Lybrate.com has an excellent community of Endocrinologists in India. You will find Endocrinologists with more than 41 years of experience on Lybrate.com. You can find Endocrinologists online in Chennai and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.
Book Clinic Appointment
Treatment Of Erectile Dysfunction
Treatment Of Male Sexual Problems
Treatment Of Female Sexual Problems
Thyroid Problems Treatment
Thyroid Disorder Treatment
Diabetic Diet Counseling
Urinary Incontinence (Ui) Treatment
Pre And Post Delivery Care
Sperm Donor Program
Adult Diabetes Treatment
Type 1 Diabetes Treatment
Submit a review for Dr. ShanmuganadhamYour feedback matters!
I am 72 years old male. I have heart problem. I went through by-pass surgery in 2000 and implanted pace maker ion 2008. Now I am under medication I have type two diabetic patient also. Now I have hip pain problem. When I walk I feel pain in the hip and right leg. Please advise.
I that of taking Purim tablets from Himalaya drugs to cleanse/purify my blood. I have a history of little uric acid as ll. I cannot take too many medicine as I keep travelling. Can anybody prescribe me one single medicine which has various benefit along with my current problems and also I have little low libido. I prefer Ayurveda or homeopathy medicine. I use to take homeopathy medicine for boosting my sexual desires but the doctor never use to share his tonic information. He use to collect 500rs for 30 ml tonic and he use to mix 2-3 variety of tonic in one 30 ml bottle, which actually worked. I had very long duration and enjoyed lot with the medicine. But uric acid use to shoot up by that medicine. I want medicine which can balance my uric acid as ll as maintain my man hood life. Dear, doctors, I am 35 years old guy. Kindly prescribe me a single medicine at least for blood purifying and uric acid, also the dosage and how long should I take for permanent cure. Blood purifying I want to clear the toxins from my body. Thanks and appreciate for the patience that you see to my question .regards :shankar.
I am 76 years of age, having retired as Class I Gazetted Oficer from Ministry of Defence in 1996. Two years ago I lost my life partner in a sudden demise.I am a patient of Dilated Cardio Myopathy, Diabetic Type 2 Mellitus, having two stones each in both the kidneys, having arthritus in both the knees. I lose breath after walking a few yards or after tension due to any reason. I don't feel any appetite, rather suffer from constipation on having minimum bite at Lunch or Dinner. Obviously I wish to die in a working condition and without abnormal sufferings. Would you like to help me by way of suggesting adverse effect free medicines as I have already undergone various tests during the last 10-14 years. You may also suggest to me hasselfree treatment. I am taking Lenoxin (1/2 tablet OD, Lasix, Veltam 0.4, Monotrte 10 (BD), Zyloric 100, Dytor 10, Telma 20, Vitcoffel and Alprax (0.25 mg for andiety). I have tried to give all the relevant information about my condition. I will be grateful for pragmatic advice.
I am 44 years old. Already I have been taken Glycomet 500 mg twice a day. From today morning to till the time I feel drowsy and not able to due the routine work actively. I want your suggestions.
I am diabetic for last 10 years. I am very irregular now I want to take care of my health Kindly guide me.
Hi. Sir I am suffering from diabetes. Fatty liver and uric acid What can I do and what I eat and what medicine you suggest for me.
I am 52 Yrs old person. I am suffering from diabetes since 2 yrs. I have got blood test for it resulting Fasting: 145 & PP: 230. Please advise me allopathic or homeopath or ayurvedic treatment. Also home remedy.
My sugar level was at 85 after tea with sugar and 45 minutes of exercise. But it shoots up to 150 after dinner along with alcohol. Whether this kind of fluctuation is OK!
I am 30yr female havng knee pain arthritis stage 2 serum uric acid is 6.4. Pls suggest me how can I get relief from pain and treatment?
