International Journal of Health Sciences and Research
Vol.13; Issue: 6; June 2023
Website: www.ijhsr.org
Case Report ISSN: 2249-9571
Homoeopathic Management in a Case of
Gynecomastia and Hyperthyroidism
Dr. Mousumi Das1, Dr. Dileep Kumar Verma2
1
Assistant Professor, Dept. of Practice of Medicine, Noble Homoeopathic College and Research Institute,
Junagadh, Gujarat
2
HOD, Professor, Dept. of Practice of Medicine, Noble Homoeopathic College and Research Institute,
Junagadh, Gujarat
Corresponding Author: Dr. Mousumi Das
DOI: https://doi.org/10.52403/ijhsr.20230635
ABSTRACT
Gynecomastia is the term used to describe the benign growth of glandular breast tissue in men. Males
of any age, from infancy to old age, can be affected by it. It is explained by the formation of breast
tissue that is larger than 2 cm. Nearly all cases are physiological, however it's critical to identify
pathological causes because they require specialised care or treatment. Up to 70% of all boys and up
to 2/3 of all adult males develop pubertal gynecomastia, which can be felt when being examined.
Physiological gynaecomastia is usually seen in newborns, adolescents, and older men. A case of a 20
year old boy is presented here who was presented with pathological gynaecomastia and
hyperthyroidism was treated with individualised homoeopathic medicine. The gynaecomastia and
hyperthyroidism disappeared within a short period of treatment with general improvement of the
patient.
Keywords: Physiological Gynecomastia, Pathological gynecomastia, Repertorisation, Individualised
homoeopathic medicine.
INTRODUCTION other areas on the chest wall, gynecomastia
Gynecomastia is described as a benign, can be distinguished from lipomastia,
unilateral or bilateral enlargement of commonly known as fatty breasts or
glandular breast tissue in men. It occurs in pseudogynecomastia2. Gynecomastia is
newborn, pubertal, and elderly males, which present in 60–90% of neonates and
signifies a trimodal age distribution. During generally settles spontaneously in less than a
puberty 50 to 60% boys experienced few weeks. Almost 60% boys during their
Gynaecomastia which is generally bilateral puberty age of 14 develop gynecomastia.
and perhaps asymmetric in size. Almost all However, in most cases this settles down
cases are physiological; It has been within a span of a few months. By the age
observed that physiological gynecomastia of 19, the prevalence of the disease remains
get resolved within 6 months to 2 years after at 5–15% only. After puberty, gynecomastia
onset. Persistence indicates the presence of occurs in 33-41% of normal males aged 25-
a pathological condition which requires a 45 and in 55-60% of males over 50 years of
specific treatment1. By comparing the age. Gynecomastia is strongly associated
location of the subareolar tissue on with the existence of obesity3. Gynae
palpation to the adjacent subcutaneous denotes “woman” and mastos denotes
adipose tissue in the anterior axillary fold or “breast” in Greek3.
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Dr. Mousumi Das et.al. Homoeopathic management in a case of gynecomastia and hyperthyroidism
Causes of gynecomastia4
Physiological factors Aging or Puberty
Endocrine tumours Pituitary, Adrenocortical and Testicular tumours, or ectopic hCG-secretion.
Endocrine dysfunctions Hyperthyroidism, Hypogonadism, Obesity or refeeding
Non-endocrine diseases Renal failure or HIV and Cirrhosis,
Drug-induced factors Medications, illicit drugs or anabolic steroids.
Idiopathic factors
Physiological Gynecomastia5: • Estrogen-secreting tumors: The most
Physiological gynecomastia occurs soon common clinical manifestation of
after birth in both sex due to high level of adrenal tumour is gynecomastia in
estradiol and progesterone during adults. The symptoms of excess
pregnancy. These hormones stimulate breast mineralocorticoid and presence of an
tissue in the neonates. Another pathway is abdominal mass along with weight loss
neonatal surge of gonadotropins and raised indicate gynecomastia. In case of
conversion of steroid hormone precursors to testicular cancer gynecomastia may be
sex steroids. It can carry on for a few weeks the first sign7.
after birth. Puberty creates secondary • Non-estrogen-secreting tumors7:
conditions in which gynecomastia can Different types of neoplasms have the
occur. Gynecomastia is a common symptom potential to produce gynecomastia by
occurring in healthy aged people due to increasing the rate of human chorionic
increased aromatase activity. gonadotropin (hCG). This includes
choriocarcinoma, gastric carcinoma,
Non physiological Gynecomastia renal cell carcinoma, and gastric
• Persistent pubertal gynecomastia: carcinoma. The aromatase activity in the
Additional evaluation is recommended if Leydig cells increases due to high levels
physiologic gynecomastia persists after of hCG hormone which results in excess
2 years or after age 17. Use of drugs or E2.
substances related to gynecomastia or
other disorders may be a factor6 CASE PROPER
• Cirrhosis: Liver damage can impair Patient details:
hepatic degradation of estrogen and A 20-year-old Muslim boy with low
increase levels of sex hormone-binding socioeconomic status reported to NIH OPD
globulin, leading to elevated peripheral on 8th February 2019 with unilateral
estrogen6. enlargement of breast with hyperthyroidism
• Chronic renal insufficiency: for 1 year. Slight tenderness present in the
Malnutrition occurs in up to 40% of right sided breast. No nipple discharge
patients with renal failure and may present, no overlying skin changes noticed,
contribute to gynecomastia in men. no testicular swelling and masses have been
Although dialysis ameliorates noticed. No history of undescended testis
gynecomastia caused by malnutrition, and any kind of viral infections (i.e.
only renal transplantation eliminates mumps). Now no modern medication should
nutritional and hormonal causes of be undertaken. The patients should be
gynecomastia6. interviewed alone to assess potential illicit
• Primary hypogonadism: Gynecomastia drug use. The patient had unexpected
may be the only symptom in men with weight loss for the last 8 months, from 65
primary hypogonadism6. kg to 54 kg, and profuse sweating over the
• Hyperthyroidism: Gynecomastia back, face, neck. Excessive hair fall starts
occurs in 10-40% of men with from the last 4 to 5 months. Gets irritated
hyperthyroidism, but it is rarely the only easily. Feeling overtired and strong desire
symptom6. for sleep for the last 3 to 4 months.
