When we discuss about inflammation, we have an overwhelming scenario in our mind. However, inflammation is body’s natural defense mechanism towards infection, injury or harmful stimuli. Everyone has little inflammation in our body and it is mandatory to have. When, it is too high or too low, it causes long -term effects in disease progression. High inflammation that is left untreated for a prolonged time period may harm our immune system as well as organs. Internal inflammatory environment is favorable to grow any kind of disease and fuel it to disease progression. Ringworm is a fungal infection and caused by mold like parasite (dermatophytes), which live in dead skin, hair. It is a contagious disease and is spread through pets, moist environment, when we use clothes or come in contact with infected person, contaminated surface, polluted water, too much sweating, dirty clothes spread infection fast.  It generally starts as round -shaped ring red, itchy skin. Well, anyone can develop it in lifetime. However, People with suppressed immune system like hypothyroidism, Graves’ disease, Type 1 and type 2 diabetes and rheumatoid arthritis, are more prone to get infected by ring worm. We will navigate a successful recovery of ring worm management case study, addressing inflammatory marker and other contributing factors.

Inflammation is a powerful biomarker of any kind of disease generation and it significant huge contribution in disease progression. We may be aware of that or may not. When inflammation is in peak, it energizes and fuels other factor to develop disease. So if we do not address the inflammation and jump to treat the disease, we may end up with 80% chances of re-occurrence of the disease. However, disease development and progression starts with leaving inflammation untreated for long time. Visceral fat is available for everyone. Even skinny people also have visceral fat. When someone has visceral fat exceeds normal limits and it has been ignored for long time (approximately 13-15 years) it causes serious inflammation inside our body and easy to fuel a disease. In my clinical experience, I have observed that people with chronic diseases like Cancer, Rheumatoid arthritis, psoriasis, and allergy issue are detected with elevated level of inflammation markers like ESR, CRP/ hsCRP, Ferritin level homocysteine. Again, there is a positive co-relation between homocysteine and B12 levels. When Vitamin B12 serum level is high approximately 560 pg/ml), Homocysteine level goes down. I have observed how inflammation fuels in disease generation and further strengthens its progression. Along with that, other contributing factor like Vitamin D deficiency, poor gut micro biome, parasite infection, grade 1 or grade 2 fatty livers, kidney issues, imbalance in electrolytes, cardiac risk marker and have significant impact in disease progression. 

Symptoms and causes of Ringworm development: 

Ring worm is a fungal infection caused by mold like parasite, which lives in our dead skin and hair. It is not caused by any kind of worm, though it gives vibes of worm infection, with its name. It grows in humidity, connection with pets, it is contagious in nature and so it spreads through infected person, sharing their clothes and other important goodies. It also develops from unhealthy and contaminated water, rotten food and unhygienic environment. It can appear in any part of body and causes small red, ring shape round circle with itchiness. People with suppressed immune system like type 1 and type 2 diabetes, hypothyroidism, rheumatoid arthritis, cancer and so on are more prone to develop ringworm. When immune system is weak and suppressed, it doesn’t do its work properly. As a result, we can catch any disease easily.

Parasite infection, hidden causes of several diseases:

Research evidence suggests that there is a strong chance of parasite infection behind several diseases. People with diabetes, thyroid issue, cancer, rheumatoid arthritis, autism, schizophrenia, depression-all of them are infected with parasite. This is one important contributing factor behind several diseases. It may manifests in formal way for few or it may manifest in different way. Even I have observed in my clinic, patients visit with autism, diabetes, hypothyroidism, cancer- most of the time they complain about grinding teeth specially at night, frequent hunger, vomiting, nausea, crumbling sound from stomach, dizziness. W.H.O has announced that there are three main parasite infections involved with stomach, bile, pancreatic, bladder cancer .They are- 1) Schistosoma haematobium infection, 2) Opisthorchis viverrini infection, 3) clonorchis sinensis infection. However, reality is beyond that mentioned 3 parasite infection, other kind of parasitic involvement is also there. It is quite reasonable and valid, since it is linked with gut micro biome. 90% of the population has dysbiosis and if we do not have balanced gut micro biome, no doubt it will fuel in parasite development.

Vitamin D deficiency, another unknown contributor of several diseases:

