{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T03:57:44Z","timestamp":1768449464667,"version":"3.49.0"},"reference-count":33,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,3,22]],"date-time":"2024-03-22T00:00:00Z","timestamp":1711065600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea (NRF)","doi-asserted-by":"publisher","award":["NRF-2022R1A2C1013518"],"award-info":[{"award-number":["NRF-2022R1A2C1013518"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Hypothyroidism is more common in women and individuals between 30 and 50 years old. This case report depicts the clinical outcomes of MOK pharmacopuncture, a type of Korean medicine treatment, for an elderly male patient with hypothyroidism who was on long-term L-thyroxine (LT4) therapy but still felt chronically lethargic and tired and was generally in poor health. A 72-year-old Korean man has been on LT4 since being diagnosed with hypothyroidism 16 years ago and has tried to discontinue hormone supplements in the past. The patient was treated with MOK pharmacopuncture, mainly at the ST10 acupoint, twice a week for four months. Following the treatment, the T3, free-T4, and TPO Ab levels and thyroiditis status on ultrasound showed improvement. Additionally, there were a normalization of ESR levels, an enhancement in the quality of life, a reduction in depression scores, an improvement in the antioxidant status, and an alleviation of major symptoms when compared to pre-treatment conditions. This case report demonstrates the potential of MOK pharmacopuncture as a complementary treatment for an elderly man with hypothyroidism who had a poor quality of life due to fatigue and lethargy despite LT4 treatment.<\/jats:p>","DOI":"10.3390\/jpm14040331","type":"journal-article","created":{"date-parts":[[2024,3,22]],"date-time":"2024-03-22T05:10:53Z","timestamp":1711084253000},"page":"331","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical Outcomes of MOK Pharmacopuncture in an Elderly Male Patient with Hypothyroidism\u2014A Case Report and Literature Review"],"prefix":"10.3390","volume":"14","author":[{"given":"Jin-Ho","family":"Jeong","sequence":"first","affiliation":[{"name":"Namsangcheon Korean Medicine Clinic, Seoul 06656, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6304-1972","authenticated-orcid":false,"given":"Ji Hye","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Acupuncture and Moxibustion Medicine, College of Korean Medicine, Gachon University, Seongnam 13120, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,22]]},"reference":[{"key":"ref_1","first-page":"1579","article-title":"Neurodevelopmental assessment of patients with congenital hypothyroidism","volume":"145","author":"Bedregal","year":"2017","journal-title":"Rev. Med. Chile"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1089\/thy.2018.0436","article-title":"Resolution of hypothyroidism restores cold-induced thermo-genesis in humans","volume":"29","author":"Maushart","year":"2019","journal-title":"Thyroid"},{"key":"ref_3","unstructured":"Singh, S., and Sandhu, S. (2023). Thyroid Disease and Pregnancy, StatPearls Publication."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"988","DOI":"10.4158\/EP12280.GL","article-title":"Woeber for the American Association of Clinical Endocrinologists and American Thyroid Association Taskforce on Hypothyroidism in Adults. Clinical practice guidelines for hypothyroidism in adults: Cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association","volume":"18","author":"Garber","year":"2012","journal-title":"Endocr. Pract."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1159\/000048140","article-title":"Thyroid Hormone Replacement Therapy","volume":"56","author":"Wiersinga","year":"2001","journal-title":"Horm. Res. Paediatr."},{"key":"ref_6","unstructured":"Cho, B.Y. (2001). Clinical Thyroidology, Korea Medical Book Publishing Company. [2nd ed.]."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1016\/j.joim.2018.09.002","article-title":"An overview of the contribution of acupuncture to thyroid disorders","volume":"16","author":"Cheng","year":"2018","journal-title":"J. Integr. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"267","DOI":"10.13045\/jar.2022.00178","article-title":"A Study on the Significance of Acupuncture and Pharmacopuncture Therapy for Cold Accumulation Through a Literature Review on the Historical Development Process in Cold Accumulation Treatment","volume":"39","author":"Jeong","year":"2022","journal-title":"J. Acupunct. Res."},{"key":"ref_9","unstructured":"Jung, C., Ahn, Y., Jung, J., and Ku, J. (2023). Pharmacopuncture Clinical Guide, Koonja Publication."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Hwang, J.H., Kang, S.Y., Kang, A.N., Jung, H.W., Jung, C., Jeong, J.H., and Park, Y.K. (2017). MOK, a pharmacopuncture medicine, regulates thyroid dysfunction in L-thyroxin-induced hyperthyroidism in rats through the regulation of oxidation and the TRPV1 ion channel. BMC Complement. Altern. Med., 17.","DOI":"10.1186\/s12906-017-2036-1"},{"key":"ref_11","first-page":"310","article-title":"Therapeutic effects of acupuncture with MOK, a polyherbal medicine, on PTU-induced hypothyroidism in rats","volume":"16","author":"Hwang","year":"2018","journal-title":"Exp. Ther. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"39","DOI":"10.13045\/acupunct.2017081","article-title":"Effects of MOK, a pharmacopuncture medicine, on the TH1\/TH2 immune response and antioxidation in Con A-stimulated primary mouse splenocytes","volume":"34","author":"Hwang","year":"2017","journal-title":"Acupuncture"},{"key":"ref_13","first-page":"26","article-title":"Anti-inflammatory and antioxidant effects of MOK, a polyherbal extract, on lipopolysaccharide-stimulated RAW 264.7 macrophages","volume":"43","author":"Hwang","year":"2019","journal-title":"Int. J. Mol. Med."