Exploring the aspect of psychosomatics in hypothyroidism: The WOMED model of body–mind interactions based on musculoskeletal changes, psychological stressors, and low levels of magnesium

Abstract

Patients with hypothyroidism can present a series of so-called residual symptoms which are said to be without physical pathology. These symptoms, however, affect negatively the well-being state of these patients. Currently there are no explanations for this situation.

Based on previous investigations done with thyroid disease patients we have carried out a clinical examination which is centered on musculoskeletal features together with a simple evaluation of psychological stressors (scaled 1–3). Laboratory diagnosis was focused on serum magnesium. This report includes the data from 166 women including 58 euthyroid controls (six males) and 108 patients with hypothyroidism (eight males).

The most common complaints seen in our patients included fatigue, being easily tired, concentration deficit, ankle instability, and gait insecurity, giving way of the ankle, muscle cramps in the shanks, visual disturbances, irritability, and vertigo sensation. Besides this symptomatology a great majority of the patients (89.5%) presented musculoskeletal alterations. The main finding was that of lateral tension which entails an eccentric muscle action of the affected lower extremity. Lateral tension was always accompanied by (forward) rotation of the hemi-pelvis of the affected side. Idiopathic moving toes were found to be independent of lateral tension. Stress scores in patients were higher in patients than in the control group. Serum magnesium levels were significantly lower in patients (0.87 ± 0.1 mmol/l vs. 0.92 ± 0.07 mmol/l, p = 0.041) and showed a trend toward an inverse correlation to the intensity of lateral tension as well as to the stress score. Patients having magnesium levels below 0.9 mmol/l received 3× 1.4 mmol daily of elemental magnesium in the form of 400 mg of magnesium citrate. In cases presenting stress scores of 2 or 3 a relaxation treatment procedure was included in the treatment. This treatment was extended to the use of acupuncture on points of the Triple Burner meridian. Treatment success was observed in 90% of cases, i.e. residual symptoms were no longer present and patients reported an improved feeling of well-being.

We hypothesize that magnesium deficit is facilitated by the presence of physical and psychological stressors. This condition has the potential to negatively influence the function of Complex V of oxidative phosphorylation which relies on magnesium-ATP. Reproductive processes, which have high energetic requirements in women, could thus be affected. The disappearance of the so-called psychosomatic symptoms after our therapeutic scheme brings a new light into this field of medicine and it stresses the importance of holistic handling. Understanding of body–mind interactions is explained by discussing thermodynamics, noesis, Salutogenesis and Resilience, and shamanism.