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Chronic fatigue and depressionCASE FROM THE CENTER
Chronic Fatigue and Depression
Hugh D. Riordan, M.D.1 and Dr. James A. Jackson2
The patient is a 55 year old female, married she had been taking thyroid for two years, "not with three adult children and is employed as an because it was low, but because it might help!" elementary school teacher. She had been seen The psychological evaluation revealed the previously by numerous physicians for treatment patient had signs of severe, agitated depression of long standing "depression". Just prior to her with a high level of fear and panic. Laboratory first visit to The Center she was under the care of test results showed the CBC, urinalysis, Candida a psychologist and a psychiatrist. IgG antibody titer, vitamin B1, A, C, E, folate, B12 On her first visit she listed the following and buffy coat vitamin C in the accepted complaints: "depression, shakiness, sleeplessness, reference range. A cholecystography examination head and body aches, dry mouth, indigestion, revealed a normal gall bladder. A glucose stomach cramps and gas, anxious, fatigue, job tolerance test was borderline for hyhpoglycemia, stress, dizziness, fluid retention, swollen eyes, however, the fructosamine, glucose and A.M. popping ears, chills, night sweats, cold hands and Cortisol levels were all within the reference feet, dry coarse skin, hair loss and no energy." ranges. Thyroid function tests were also normal. When asked to list her most dominant feelings The urine vitamin C screen was "0" mg/dL. Dur-two weeks prior to her visit she list ing her Center visits, three different hair analyses "helpless/hopeless, panic, anger, anxious and were done for trace and toxic minerals. The first frustrated". Two years ago her problems became hair analysis showed elevated levels of sulfur and so severe she had to take three months sick leave magnesium and low levels of phosphorus, copper from her teaching position. Just prior to her visit, and zinc. Based on the physical, history and a psychologist advised her to quit her teaching preliminary laboratory results, a diagnosis of position to avoid stress. fibromyositis, depression and zinc deficiency was On her first visit to The Center, a complete made. She was initially treated with buffered physical examination, nutritional profile, psy- vitamin C, 1000 mg two times a day, zinc, 0.6 mL chological and mental evaluation and laboratory in juice or water once a day, niacinamide 500 mg tests were performed. In reviewing her past once a day and intravenous calcium. records, no evaluation of the patient's nutritional A second hair analysis a month after her first status was found. Only the basic laboratory examination showed elevated magnesium, barium procedures, CBC and urinalysis were performed and strontium and decreased levels of copper, on the patient. In addition to the history given zinc and phosphorus. The same treatment was above, she had the usual childhood diseases and a contained except her zinc intake was increased. tonsillectomy at four years of age. Her spouse, Her depression, shakiness, sleepiness, body aches children, siblings and parents were still living. and stomach cramps gradually decreased. A third She denied any history of smoking or alcohol use. hair analysis again showed a decreased zinc and She stated an allergy to sulfa drugs. elevated magnesium levels. Her zinc intake was A list of medications she was presently taking substantially increased. included: "Estertest, Bumex, Advil, Atarax Syrup, On her next visit (about six months after the Pepsid, Haldol, Prozac, Librium, B12 and Armour first visit) the patient stated that her physical and Thyroid". She stated mental conditions were much improved. Physical and psychological evaluations showed an 1. The Center for the Improvement of Human Functioning increased energy level, much less pain and a International, Inc., 3100 Hillside, Wichita, Kansas 67219. 2. Professor and Chair, Clinical Sciences Department, The Wichita State University, Wichita, Kansas 67208. Journal of Orthomolecular Medicine Vol. 7, No. 2, 1992 continued on zinc sufficient to correct her deficiency, together with other nutrients as described above. She has slowly been "weaned" from her long list of previous medications. The patient continues in her job and to improve with less pain, stress, anxiety and greatly improved mental outlook. This case illustrates the importance of the multifactorial approach to disease and the need for monitoring nutrient levels to insure adequate tissue uptake of what has been prescribed.
Nombre de la asignatura: Práctica Forense ICarga académica: 4 CréditosModalidad: SemipresencialClave: DER-439Pre-requisito: DER-324/ DER 325Fecha de elaboración: _______________Responsable de elaboración: _______________Presentado a: Lic. Luis A. Luna Paulino Directora Escuela de DerechoModificaciones:1ª: Fecha: Mayo, 2005 Responsable: Lic. Jaime King2ª: Fecha : ____________ Responsable: _