B: Goiter

Question 0

Where does the Dz occur on the body?

Answer 0

Neck

Question 1

Goitre is part of which Dz?

Answer 1

Hyperthyroidism

Question 2

What causes Goitrer?

Answer 2

Lack of iodine - esp lack of sea products
OR
Inability of body to utilize iodine present in diet

Question 3

How big can Goitre get?

Answer 3

Over 10 kg

Question 4

Which other Dz does Goitre sometimes combine with?

Answer 4

Hyperthyrodism

Question 5

TCM Causes of Goiter

Answer 5

1. Stress —> Liv Qi Stag—> D-Ph & Bl Stasis
   usually quick tempered and highly stressed folks
2. Irregular Diet —> Sp St—> Ph-D
3. Constitution —-> Women (babies, etc) stresses liver —>use up iodine during pregnancy/ etc—> goitre
4. Constitution —> Yin Xu—> Xu Fire Flares Up/ Qi Stag–> Goiter

Question 6

3 elements to Goitre

Answer 6

Qi Stagnation, Phlegm, Blood Stasis

Question 7

Diagnosis and Differentiation of Goitre:

Answer 7

1 - big neck - palpation will show it’s swollen
2 - thyroid Fx test
3 - rule out swollen lymph nodes / tuberculosis in Lymph nodes
best to check from behind the patient so that hands are on thyroid gland, then ask patient to swallow… the thyroid gland will go up and down, allowing you to differentiate between thyroid and glands. Location of Thyroid gland is around St 9

Question 8

If combined with Hyperthyroid:

need to Ddx between:

Answer 8

Diabetes - because they’ll want to eat a lot

Question 9

Qi Ying (lumps)/ Goiter types
types

Answer 9

Blood Stasis (harder, fixed)
Stone (often cancer, hard as a stone)
Jing (tendon/vessels - varicose veins around it)
Rou (between Jing and Stone - texture is medium, like fresh meat)

Question 10

Differentiation types for Goitre

Answer 10

1. Shi vs Xu
   (Qi, Phelgm, Blood Stasis, Accumulation in neck are all Shi)
   (later, after Zheng Qi damaged and Yin damaged can have Yin and Qi Xu, especially Ht-Liv Yin Xu)
2. Heat or Cold
   (pulse, temperature, skin colour, metabolism
   (Heat= Liv Fire Flare up, or Ht-Liv Yin Xu –> Xu Fire Flares Up)

Question 11

Types of Goitre

check with Jiu Lin

Answer 11

1. Qi Stag + Phlegm Retention
   - LI 4, Lu 7, if severe St 36, 40, SJ 3, Ren 23
2. Deficiency Fire
3. Liver Fire Flare Up
   - UB 18, Liv 2, 3, GB 34,
4. Ht Liver Yin Xu
   - Ht 7, UB 15, 18, K 3

Question 12

Qi Xu pts for Goitre

Answer 12

Ren 6, UB 20

Question 13

Auricular Acupuncture:

Answer 13

Related organs:

+ endocrine, thyroid

Question 14

Plumb Blossom for Goitre:

Answer 14

Around Neck or C1-c7 bilateral topping from top to bottom, moderate stim, both front and back

Question 15

Diet for Goitre:

Answer 15

Eat more sea products, take iodine
Try to eat variety
Eat fresh food
Less spicy and greasy food
Decrease stress, regulate emotions
Avoid overexcitement
Qi Gong to help calm mind