},{"key":"ref_14","unstructured":"Nam, S.C. (2009). Immuno Pharmacopuncture, Meridian and Collateral Med Book."},{"key":"ref_15","first-page":"1088","article-title":"Study on the activity of autonomic nerve system using Dinamika on stroke","volume":"19","author":"Lee","year":"2005","journal-title":"J. Physiol. Pathol. Korean Med."},{"key":"ref_16","unstructured":"Jo, S.H. (2015). The Effect of Sporting Activity on Physical Activity and Solution to Stress. [Ph.D. Thesis, Josun University]."},{"key":"ref_17","unstructured":"Malaty, W. (2017, January 04). Primary Hypothyroidism. Available online: https:\/\/bestpractice.bmj.com\/topics\/en-us\/535\/pdf\/535.pdf."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1530\/eje.1.01907","article-title":"Health status in patients with sub-clinical hypothyroidism","volume":"152","author":"Razvi","year":"2005","journal-title":"Eur. J. Endocrinol."},{"key":"ref_19","first-page":"30","article-title":"A Comparison between the Quality of Life and Mental Health of Patients with Hypothyroidism and Normal People Referred to Motahari Clinic of Shiraz University of Medical Sciences","volume":"5","author":"Rakhshan","year":"2017","journal-title":"Int. J. Community Based Nurs. Midwifery"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.eujim.2019.03.001","article-title":"Usage status and satisfaction with pharmacopuncture in Korea: A survey among Korean medicine doctors","volume":"27","author":"Park","year":"2019","journal-title":"Eur. J. Integr. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1016\/S2213-8587(16)30276-5","article-title":"Levothyroxine overuse: Time for an about face?","volume":"5","author":"Maraka","year":"2017","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13044-018-0045-x","article-title":"Management of hypothyroidism with combination thyroxine (T4) and triiodothyronine (T3) hormone replacement in clinical practice: A review of suggested guidance","volume":"11","author":"Dayan","year":"2018","journal-title":"Thyroid. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1046\/j.1365-2265.2002.01654.x","article-title":"Psychological well-being in patients on \u2018adequate\u2019 doses of l-thyroxine: Results of a large, controlled community-based questionnaire study","volume":"57","author":"Saravanan","year":"2002","journal-title":"Clin. Endocrinol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"521","DOI":"10.3389\/fimmu.2017.00521","article-title":"Thyroid Autoimmunity: Role of Anti-thyroid Antibodies in Thyroid and Extra-Thyroidal Diseases","volume":"8","author":"Wahl","year":"2017","journal-title":"Front. Immunol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2646","DOI":"10.1056\/NEJMra021194","article-title":"Thyroiditis","volume":"348","author":"Pearce","year":"2003","journal-title":"N. Engl. J. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1210\/edrv.22.5.0441","article-title":"Postpartum Thyroiditis and Autoimmune Thyroiditis in Women of Childbearing Age: Recent Insights and Consequences for Antenatal and Postnatal Care","volume":"22","author":"Muller","year":"2001","journal-title":"Endocr. Rev."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"6757154","DOI":"10.1155\/2016\/6757154","article-title":"Thyroid hormones, oxidative stress, and inflammation","volume":"2016","author":"Mancini","year":"2016","journal-title":"Mediat. Inflamm."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1530\/EJE-15-0617","article-title":"The relationship between oxidative stress and autoimmunity in Hashimoto\u2019s thyroiditis","volume":"173","author":"Ates","year":"2015","journal-title":"Eur. J. Endocrinol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1159\/000342623","article-title":"Is thyroid autoimmunity per se a determinant of quality of life in patients with auto-immune hypothyroidism?","volume":"1","author":"Watt","year":"2012","journal-title":"Eur. Thyroid. J."},{"key":"ref_30","first-page":"287","article-title":"Correlation of quality of life and hypothyroidism in patients referred to hospitals affiliated by Medical Science Universities of Tehran in 2007","volume":"19","author":"Mollahoseyni","year":"2009","journal-title":"Med. Sci."},{"key":"ref_31","first-page":"e28201","article-title":"Hypothyroidism and Depression: A Narrative Review","volume":"14","author":"Nuguru","year":"2022","journal-title":"Cureus"},{"key":"ref_32","first-page":"76","article-title":"Effect of gastrointestinal disorders in autoimmune thyroid diseases","volume":"4","author":"Carvalho","year":"2014","journal-title":"Transl. Gastrointest Cancer"},{"key":"ref_33","first-page":"623","article-title":"Practitioner training course 1: Endocrine diseases; Primary treatment principles for chronic diseases: Treatment of hyperthyroidism and hypothyroidism","volume":"2","author":"Song","year":"2003","journal-title":"Korean Soc. Intern. Med. Fall Conf. Proc."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/14\/4\/331\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:17:45Z","timestamp":1760105865000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/14\/4\/331"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,22]]},"references-count":33,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,4]]}},"alternative-id":["jpm14040331"],"URL":"https:\/\/doi.org\/10.3390\/jpm14040331","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,22]]}}}