AKOM News
Contributed by Dr. Jewon Lee, Director of BM Korean Internal Medicine Clinic
: Peering into Internal Medicine, 31st
2026. 6. 11.
"The essence of a doctor lies in 'diagnostic authority.' A Korean Medicine physician who combines modern diagnostic tools with holistic insight is already a universal doctor recognized by the world."
1. "My jaw and shoulders are stiff, and I haven't had my period for 4 months."
A foreign resident receiving treatment for diabetes and fatty liver at our clinic asked me to examine his daughter, who was visiting Korea.
The 16-year-old female patient had developed an unconscious habit of clenching her teeth about two years ago.
The tension spread from her temporomandibular joint (TMJ) to her neck and shoulders, causing severe pain.
Moreover, her menstrual cycle, which had been irregular since her first period at 13, had completely stopped for the past four months (amenorrhea).
Although her stay in Korea was short, her father wanted a deep, comprehensive diagnosis from an Internal Medicine specialist.
2. Medical History: Diagnosed with 'Hashimoto's Thyroiditis'
Upon detailed history taking, the patient revealed she had been taking levothyroxine (thyroid hormone) for 3 to 4 years after being diagnosed with 'Hashimoto's thyroiditis' in her home country.
Her diet mainly consisted of oatmeal and bread, and she enjoyed sweet snacks after meals.
Her body composition analysis showed her BMI was within the normal range.
3. The Inner Side of Symptoms Revealed by Objective Tests
To evaluate her condition objectively, we actively utilized modern diagnostic tools.
- Thyroid Ultrasound: Contrary to the diagnosis in her home country (which claimed her thyroid was half the normal size), her thyroid volume was in the top 14% for her age. However, coarse echotexture and decreased echogenicity—typical signs of Hashimoto's—were observed.
- Blood Tests: Thyroid autoantibodies (Anti-TPO Ab, Thyroglobulin Ab) were elevated, and TSH was high, indicating subclinical hypothyroidism.
- Inflammation and Metabolic Markers: The hs-CRP level (an inflammation marker) was significantly elevated at 11.16 mg/L, and HOMA2-IR (insulin resistance) was 1.58, suspecting lowered insulin sensitivity. Low estrogen levels also strongly suggested dysfunction in the hypothalamic-pituitary-ovarian (HPO) axis related to her amenorrhea.
Figure 1. Thyroid Ultrasound of a 16-Year-Old Female Patient.
(A) Right lobe transverse view, (B) Right lobe longitudinal view, (C) Left lobe transverse view, (D) Left lobe longitudinal view. Shows decreased overall echogenicity and a coarse, heterogeneous echotexture of the thyroid parenchyma, which are common ultrasound findings in Hashimoto's thyroiditis.
Figure 2. Distribution of the Patient's Total Thyroid Volume Compared to a Pediatric and Adolescent Cohort by Age.
Applying the Brunn formula (correction factor 0.479) after 3-axis ultrasound measurement, the patient's total thyroid volume was calculated at 10.14 mL. Compared to the thyroid volume distribution of a control group of the same age (16-year-old females), the patient's volume corresponds to approximately the 86th percentile (top 14%). This result contradicts the assessment by the medical staff in her home country that the thyroid had "atrophied to about half the size of a normal person."
Table 1. Initial Diagnostic Laboratory Test Results of the 16-Year-Old Female Patient.
Confirmed subclinical hypothyroidism due to Hashimoto's thyroiditis, indicated by elevated thyroid autoantibodies (Anti-TPO Ab, Thyroglobulin Ab) and increased TSH. The elevated hs-CRP suggests increased inflammatory activity in the body, while the elevated HOMA2-IR suggests possible lowered insulin sensitivity. The decreased estrogen (Estradiol) level suggests a potential dysfunction of the hypothalamic-pituitary-ovarian (HPO) axis related to the amenorrhea symptom.
In Korean Medicine, these findings indicated a Damp-Heat Pattern (Seup-yeol-jeung / 濕熱證), a state where pathological heat and inflammatory moisture accumulate in the body.
4. Holistic Insight Piercing Through Fragmented Symptoms
Her condition was not something that could be resolved simply by 'treating the TMJ and adjusting the thyroid medication dose'.
The fragmented symptoms—amenorrhea, TMJ pain, and Hashimoto's thyroiditis—were chain reactions stemming from a single root: 'a complex metabolic dysfunction intertwined with chronic inflammation, lowered insulin sensitivity, and immune system abnormalities.'
When I explained the inner workings of her symptoms comprehensively based on the holistic perspective of Korean Medicine, her father expressed deep trust, exclaiming, "Gorgeous! She never received such a detailed explanation back home."
5. A True Doctor Fusing Modern Science and Traditional Wisdom
I advised the patient not to be buried in the name of the disease but to look at the root cause.
For her TMJ and shoulder pain, we performed immediate acupuncture and Chuna manual therapy, which brought immense satisfaction.
To help her recover her metabolic function upon returning home, we prescribed herbal medicine based on Soyosan (逍遙散), which harmonizes hormones and relieves stress.
We also issued official English medical certificates and prescriptions so she would have no issues at immigration.
Korean Medicine physicians are not beings stuck in the past, bound by the prejudice that 'they cannot use the products of modern science.'
We are universal doctors who objectively evaluate clinical phenomena through modern diagnostic tools (Science), interpret that data with a holistic perspective (Art), and offer optimal treatments without limitations on tools.
As 'true primary care physicians for chronic diseases,' Korean Medicine physicians will fulfill the mission of restoring healthy freedom to patients around the world.
▼ You can see the full content on AKOM News.▼
Peering into Internal Medicine 31 - AKOM News
"My jaw and shoulders are stiff, and I haven't had a period for 4 months"
The essence of a doctor lies in 'diagnostic authority.' A Korean Medicine physician who combines modern diagnostic tools with holistic insight is already a universal doctor recognized by the world.
www.akomnews.com
