Kidney, remove
Liver Qi stagnation, remove the phlegm, lift the clear Yang, warm the Kidney Yang and balance
the Yin and Yang. [4] [10] [11] [12]
Conclusion
Acupuncture as a treatment for hypothyroidism and secondary complications can give very
satisfying results with a high percentage of efficiency and success. The treatment is long-term
and careful monitoring of the patient's condition is required.
References
Beng LL; Lack of yin and yang together can trigger hypothyroidism; 2016 [www.asiaone.com]
Abbate S; The Early Diagnosis and Treatment of Hypothyroidism; Acupuncture Today July,
2001, Vol. 02, Issue 07
Liu W; Safe and effective treatments for thyroid disorders; 2009 [www.tcmpage.com]
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Panthi S, Gao T; Diagnosis and management of primary hypothyroidism in Traditional Chinese
Medicine (TCM) and Traditional Indian Medicine (Ayurveda); Int J Clin Endocrinal
Metab 1 (1): 009, 2015
Kumar A, Shekhar S, Dhole B; Thyroid and male reproduction; Indian J Endocrinal Metab. 2014
Jan-Feb; 18(1): 2331.
Krassas GE, Pesticides N, Deligianni V, Miras K; A prospective controlled study of the impact
of hyperthyroidism on reproductive function in males; J Endocrinal Metab.
2002;87:366771
Corrales-Hernandez JJ, Miralles-Garcia JM, Garcia-Diez LC; Primary hypothyroidism and
human spermatogenesis; Arch Androl. 1990;25:217.
Nikoobakht MR, Aloosh M, Nikoobakht N, Mehrsay AR, Biniaz F, Karjalian MA.; The role of
hypothyroidism in male infertility and erectile dysfunction; Urol J. 2012
Winter;9(1):405-9.
Malikov D; Traditional Chinese Medicine Approach to Hypothyroidism; Int J Complement Alt
Med 5(1): 00142. DOI: 10.15406/ijcam.2017.05.00142
Arosvska B, Zhu J, Kozovska K; Case Report: Acupuncture Treatment for Hypothyroidism;
Imperial Journal of Interdisciplinary Research (IJIR) Vol-2, Issue-5, 2016
Arsovska B, Zhu J; Thyroid disorder: treatment with acupuncture; Int J Sci Rep. 2017
Jul;3(7):227-229
Kecskes AA; Traditional Chinese Medicine and Thyroid Disease; 2018
[www.pacificcollege.edu]
... [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] ...
... 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] ...
... [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] ...
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Spermatogenic function was studied in 10 patients, previously diagnosed as having primary hypothyroidism, in whom a state of hypothyroidism has been induced by discontinuation or a decrease in treatment with levothyroxine over at least one spermatogenic cycle. Most of the patients had fathered children before the study. When the results obtained in the hypothyroid state were compared with those from a group of 16 controls with proven fertility, slight anomalies were observed; these were characterized by a decrease in seminal volume (p less than 0.05), progressive forward motility (p less than 0.01), and the cumulative percentage of mobile forms (p less than 0.01). There were no anomalies in sperm density or in the percentage of spermatozoa with normal morphology. No alterations in circulating levels of testosterone and gonadotropins existed. Induction of hypothyroidism did not lead to seminal or hormonal modifications compared with the same patients in a situation of euthyroidism. Short-term postpuberal hypothyroidism did not cause seminal alterations sufficiently intense to induce male infertility.
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The aim of this prospective controlled study was to ascertain the effect of hyperthyroidism on sperm quality and composition. We studied 23 thyrotoxic male patients, aged 43.8 +/- 2.4 yr (mean +/- SEM), and 15 healthy male controls of approximately the same age (42.2 +/- 2.2 yr). Two semen analyses at intervals of 2-3 wk were obtained before and about 5 months after euthyroidism was achieved either by methimazole alone (14 patients) or (131)I plus methimazole (9 patients). Total fructose, zinc (Zn), and magnesium (Mg) were also measured in seminal plasma in 16 patients, because 7 had semen volume less than 2 ml. In the control group semen analysis was performed only once. Mean (+/-SEM) semen volume was within normal range both in patients (3.3 +/- 0.2 ml) and controls (3.5 +/- 0.4 ml; P = NS). Mean sperm density was lower in patients, although the difference compared with controls did not reach statistical significance (35.7 +/- 5.3 vs. 51.5 +/- 6.1 x 10(6)/ml; P = 0.062). The same was found with sperm morphology (68 +/- 7% vs. 78 +/- 8%; P = NS). Finally, mean motility was lower in thyrotoxic males than in controls (28 +/- 8% vs. 57 +/- 7%; P < 0.01). After treatment, sperm density and motility improved [35.7 +/- 5.3 vs. 43.3 +/- 6.5 x 10(6)/ml (P = NS) and 28 +/- 8% vs. 45 +/- 7% (P < 0.05), respectively], but sperm morphology did not change (68 +/- 7% vs. 70 +/- 6%; P = NS). Mean values for fructose, Zn, and Mg did not differ between controls and patients either before or after achievement of euthyroidism [9.2 +/- 0.7, 3.0 +/- 0.5, and 4.2 +/- 0.7 nmol/liter vs. 8.6 +/- 0.9, 3.0 +/- 0.5, and 4.7 +/- 0.8 nmol/liter (patients before) and 9.1 +/- 0.7, 3.1 +/- 0.6, and 4.5 +/- 0.9 nmol/liter (patients after treatment) for fructose, Zn, and Mg, respectively]. Moreover, according to the treatment given, no statistically significant differences were found before or after treatment. Finally, seminal plasma fructose, Zn, and Mg levels did not correlate with sperm parameters or with pretreatment thyroid hormone levels. In conclusion, the results of our study indicate that male patients with hyperthyroidism have abnormalities in seminal parameters, mainly sperm motility. These abnormalities improve or normalize when the patients become euthyroid. Restoration of sperm parameters was independent of the treatment provided for the hyperthyroid syndrome. Moreover, seminal plasma elements, such as fructose, Zn, and Mg, did not correlate with sperm density, motility, or morphology.