Individualized Homoeopathic Management of Primary Hypothyroidism Evaluated by Zulewski Clinical Score: A Case Report

Hypothyroidism is a hypometabolic clinical state caused by either persistent insufficient thyroid hormone production or, less frequently, peripheral tissue resistance to thyroid hormone actions. Conventional management centers on lifelong hormone replacement with levothyroxine. Individualized homoeopathy offers a holistic constitutional approach aimed at stimulating physiological recovery. A 44-year-old premenopausal female presented with excessive hair fall, postprandial abdominal heaviness aggravated by milk, heartburn, dry cracked lips, upward heat flushes, and unsatisfactory bowel evacuation. Clinical assessment revealed an initial Zulewski’s Clinical Score of 4. Baseline serum investigations showed an elevated TSH (9.39 µIU/mL) and low free T4 (0.886 ng/dL), confirming primary hypothyroidism. Based on a detailed totality of symptoms—emphasizing mental hurry, intolerance of consolation, irritability from domestic disorder, and classic gastrointestinal features—Kali carbonicum 200C was prescribed in infrequent single doses as needed. Over a 6-month period, the patient demonstrated steady clinical improvement, with the Zulewski score decreasing from 4 to 1. By the 6th month, repeat biochemical testing confirmed normalization of thyroid function (TSH 4.81 µIU/mL, FT4 0.919 ng/dL, FT3 2.87 pg/mL). A long-term follow-up at 15 months revealed sustained biochemical euthyroidism (TSH 4.14 µIU/mL) without the need for levothyroxine substitution. Can conclude that Individualized constitutional homoeopathic intervention with Kali carbonicum successfully restored biochemical euthyroidism and produced lasting clinical remission in a premenopausal patient with primary hypothyroidism.