My husband is 44years old. Last year he diagnosed with diabetes, Though it is in control and he is on medication. He is having normal weight and suffering from high BP for last 5years. Kindly guide me how to reduce and keep on check, the adverse effect of both disease on other body organs like kidneys, eyes.
One of my friend tells about kaccha banana peel in glass of water over night & to drink emty stomach in the morning will help in a regular way lowering down or control diabetes. Pls clear the natural way of this therapy. Regards.
Sir I got my Tsh levels as 28. Any risk for the same pls. I already using thyronorm 100 mg still my tsh levels r 28.
What is whole grain? What all grains is good for diabetics? I am 60 years and just have found to be diabetic with moderate count of 150.
Breastfeeding or nursing is the feeding of babies and young children with milk from a woman's breast. Health professionals recommend that breastfeeding begin within the first hour of a baby's life and continued as often and as much as the baby wants. During the first few weeks of life babies may nurse roughly every two to three hours. The duration of a feeding is usually ten to fifteen minutes on each breast. Older children feed less often. Mothers may pump milk so that it can be used later when breastfeeding is not possible. Breastfeeding has a number of benefits to both mother and baby, which infant formula lacks.
Deaths of an estimated 820,000 children under the age of five could be prevented globally every year with increased breastfeeding. Breastfeeding decreases the risk of respiratory tract infections and diarrhea, both in developing and developed countries. Other benefits include lower risks of:
- Food allergies,
- Celiac disease,
- Type 1 diabetes,
- And leukemia.
Breastfeeding may also improve cognitive development and decrease the risk of obesity in adulthood.
Mothers may feel pressure to breastfeed; however in the developed world children generally grow up normally when bottle feed
Benefits for the mother include less blood loss following delivery, better uterus shrinkage, weight loss, and less postpartum depression.
Breastfeeding delays the return of menstruation and fertility, a phenomenon known as lactational amenorrhea. Long term benefits for the mother include decreased risk of breast cancer, cardiovascular disease, and rheumatoid arthritis.
Breastfeeding is often less expensive than infant formula.
Health organizations, including the world health organization (who), recommend only breastfeeding for six months. This means that no other foods or drinks other than possibly vitamin D are typically given. After the introduction of foods at six months of age, they recommend continued breastfeeding until at least one to two years of age. Globally about 38% of infants are only breastfed during their first six months of life
In the united states, about 75% of women begin breastfeeding and about 13% only breastfeed until the age of six months. Medical conditions that do not allow breastfeeding are rare.
Mothers who take certain recreational drugs and medications should not breastfeed.
Smoking, limited intake of alcohol, and coffee are not reasons to avoid breastfeeding.
Hypothyroidism is a condition in which the thyroid gland is not producing the thyroid hormones adequately. This is a fairly common condition.
What is thyroid gland?
The thyroid gland is a small butterfly-shaped gland located just below Adam’s apple. It encircles the windpipe or the trachea. It is about 4 cms in height and weighs about 18 gms. This gland is responsible for the secretion of thyroid hormones. Hormones are chemicals produced by special glands like thyroid, adrenals, ovaries etc. They act as messengers and are carried by the blood to the various target organs.
What are the hormones produced by thyroid gland and what do they do?
The thyroid hormones are of two types – T3 (Tri iodo thyronine) and T4 (Thyroxine). These hormones are mainly responsible for the body’s metabolism - a process in which food is converted into energy in the cells. They influence growth and development and regulate various bodily functions which are mentioned below:
- Body temperature
- Body weight
- Metabolism of fat
- Menstrual cycles in females
- Functioning of Nervous system
- Burning calories etc.
What is Hypothyroidism?
Inadequate production of hormones by the thyroid gland is termed as hypothyroidism. This is also called Underactive thyroid state. Hypothyroidism can make the body’s development to slow down and reduces metabolism rates.
What are the causes of Hypothyroidism?
