This month I would like report on what might seem to be a minor problem but take the time to explore what might be behind it.
A 60 year old woman, a retired operating room nurse and cattle farmer's wife, presented with pain in her left ankle. The pain had begun without any preceding history of recent trauma or strain but had followed a day when she had been (in cold weather) on her feet on pavement for most of the day. She had been helping prepare for a parade in her local community.
In other words, she was a vigorous, healthy woman who had developed a mysterious medial ankle pain. Her family physician had investigated with an x-ray, but nothing came of it.
In the background, her husband of many years was suffering from chronic renal failure. He also had been a vigorous man, as one needs to be, cattle-farming in a northern Canadian climate. I knew both him and his wife well. They both had optimistic dispositions and an appetite for life.
Examining her ankle, there was tender swelling just below the medial malleolus. The ankle had full range of motion, and there was no sign of somatic dysfunction of the distal fibula, .i.e. restriction of motion at the distal talo-fibular joint. The ankle swelling extended somewhat posteriorly and anteriorly to the most painful spot, under the medial malleolus. My diagnosis was tenosynovitis of the tibialis posterior and/or flexor digitorum longus tendons.
But why should this have developed with no trauma of strain? There must be a systemic factor (or two). Further questioning revealed that the patient was having breast tenderness and some nodularity of the breast tissue. She also had noticed some drop in her energy.
In my experience, breast cysts, or increased density of the tissues (fibrocystic disease) is always connected to iodine deficiency. I learned this from the late professor William Ghent of Queen's university in Canada. Years ago, I had contacted him (even though he was a surgeon) because of unexplained iodine deficiency in my sheep flock. He was from a farm family in Saskatchewan on the Canadian prairies, so knew something about animal husbandry and the close connection with health and nutrition in livestock. He also had been a surgeon on Canada's east coast; later moved to central Canada and noticed a marked difference in the incidence of breast cysts. They were rare near the seacoast, but common far from the ocean. In his research (with Dr. Bernard Erskin of the Medical College of Pennsylvania), the connection with iodine with breast disease was discovered.
Iodine deficiency used to be common in North America but had been almost abolished by adding iodine to table salt. This has changed in recent years with the low-salt diet fad (promoted by the government and the medical authorities). As a result, iodine deficiency is becoming more and more common, but sadly undiagnosed by most physicians.
In my patient's case, as a nurse and loving wife, she was preparing all her husband's food, which was (naturally) low salt and deficient in many other nutrients because of his renal failure. For convenience sake she ate the same food as her husband; hence low salt, low iodine, and the resultant changes in her breasts.
There is another nutrient deficiency that shows up in connective tissue disorders of the extremities and that is vitamin B6. Tendonitis, tenosynovitis, "trigger finger" (a snapping and sudden release of the finger tendons) and even carpal tunnel syndrome are often found to be associated with vitamin B6 deficiency. Trigger fingers can avoid surgery and be successfully treated with two or three months of vitamin B6 200 mgm/day.
In my patient, autonomic response testing indicated her to be both iodine and vitamin B6 deficient. In addition, the tenosynovitis responded as if it were an interference field. My treatment therefore began with quaddles of dilute procaine injected every 2 centimeters into the skin over the inflamed tendons. I also prescribed SSKI (supersaturated iodine) 5 drops in a glass of water each day, and vitamin B6 200 mgm/day.
Three weeks later my patient returned and reported that the pain had suddenly disappeared on "day 11".
One might wonder if the sudden response was from the neural therapy, although an 11-day interval seems long. (4 or 5-day latency is not uncommon in my experience, especially when obvious inflammation is present.) Yet a sudden response to the nutritional prescription would also be unusual. Or perhaps the three different therapies potentiated each other?