Vitiligo or Leucoderma is a genetic disorder triggered due to mental stress and constipation. Leucoderma or vitiligo is called Shivita kushta according to Ayurveda and is caused due to defect in brajak pitta. Brajak pitta is a color forming agent in body and defect in formation of brajak pitta causes vitiligo. There are many causes, which can trigger vitiligo other than stress and genetics.

There are certain food combinations , such as taking milk and sour fruits together can trigger vitiligo. Also, using excessive salty food and meat products with milk can trigger disease. Deficiency of copper and vitamin B12 can trigger this disease. So treatment of vitiligo is done taking in account many factors.

Toxins produced in body are neutralized using herbal medicines, which helps in stopping the spread of disease. External herbal application containing Wrightia Tinctoria help in repigmentation on white skin. According to modern science steroids are used in pulse therapy where steroids are used 2 times a week.

This also prevents the disease from spreading. In some severe cases integration of allopathic and Ayurveda is key to success.

There are few important points, which vitiligo patients should always take in account, such as:
When disease is spreading sitting in sun for prolonged period can trigger the spread.
Using Brinjal and raw tomatoes and excess of vitamin C is not good.
Irregular lifestyle is a trigger the disease along with consumption of alcohol.

All About Vitiligo

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

It is hard to escape the harsh rays of the sun during summers. Staying outdoors for too long will lead to tanned skin, which is a sign of skin damage. Sometimes skin damage can get severe and lead to diseases like skin cancer. To prevent your skin from damaging and keep it healthy, here are seven pro tips:

1. Aever skip the sunscreen: sunscreen with spf 15 or more will help in protecting your skin from harmful uv rays. Even if you are going to be out in the sun for more than 15 minutes, make sure to apply sunscreen generously. Remember, the higher the spf, the better is the protection.

2. Always wear sunglasses: sun damage can lead to premature signs of aging; especially wrinkles around the eyes since the skin around your eyes are very thin. Wider lenses that can block out 99% of sun rays are recommended to protect your eyes.

3. Your lips need protection too: just like your eyes, the skin is much more delicate and thinner on your lips. Your lips are susceptible to tanning as well, along with the risk of fine lines around the mouth if not well protected. Always apply a lip protection balm when going out.

4. Upf clothing: garment with special upf (ultraviolet protection factor) coating can shield you from harmful uva and uvb rays. Like spf, the higher the upf, they better it will protect you. Regular clothes can protect you as well, provided they are woven tightly and are of a darker color.

5. Keeping a close look at the time: uv rays are the strongest and mostly harmful from 10 a. M. To 4 p. M. If you are out during these hours, do not forget the sunscreen, umbrella and sunglasses.

6. Don't forget to protect your head: a hat with a brim of 2 to 3 inches all around shield the skin of your neck, face and ears and protects you from skin damage.

7. Apply religiously: even if your sunscreen promises that it is sweat proof, waterproof or rub proof, it never completely is, as no product works the same for everybody. So apply your sunscreen throughout the day.

How to Prevent Our Skin From Sun Damage

Can scratching your head lead to hair loss? (and how to banish that nagging itch without scratching)

Yes! scratching your head actually leads to hair loss so you should avoid doing it.

Scratching your head with your fingernails for as little as 90 minutes is enough to remove all your cuticular scale. A cuticular scale is a protective covering on every individual strand of hair. The loss of this covering leaves your hair shaft weak and damaged and hence leaves your hair susceptible to easy breakage and hair loss.

There are several ways you can deal with itchiness in your scalp that does not include scratching your head. These alternative ways will help ensure you don't suffer from any hair loss.

These include

1. Instead of scratching, pat or rub the sensitive area with the flat of your fingers.

2. Having a dry scalp can also increase itchiness. It would bee a good idea to use natural oil on your hair before you wash it if that's the reason behind your itch.

3. Sensitivity to a new product may be causing a sudden itchiness in your scalp. So, if you have switched to a new shampoo, mousse or anything else, do try abstaining from applying it for a few days to see if the itchiness subsides.

4. When your scalp feels itchy, try and distract yourself. The more you think about how itchy your scalp is, the more it will itch.

While scratching your hair does lead to hair loss, the good news is your hair will grow back because the damage is not permanent. However, it is not advisable to keep scratching your head because you'll just lose more hair.

