Red palms and the liver – what do they tell us?

by Dr Sandra Cabot

One of my middle aged female patients has had very red palms for many years. She also complained of weight loss, muscle weakness, a racing heart beat, fatigue and insomnia. She was very stressed and smoked cigarettes at night to cope with the stress. She did not understand why she was losing weight as she was eating more than normal. She had seen several doctors and they had checked her levels of oestrogen and told her that all her symptoms were due to menopause. She had come to believe that menopause was an awful experience and began questioning her friends to see if they were experiencing similar problems.

I decided that we needed to look deeper and I ordered thyroid function tests and an ultrasound scan of her liver. I was not surprised to find that she had liver disease, although her liver enzymes were only slightly elevated. What the ultrasound scan did show was a liver enlarged with multiple cysts and I could feel her hard enlarged liver when I examined her abdomen.

Her blood tests for thyroid function showed a very overactive thyroid gland, which explained her weight loss, racing heart beat, and insomnia and muscle weakness. Her blood tests revealed very high levels of the thyroid antibody known as TSH receptor antibodies and these were causing her over active thyroid gland – this autoimmune condition is known as Grave’s disease.

I commenced her on a course of medication (called Neomercazole) to reduce the production of thyroid hormone by her thyroid gland. If I did not do this, she could go into heart failure with her heart racing so fast. I also told her to avoid gluten containing foods and to start using stress management techniques such as exercise and meditation and to avoid smoking cigarettes.

When she returned 4 weeks later, the redness of her palms had decreased by 50% and she was very pleased by this, as she had always been embarrassed by her very red palms. Her thyroid function had improved and was now only slightly overactive.

She will always have to take special care of her liver, as she has a mild case of polycystic liver disease, but with nutritional medicine she should do very well. She provides an interesting case history, which illustrates how two separate and unrelated diseases, were masquerading as menopause.


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