Vitamin D is not just a vitamin, it is like steroid hormone. It has influence over all of our physical system. It helps in regulating calcium absorption for strong bones, it reduces inflammation, strong command over immune system, it manages metabolic system, and it controls muscles and nerve function. People with metabolic diseases like blood sugar issue, hypothyroidism, skin issues like psoriasis, eczema, vitiligo; ringworm- mostly Vitamin deficient in Vitamin D. It is because Vitamin D inadequacy makes our immune system weaken and suppressed. Our immune system cannot perform its job properly. It has also remarkable impact in cardiovascular and mental health. Even Patients with high BP ,visits in my clinic always have vitamin D inadequacy and for mental issues it has a super power towards mood swing, depression, aggression. When I administer little high dose vitamin D to address the issue for short period of time, its therapeutic effect gives us much benefit. Metabolic diseases and skin issue: People with metabolic diseases like thyroid issue, blood sugar issue, Grade 1-4 Fatty liver issue – are prone to develop skin issue. When the blood sugar issue is just in initial stage, it manifests with any kind of fungal issues like Pityriasis Alba or ringworm. After performing full body assessment they found, Vitamin D deficiency along with elevated blood sugar level. Even for thyroid issue also skin problem is common symptom and again vitamin D deficiency is also another factor to be attributed. Few of them even develop Grade 1 Fatty liver and it confirms by USG abdomen and Pelvis. High allergy level, trigger of skin infection: Most of the skin issues have elevated allergy level. Allergy is an overreaction of immune system towards harmless substances of environment. When our immune system is little weak, it cannot properly identify which one is good and which one is bad. It over reacts on simple facts and manifest it through alarming signal like itching, swallowed, inflammation, runny nose, red eyes and so on. I have observed patients with skin issue have pretty elevated level of allergy level like 6500 IU/ml, 4000 IU/ml, and 3500 IU/ml and so on. One 35 years old lady visited with ringworm issue. For past 1 year she has visited from one Derma to another one without any hope. It was spread to her almost all body parts. After taking her case study, I asked her to run full body assessment test and I wondered when everything came positive as I suspected from that case study booklet. Her sugar level was elevated; allergy level was 3500 IU/ml, Vitamin D deficiency with serum level 16ng/ml, Grade -1 fatty liver, UTI issue. An individual case study of Ringworm re-occurrence and recovery upon addressing inflammation marker and other contributing factors

Patient name: Naya Patel

Age: 44 years

Gender: Female

Marital status: Married

Education: MBA

Complain about ringworm in right arm

Diagnosis: based on full body assessment

Case Study of Naya Patel:

 Naya Patel, 44 years old lady visited my clinic (Dr.Sabita’s Multispecialty Homeo Care (Cancer, Physical, Mental) Bangalore, India, with the complaint of Ringworm. Her right hand forearm had a small red color ring shaped circle with itchiness. It was quite red and itchiness was making thing worst. She was a hypothyroidism patient with low vitamin D serum level. When I enquired about the exact cause, she has informed that she had a Goa trip 1 week ago. Whole day she enjoyed in beach, spent time in boating and cloth got little wet. However, it dried up itself. She stayed with wet cloth from evening 4PM to early morning 1 AM. Though the cloth got dry, the humidity and the water stayed in body for long time. When she came back to hotel, it was almost 2 AM. After 1 week of the incident she saw one big red ring circle appeared in her right arm. She immediately visited my clinic. I ordered for full body blood work. However, she refused and asked me to just provide medicine for ringworm. I have provided her medicine for ring worm (SBL Arsenic Album 30+ SBL Sepia 30+SBL Tellurium 30+ SBL Bacillium 30)..Mixed all in 1 bottle in equal proportion and shaked it...4 drops 3 times, without water. I have provided her Allen derma plus ointment for external application. However, I was suspicious about re-occurrence. Medicine worked like magic since it was immediate case, no delay was there. Naya was very much happy with the result. Within 4 days it cleared up. So she has stopped the medicine without any notification.  After 1 week, it re-occurred in left hand wrist. She was wearing few bracelets and may be while taking bath, water was getting stuck there making that place wet for long time. She again got ring worm in that place in wrist and continued medicine for 2 more weeks and it cured.

Again 3rd time it re-appeared in left hand forearm and she continued the same medicine for 2 weeks and cured it. After 1 week, it reappeared again in left arm and she realized the importance of full body blood work. She visited my clinic and explained everything and asked me to figure it out. I ordered for full body blood work and her result was quite shocking. We have presented a full body blood work report with all most all parameters:

1. Hba1c: 5.2 %( normal: below 5.7%)
2. Fasting Blood sugar: 96.64 mg/dl( Normal: 70-100 mg/dl)
3. Postprandial  blood sugar:92 mg/dl(Normal: 70-140 mg/dl)
4. 25-OH Vitamin D( Total): 20.4 ng/ml ( Normal: 30-100 ng/ml)
5. Hemoglobin: 11.8 ( normal range: 12-15)
6. Vitamin B12: 453 pg/mL ( Normal: 197-771 pg/ml)
7. Homocysteine: 10.42 umol/L ( normal level: <15 umol/L)
8. ESR: 75 mm/hr ( normal: Female: 0-30 mm/hr)
9. hsCRP: <0.9 mg/L ( Normal: <1.0 mg/L)
10. Total IgE: 380 IU/ml ( Normal : <100 IU/ml)
11. Thyroid Profile: T3 : 98ng/dl ( Normal: 80-200 ng/dl)
12. T4: 5.37ug/dl (Normal: 4.8-12.7 ug/dl)
13. TSH: 12.2 ( Normal:0.54-4.30 uIG/mL)
14. Lipid Profile: Elevated LDL
15. Cardiac Risk Marker: 
16. A1 (APO-A1): 158 mg/dl (Female: 94-162 mg/dl)
17. B (APO-B):80 mg/dl (Female: 53-138 mg/dl)
18. APO B/ APO A1 Ratio (APO B/A1): 0.5 ratios (normal range: 0.38-1.14 ratio)
19. RA Quantity: <10 IU/ml( Normal: <18 IU/ml)
20. Electrolytes: Normal
21. Iron Profile with Ferritin: Everything is normal
22. Exception: Transferrin Saturation: 48%
23. (Normal: 13-45%)
24. Kidney Profile: BUN/Sr. CREATINE RATIO: 31.4 Ratio( Normal: 9:1-23:1)
25. UREA/ SR. CREATINE RATIO: 67.2 Ratio ( Normal:<52)
26. Urine microscopy :Normal 
27. Liver Profile: Slight increase in Bilirubin Level 0.21mg/dL ( normal:0-0.20 mg/dL)
28. Amylase: 73.5 U/L ( Normal: 28-100 U/L)
29. Lipase: 44.3 U/L ( Normal: 5.0-60.0 U/L)