If you would like to consult with me privately, please click on 'consult'.
Related Tip: Should You Oil Hair When You Have Dandruff Problem?

Can scratching your head lead to hair loss? (And how to banish that nagging itch without scratching)

Hives, also called urticaria are swollen welts or bumps that appear on your skin suddenly.

They itch, burn and sting and can happen anywhere on your body. You can get them on your face, lips, tongue, ears or chest. And in size, they can be as small as an eraser to as large as a plate. They also form plaques and can last for hours or up to several days.

Types

Acute urticaria - These type of hives last less than six weeks. The most common causes are allergies due to certain foods and medications, or infections. These hives can also happen due to diseases or insect bites.
Chronic urticaria - Hives lasting more than six weeks come under this category. What causes them is usually more difficult to identify than what causes acute urticaria. In some cases, chronic hives are caused due to thyroid disease, hepatitis or even cancer. This type can affect your internal organs like lungs, muscles, and the gut. Thus, symptoms include muscle soreness, shortness of breath, vomiting, and diarrhoea.
Physical urticaria - These types are caused due to direct physical stimulation of the skin due to cold, heat, sun exposure, vibration, pressure, sweating, and exercise.
What causes hives?

Hives happen mostly due to allergies. Some of the common hive triggers are-

Certain foods, especially peanuts, eggs, nuts and shellfish- Fresh foods are more likely to cause hives as compared to cooked foods. Certain food additives and preservatives can also play culprits. Medicines like penicillin and sulfa- based antibiotics, aspirin and ibuprofen which are non-steroidal anti-inflammatory medications, high blood pressure drugs like ACE inhibitors, and painkillers such as codeine can also trigger hives. Other things that may cause it are:

Insect bites
Latex
Transfusion of blood
Bacterial infections, including urinary tract infections and infected throat
Viral infections- common cold and hepatitis
Pollen grains
Plants like poison oak and poison ivy
Sunlight
Cold weather
Pet dander 
If you wish to discuss about any specific problem, you can consult a dermatologist.

What Are Hives? What Causes Them?

One of the most important functions of the skin is protection. During this process, it comes in contact with various substances including chemicals, pollen, dust, and other pollutants. While it does protect the overall body from all these, there is some damage that is inevitably done to the skin through these exposures. Different skin and different bodies react differently to these, and while some may have no reaction, others develop allergies. This is also defined by how strong the person s immunity is.

Hives is one of the most common skin allergy responses. While it is not easy to pinpoint what causes the allergy or the hives, the causative agent can be nailed by observing patterns and excluding out some of the causative agents. There are a set of regular household and surrounding items that could lead to urticaria, and working around these can help pin down the source.

Origin: When the body encounters a foreign body, it produces what are known as histamines. When they are produced, the plasma in the cell leaks out, producing a red and swollen appearance. Hives are red, itchy, raised patches on the skin. They are seen in about 20% of the population. Hives are usually allergic in nature, implying that they occur when there is a foreign substance that induces an allergic reaction. Hives can appear either due to coming in touch with some substance or due to eating some allergy-inducing substance.

Hives can be acute or chronic. Acute is when the hives appear in response to an allergic reaction. These usually disappear in a matter of days to a week at the maximum. In some people, they could be chronic and can last for months together.

Treatment: Given that they are allergic in nature, managing hives includes a combination of immediate treatment as well as preventive measures. While most are topically managed, others might require systemic intervention also.

Once the hives have developed, the following can help in the relief of symptoms and prevent from spreading further. The redness and swelling will take some time to disappear.

Avoid tight-fitting clothes
Use cool compresses on the hives
Avoid warm or hot shower
Stay in a cooler room
Avoid itching the hives
Use topical moisturizer to prevent dryness
Use topical steroid cream to manage the inflammation
Take a systemic antihistamine or an injection of epinephrine if required.
While these help in managing the hives which have occurred, preventing is via the following.

Avoid the source once identified
If the source is not yet known, record when the hives are occurring
Manage stress and see hives appear much less
Increase moisturizer use
Keep an antihistamine handy so you can take it immediately in case of suspected hives. 

Urticaria (Hives) - The Best Way It Can Be Treated!

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