Hypothyroidism can be caused by a number of factors:
- Hashimoto's thyroiditis: This is the commonest cause. This is an autoimmune disorder (normally body’s defence system fight against external infections. In autoimmune disorder the defence system attacks the healthy cells of the body by mistake). In Hashimoto’s thyroiditis the immune system/defence system produces antibodies that attack the thyroid gland and destroy it.
- Iodine deficiency in diet. For the production of thyroid hormones iodine is very important. The body does not produce iodine normally, so it needs to be supplemented from outside. Iodine is mainly present in the food we eat. It is mainly present in shellfish, salt-water fish, eggs, dairy products. If a person does not eat iodine rich foods, he may end up with iodine deficiency leading to hypothyroidism. Currently, this causative factor is on the decline due to government initiative of table salt with iodine.
- Surgery: Surgery to remove thyroid gland (for e.g. thyroid cancer treatment, overactive thyroid etc.)
- Radiation to the neck (to treat cancer in the neck area): The thyroid gland cells are damaged due to the radiation.
- Treatment with radioactive iodine: This treatment is used for managing hyperthyroidism/overactive thyroid, where the thyroid gland produces excessive thyroid hormones. One of the treatment modalities is by radioactive iodine. Sometimes this radiotherapy destroys normal functioning cells which lead to hypothyroidism.
- Certain medicines: Certain medicines used to treat heart conditions, cancer, psychiatric conditions etc. – for e.g. amiodarone, lithium, interleukin-2, interferon-alpha.
- Pregnancy: Pregnancy (the reason is unclear but it has been noticed that the thyroid may get inflamed after delivery – this is called Postpartum thyroiditis.
- Damage to the pituitary gland: Pituitary gland is a gland which is present in the brain. It produces a hormone called TSH (Thyroxine-Stimulating hormone).The TSH tells the thyroid gland how much thyroid hormone it should make. If the levels of thyroid hormone in the blood are low, then the TSH will stimulate the thyroid gland to produce more Thyroid hormone.
- Hypothalamus disorders: This is an organ in the brain. This produces a hormone called TRH (Thyrotropin Releasing Hormone) which acts on the Pituitary gland to secrete TSH. So any disorder of Pituitary gland will indirectly effect the production and secretion of Thyroid hormones. These are very rare disorders.
- Congenital thyroid defects: Some babies are born with thyroid problems. This is due to the thyroid not being developed normally during pregnancy. Sometimes the thyroid gland does not function normal. This can be identified by screening for thyroid disorders in the first week after delivery. This is usually by a blood test using a small drop of blood from the baby’s heel.
What are the different types of hypothyroidism?
One classification is based on whether the defect is with the thyroid gland or not:
- Primary hypothyroidism: The problem is in the thyroid gland itself and thus there is reduced production /secretion of thyroid hormones.
- Secondary hypothyroidism: Here the problem is with the Pituitary gland or the Hypothalamus. This results in abnormal production of TSH or TRH, which indirectly leads to less production and secretion of thyroid hormones.
Another classification is based on the symptoms and levels of the thyroid hormones and TSH:
- Overt hypothyroidism: Here the patient is having the symptoms. Further the T3/T4 are low and TSH is high
- Subclinical hypothyroidism: Here patient may or may not have symptoms. The T3/T4 levels are normal but TSH is high. In this situation the patient is at an increased risk of developing overt hypothyroidism in the future especially if he has Thyroid peroxidase antibodies on testing.
Who are at risk of developing Hypothyroidism?
- Women have a higher risk of suffering from hypothyroidism than men.
- Older people are at increased risk.
- People suffering from other autoimmune diseases like Coeliac disease, Type-1 Diabetes Mellitus, Vitiligo, Pernicious anemia, Multiple sclerosis, Rheumatoid arthritis, Addison’s disease etc.
- People with psychiatric conditions such as bipolar disorder
- People with Chromosomal abnormalities like Down syndrome, Turners syndrome also have a high risk of suffering from hypothyroidism.