As we can see in above blood work report, inflammation marker ESR is pretty high for this patient. It is 75 mm/hr, whereas it should be below 30 mm/hr. Vitamin D serum level is also 21 ng/ml, whereas it should be in between 30-100 ng/ml. Allergy level is also little elevated. It should be below 100 IU/ml, whereas it is 380 IU/ml. Again in thyroid profile T3, T4 appears to be normal. However, TSH level is pretty high and it is 12 IU/ml, where as it should be 2-4.50 IU/ml. Iron profile is looking good, except the Transferrin Saturation: 48%, (Normal: 13-45%). Administration and treatment: I have provided her inflammation drop along with ring worm medicine. I asked her to continue her thyroid medicine Adel 6, SBL Thyrodinum 30, SBL Iodinum 30, SBL Baryta carb 200+ SBL calcarea carb+ SBL sepia 200+ SBL Lachesis 200, Histaminum 30 4 drops 3 times for allergy and addressed all other issues. She was given Nutrija 5000 Iu Vitamin D3K2, 2times-after breakfast and lunch for 3 months and continues until vitamin D serum level goes up till 90 ng/ml. She was asked for daily 2 over soaked Brazil nut for selenium. She was also provided Nutrilite Cal mag D plus K2, Calcium supplement daily 2 after food. She was given Allen B12, daily 1 before going to bed. After 1 month, when she visited for follow up, everything was in control. Her ringworm was cleared up and didn’t re-occur again.

This case study explains about contributing factors of Ringworm development and gradual progression. We can see that how inflammation marker added weightage in disease generation and progression. Since her inflammation marker was elevated, it was a strong internal support for disease progression. If she wouldn’t have high inflammation, it might have cured in one go. However, we must think about humidity also. How much it nurtured to grow ringworm. After taking bath, if water gets dried up in body or we do not make our body dry properly or wear wet cloth, sometimes it may give fungal infection. Since water died up in body, it made a favorable condition to grow ringworm like fungal infection. Again Low serum level of vitamin D is another important factor to fuel up any skin disease. Other contributing factors are like high TSH, which is a metabolic imbalance and further worsen the situation. 

We have observed from above case that how inflammation marker and other contributing factors work behind disease generation and how it progress gradually. This is the reason; we must consider inflammation control and then look for other contributing factors. If we do not check the inflammation and just treat the particular disease –suppose if patient visit with arthritis, we just give medicine for pain management and address the arthritis issue and provide some vitamin supplements- we didn’t address the issue properly. It is done only 30% and re-occurrence chance of the issue is almost 100%. We didn’t address the inflammation in our body and it was still nurturing the same environment to grow the disease again. We cannot think of particular organ for addressing the issue. We must address and control inflammation 1st and then go for other contributing factors which fuel the disease progression. In this ringworm case study, we have seen that ringworm was ongoing issue, when she didn’t address it. However, when she controlled the inflammation marker and addressed other contributing factors like vitamin D serum level and increased it, her TSH was in control, ringworm didn’t come back again. This study is an evidence of contribution of inflammation marker and other concerned factors in disease generation and progression. It shows strong connection between all organs in our body. If we wouldn’t address inflammation, vitamin D deficiency, hypothyroidism and other factors, ring worm issue might not have sorted out and keep coming back. However, addressing all concerned factors along with inflammation marker was the solution in root and it fixed the issue. This case study is the evidence of importance of inflammation marker and other contributing factors to figure out the particular issue. If we do not address all these issue and just address only ringworm, issue is not fixed and main cause lies in root. It helps and supports the issue to re-grow and come back even more powerful way. This study also proves that behind each and every disease, there is an elevated level of inflammation. We must address this inflammation first, then Vitamin D serum level adequacy and look for other contributing factors. Once we address all, issue is fixed and there is a less chance of re-occurrence.