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:

Heartbeat
Body temperature
Breathing
Body weight
Metabolism of fat
Menstrual cycles in females
Functioning of Nervous system
Digestion
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:

Depression
Constipation
Hair loss
Dry hair
Dryness of the skin
Tiredness
Body pains
Fluid retention in the body
Irregular menstrual cycle
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
Infertility
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?

Blood tests:

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
obesity
infertility
joint pains
depression
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.
References:

2013 ETA Guideline: Management of Subclinical Hypothyroidism; European Thyroid Association (Nov 2013)
Management of primary hypothyroidism: statement by the British Thyroid Association Executive Committee; British Thyroid Association (2015)
The diagnosis and management of primary hypothyroidism; Royal College of Physicians and others (June 2011)
Suh S, Kim DK; Subclinical Hypothyroidism and Cardiovascular Disease. Endocrinology Metabolism (Seoul). 2015 Aug 4.
UK Guidelines for the Use of Thyroid Function Tests; British Thyroid Association (2006)
Gaitonde DY, Rowley KD, Sweeney LB; Hypothyroidism: an update. American Family Physician. 2012 Aug 1 86(3):244-51.
Bindra A, Braunstein GD; Thyroiditis. American Family Physician. 2006 May 15 73(10):1769-76.
Wilson GR, Curry RW Jr; Subclinical thyroid disease. American Family Physician. 2005 Oct 15 72(8):1517-24.
British National Formulary; NICE Evidence Services (UK access only)
Baumgartner C, Blum MR, Rodondi N; Subclinical hypothyroidism: summary of evidence in 2014. Swiss Medical Weekly. 2014 Dec 23 144:w14058. doi: 10.4414/smw.2014.14058. eCollection 2014.

Know Everything About Hypothyroidism

Plastic surgery includes various procedures in order to repair body parts which are damaged and injured or for cosmetic reasons by transferring tissues. The most common procedures performed on patients are lipoplasty, breast augmentation, facelift, eyelid surgery and botox. There have been a lot of assumptions and myths around plastic surgery, but it is no different than any other medical procedures. Here are top plastic surgery myths that you need to be aware of.


	Women are the only customers: although women have been traditionally known to be the prime customers of plastic surgery, nowadays a lot of men are also opting for various procedures. Non penetrating mild procedures like botox, laser, and dermal fillers are highly popular among men. These are low cost and effective procedures that can make a mile of difference in your look.
	It's all about looking good: there are certainly many procedures focused on restructuring the body parts to enhance beauty but plastic surgery includes a lot of other procedures such as correcting sports injuries, burns, disfigurement due to an accident etc. Cosmetic surgeries are usually opted in those cases where normal exercises, diets and weight loss programs cannot alter the structure of a particular area.
	You will look young forever after opting for a plastic surgery: you can get procedures done to turn back time, but it is difficult to stay that way forever. Plastic surgery usually lasts for decades barring the non-invasive procedures such as botox and laser which are semi- permanent. A healthy lifestyle and occasional clinical touch ups can take away years from your look but it is humanly impossible to remain in the same way forever.
	Gives you smooth skin with no scars: there are procedures to reduce the appearance of scars but a surgery will sustain some kind of scar no matter how minuscule. Post surgery treatments are available to diminish scars but a slight remnant is to be endured.


If you are in need of plastic surgery it is advisable to gather necessary information before going through any procedure rather than believe assumptions.


Busting Plastic Surgery Myths

It is a common knowledge that beer has health benefits when used in masks, scrubs, as conditioners, etc. This reason is good enough for even non-drinkers to stock up their fridges with cans of beer. 
Here are a few ways by which we can use beer to make our skin and hair better:

Use beer as a conditioner - Beer happens to be an excellent conditioner. Mixing one cup warm beer with a teaspoon of jojoba oil makes a natural, non-greasy conditioner. Wash your hair with your regular shampoo and use this mix as a conditioner. The beer in it will give volume to your hair while jojoba oil will add shine and luster.
Use it for a face pack - Take two to three strawberries mash with a fork, add few drops of beer and make a paste. Rub this paste all over your face in a circular motion. Rinse after 15-20 minutes and apply moisturizer on your face.
Soak in beer laced water - Beer can be used in bubble bath too! Mix some soap with beer of your choice and add the mix to the running bath water. Soak in this water and feel your skin become soft and smooth.
Use beer as a hair-pack - Wash your hair with your usual shampoo. Now pour the mixture made of distilled water, beer, two teaspoon apple cider vinegar and few drops of essential oil (any scent), on your hair. Make sure it reaches the hair that is inside as well. Rinse this mixture with lukewarm water. You can do this once a month.
Get the beer glow - Take half a teaspoon of beer, one egg white and a drop of almond extract. Whisk them together and keep aside. On your washed and dried face, apply the mask and let it dry until your skin feels tight. Wash it off with lukewarm water.
From Lybrate: If you found this tip useful, please thank the doctor by clicking on the heart icon below. Also, spread good health by sharing this tip with your loved ones over Whatsapp, Facebook and other media.

Do You Know What Beer Does To Your Hair & Skin?

A Reverse abdominoplasty is a cosmetic surgery procedure used to improve the contours of the abdomen. Unlike an abdominoplasty to tummy tuck, this surgery addresses patients who have excessive skin above the belly button.  Here the skin is pulled up rather than down. 

For this surgery, an incision is made along the bottom half of the rib cage, just below the breasts. The excessive skin is removed along with fat deposits and the remaining skin is pulled in order to tighten the tissues and improve the look of the upper abdomen. This incision is usually made along the natural curves of the breast so as to minimize the visibility of the scar. 