What are the symptoms of hypothyroidism?
Symptoms vary from person to person. They may also mimic other conditions and hence be difficult to diagnose. Symptoms may also develop very slowly over a span of moths-years. Some of the characteristic symptoms of this disease are:
- Hair loss
- Dry hair
- Dryness of the skin
- Body pains
- Fluid retention in the body
- Irregular menstrual cycles
- Increased sensitivity to cold
- Reduced heart rate
- Increase in size of the thyroid gland – called Goitre. This is due to constant stimulation of the thyroid gland by TSH.
- Weight gain
- Carpal tunnel syndrome
- Hoarse voice
- Loss of libido/sex drive
- Confusion or memory problems especially in the elderly
What are the symptoms to look for in a baby if you suspect hypothyroidism?
Infants suffering from congenital hypothyroidism may show no symptoms or exhibit signs of excessive drowsiness, cold hands, cold feet, constipation, hoarse cry, poor growth or absent growth, poor appetite, bloating of abdomen, puffiness of face, swollen tongue, persistent jaundice.
How to diagnose hypothyroidism?
- TSH: This hormone is made in the pituitary gland and it stimulates the thyroid gland to produce thyroxine. If the thyroxine levels are low in the blood, the pituitary gland produces and secretes more TSH into the blood to act on the thyroid gland to produce more thyroxine. A raised TSH level indicates hypothyroidism. Other tests are not usually necessary unless a rare cause of hypothyroidism.
- T4: A low level of thyroxine indicates hypothyroidism.
- T3: these levels are generally not needed to diagnose hypothyroidism
- Anti-Thyroid peroxidase antibodies (anti-TPO antibodies) or Anti- thyroglobulin antibodies are present in 90-95% of patient with autoimmune thyroiditis.
- Other blood tests include Creatinine Kinase, Serum Lipids, Complete blood picture etc.
- Ultrasound of the neck is done if the patient presents with a thyroid swelling.
What is the treatment of hypothyroidism?
Overt hypothyroidism is treated by synthetic Thyroxin hormone which should be taken every day on an empty stomach at least 30 – 45 minutes before breakfast. The treatment is continued for the rest of the patient’s life. Regular thyroid function tests are done once every 8 weeks-12 weeks to adjust the dose of the thyroxine in the initial period of diagnosis. Once the thyroxine dose is stabilised, the tests can be done even once a year. This treatment is quite effective.
Sub-clinical hypothyroidism is only treated if the patient is a woman and is contemplating pregnancy, in patients with symptoms or if the TSH is quite high.
What are the side-effects of thyroxine medication?
There are few side effects if any. Most people tolerate these medications quite well. An important consideration before starting medication is to check if the patient has chest pain/angina. These people are started on the least available dose. If these patients are started on a higher dose they notice a worsening of their angina pains.
Side effects mainly occur if the thyroxine dose is high which leads to hyperthyroidism. The symptoms of this could be palpitations 9increased heart beat), weight loss, profuse sweating, anxiety, irritability etc.
There are some tablets which increase with thyroxine tablets. These include carbamazepine, iron supplements, calcium supplements, rifampicin, phenytoin, warfarin etc.
What are the complications of hypothyroidism?
If untreated hypothyroidism can lead to:
- Heart problems like heart attack due to increased levels of bad cholesterol like LDL, or heart failure due to fluid retention
- Joint pains
- A pregnant woman with hypothyroidism is at increased risk of giving birth to a baby with congenital hypothyroidism, also known as cretinism. Further, the woman may have pregnancy related complications like pre-eclampsia, premature delivery, low birth weight baby, anemia, post-partum haemorrhage (bleeding after delivery) etc.
- Myxoedema is another complication where the patient has extremely low levels of thyroid hormone. The body temperature drops drastically making the person lose consciousness or go into a coma. If you wish to discuss about any specific problem, you can consult an endocrinologist.