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Dr. Mousumi Das et.al. Homoeopathic management in a case of gynecomastia and hyperthyroidism
PAST HISTORY: History of typhoid 7 6. Difficulty in comprehending.
years ago.
General survey: No anaemia, cyanosis,
FAMILY HISTORY oedema, jaundice, or clubbing was noted
Paternal side: Uncle is suffering from clinically.
cirrhosis of liver and gynaecomastia. Her weight was about 54 kg. BP- 140/90
mm Hg, pulse- 78/min, respiratory rate-
Maternal side: Grandfather- Mentally 18/min.
disturb
Own side: NAD On examination: Tenderness present in
GENERALITIES right sided breast.
Physical general
Appetite: Increased. Cannot tolerate Diagnosis: Pathological gynaecomastia
hunger. with hyperthyroidism.
Thirst: Moderate, 2-3 litres/day. Analysis and evaluation of symptoms:
Desire: Egg, sweets, warm food. 1. Cannot tolerate contradiction.
Aversion: Meat 2. Desire for company.
Intolerance: Nothing particular 3. Fear of darkness.
Tongue: Clean and moist. 4. Fear of ghosts.
Stool: Passes irregularly and hard in 5. Gets irritated easily.
consistency. 6. Difficulty in comprehending.
Urine: Normal 7. Chilly patient.
Sweat: profuse sweating over the neck, 8. Desire for eggs and sweets.
back, face. 9. Aversion for meat.
Sleep: Sound. 10. Sweat so profuse on face, back, neck.
Dreams: Nothing particular. 11. Stool too hard in consistency.
Relation with hot and cold: Chilly patient 12. Excessive hair fall.
Mental general Miasmatic Analysis:
1. Cannot tolerate contradiction. All the presenting symptoms were subjected
2. Desire for company. to miasmatic analysis with the help of
3. Fear of darkness. comparison of the chronic miasms. This
4. Fear of ghosts. shows the mixed miasmatic with
5. Gets irritated easily. predominance of psora.
Repertorialsheet8,9:
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Dr. Mousumi Das et.al. Homoeopathic management in a case of gynecomastia and hyperthyroidism
RESULT Prescription: On the basis of the totality of
Repertorization was done using Kent’s symptoms, Lycopodium 30C was
repertory in RADAR software (Version prescribed. Placebo was administered for 1
10.0.08), Lycopodium clavatum covered the month.
maximum number (11) with maximum
marks (29). It was prescribed after Advice: Blood for TSH
consultation with Homoeopathy Materia
Medica and led to great results. Follow ups:
Sr. No. Date Medicine Follow ups
1. 08/02/2019 Lycopodium
Clavatum 30
2. 20/03/2019 Lycopodium Breast returns in normal shape, Fatigue reduced. Weight reduction steady
Clavatum 200
3. 25/04/2019 Placebo Excess hair fall stopped. TSH returns to normal levels.Consistency of
stool was better than previous. Weight reduction is steady.
4. 28/05/2019 Placebo No recurrence of any symptoms.
Fig.1: Before treatment Fig. 2: After treatment
Fig. No.3 – Before Treatment
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Dr. Mousumi Das et.al. Homoeopathic management in a case of gynecomastia and hyperthyroidism
Fig. 4: After treatment
DISCUSSION evaluating the symptoms, validating with
After taking a detailed case history and the knowledge of Materia Medica10. Overall
repertorisation, Lycopodium clavatum 30C improvement is obvious through
was given as a constitutional medicine, photographic evidence. Thus, this case
marked improvement reappeared within 30 report identifies the role of individualised
days, followed by overall improvement in homoeopathic medicine in gynaecomastia
the other symptoms. The same medicine with hyperthyroidism.
was repeated. The repertorisation was done
and after evaluation, based on the CONCLUSION
knowledge of Materia Medica, Lycopodium Homoeopathic medicines have sufficient
clavatum were the most similimum potential to improve the gynaecomastia of
remedies. Lycopodium clavatum was patients, reduce hyperthyroidism and limit
selected as the first prescription after disease progression without any systemic
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Volume 13; Issue: 6; June 2023
Dr. Mousumi Das et.al. Homoeopathic management in a case of gynecomastia and hyperthyroidism
side effects and can be used curatively. safe 197. https://doi.org/10.1590/s1516-
as a holistic treatment. However, this was a 31802012000300009
single case study and required a randomised 5. Swerdloff RS, Ng CM. Gynecomastia:
controlled trial that could be replicated for Etiology, Diagnosis, and Treatment.
future scientific validation. [Updated 2019 Jul 7]. In: Feingold KR,
Anawalt B, Boyce A, et al., editors.
Endotext [Internet]. South Dartmouth (MA):
Declaration by Authors MDText.com, Inc.; 2000-. Available from:
Acknowledgement: None https://www.ncbi.nlm.nih.gov/books/NBK2
Source of Funding: None 79105/
Conflict of Interest: The authors declare no 6. Dickson, Gretchen. (2012). Gynecomastia.
conflict of interest. American family physician. 85. 716-22.
7. Sansone, A., Romanelli, F., Sansone, M.,
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