Unlike many other types of cosmetic surgery, this will require a 2 to 3 day stay in the hospital. 
Women who want breast restructuring along with abdominal contouring will find this type of surgery very beneficial. This is because the placement of the incision allows the surgeon to work on both areas simultaneously. This leads to the formation of only a single scar, unlike having breast contouring surgery and a traditional abdominoplasty, which would create two separate scars. 

The incision is also made in such a way that the scar created is camouflaged by the natural contours of the breasts. In most cases, it is also not visible when wearing a two piece swimsuit and thus suits more women than the traditional tummy tuck. Another advantage of this surgery is that it does not alter the position of the belly button. 

A reverse abdominoplasty is usually performed on people who have a flat stomach below the navel, but have excessive fat and skin above the navel. It can be seen in people have experienced drastic weight loss. It may also be suggested as a follow up surgery to a traditional tummy tuck is the skin above the navel is still sagging. However, only a doctor can decide if this is the type of surgery needed for you. 

This procedure very rarely has side effects. This is because it does not interfere much with the muscle structure and only adjusts the skin. In some cases, there may be slight irregularities. This can be corrected by further liposuction. Another issue would be the recurrence of the problem is the tissue is not correctly adhered to the rib fascia. However, this is seen in very few cases. In normal scenarios, even slight weight gain at a later date is accommodated by the skin.

What Is a Reverse Abdominoplasty and Who Needs It?

Swollen breast tissues in men or boys caused by hormonal (testosterone and estrogen) imbalances is called gynecomastia. Both breasts or one breast can be affected by gynecomastia. At any point in life, from birth to puberty, even in adulthood, you might develop gynecomastia. Most of the times, gynecomastia is caused by hormonal imbalances, but there might be some underlying causes as well.
Gynecomastia is normally not a serious condition, but it can be difficult to deal with the pain and embarrassment.
It can be cured with surgery or medication if it doesn't go away on its own.

Symptoms and signs of gynecomastia include:

Enlarged glands in the breast tissue
Tenderness in the breast
The causes that trigger gynecomastia include:

Hormonal changes: Testosterone and estrogen control the sexual development in men and women respectively. Estrogen is not a hormone that only women produce; men produce it too. When the production of testosterone and estrogen are thrown out of balance, gynecomastia occurs.
Medication: Certain medications such as anabolic steroids, androgens, HIV/AIDS medicines, antibiotics and chemotherapy can cause gynecomastia.
Drugs and alcohol: Substances such as alcohol, marijuana, amphetamines, heroin and methadone cause gynecomastia.
Health condition: Certain factors, such as aging, hypogonadism (hormonal disorder), hyperthyroidism (overactive thyroid gland), tumors, kidney failure, cirrhosis, liver failure, malnutrition and starvation can lead to gynecomastia.
Herbal products: Essential oils derived from plants such as lavender or tea tree, used in lotions or shampoos, have weak estrogenic actives. They have been said to cause gynecomastia.
Gynecomastia can be cured either with medication or surgery. Surgical options for gynecomastia are, however, limited.

The two surgical options for gynecomastia include:

Liposuction: Liposuction only removes the fat from the breast, not the breast gland tissue. It has fewer complications, there is limited or zero blood loss and there is less distortion of the nipple.
Mastectomy: Mastectomy removes the gland tissues in the breast. The surgery uses minimal incisions to remove the gland tissue. Also, it involves less time to recover. 

Gynecomastia (Enlarged Breast In Men) - Know The Treatments!

We all think of sunscreen as something that goes into our vacation kit when heading out on a hike in the hills or to the beach. What we fear is being out in the sun can reduce fairness, can cause a tan, and a sunscreen will help maintain complexion.

Well, these are completely wrong notions. What we need to be aware of is that even the regular, daily sun exposure during driving or going to the office can do as much damage, if not more. The sunscreen, therefore, assumes a very important role in your daily personal care. Read on and find out more.

Relationship with skin cancer: Studies in the US have shown that skin cancer is the most common type of cancer and sun exposure is the leading cause of this. It is the regular exposure on a daily basis that cumulatively leads to this, rather than a one day exposure minus the sunscreen. Using sunscreen on a daily basis provides a good shield against skin cancer.

Slows down aging: Dry skin, wrinkles, sun spots, and dark circles on the skin are more related to unprotected exposure to the sun rather than just aging. The sun is the most powerful agent that can lead to these effects and it is very essential to guard yourself against it.

While a general belief is that the sun is less harmful during cloudy days, it is not so the case. The ultraviolet rays of the sun filter through clouds and can cause equal damage as they would during sunny summer days. Studies have shown that the rays, which filter through the clouds are capable of accelerated aging effects and continue to do so, even after you have reached home.

It is not just the amount of time, you are actually out in the sun that counts. The collagen in the skin that gives it the firmness, if is damaged, leads to sagging and bagging of skin. Using a sunscreen provides a shield against these harmful ultraviolet rays.

Research has shown a 73% reduction in the invasive forms of skin cancer by using sunscreen on a regular basis. It is a popular belief that fair complexion is more affected by exposure to the sun. It is true that darker complexion has more melanocytes that increase the natural protection, but this does not ensure complete protection against the harmful ultraviolet rays.

After reading this, a sunscreen lotion with a sun protection factor (SPF) of 15 or more should surely find its way into your grooming kit.

Why Do You Need To Use Sunscreen Daily?

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