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

Hives, also known as  urticuria  is a skin disorder that is characterized by formation of white or red welts on the surface of the skin. The sizes of the welts may vary and can last for up to six weeks or more. The disease is not life threatening but the general discomfort associated with it can interfere with your daily activities. The symptoms of hives are treated by taking anti-histamines and anti-itching medications.

Let s take a look at the symptoms:
1. Development of red or white welts, especially on torso, arms and the face
2. The welts may cause severe itching
3. Painful swelling on various parts of the body such as cheeks, lips and the insides of the throat
4. You may experience tightness in the chest and feel dizzy

What might be the causes?
Hives occur when certain cells are triggered into releasing histamine (an organic nitrogenous compound). The various factors that trigger this condition are:
1. Insects bites or parasite bites
2. Continuous scratching at the same spot
3. Various pain medications
4. Prolonged exposure to sunlight
5. High levels of stress
6. Excessive consumption of alcohol

This disease can lead to severe complications which have been listed below:
1. Severe allergic reaction: Anaphylaxis is an allergic reaction that causes the bronchial tubes to narrow down thus, obstructing normal breathing. It is a condition that may, in certain cases, lead to death as well. Hence, you need prompt medical attention if you suffer from this complication.

2. Breathing complications: Swelling on the inner parts of the throat may obstruct normal breathing and cause you to pass out. It can also increase the risk of certain immune disorders such as rheumatoid arthritis and celiac disease (a disorder caused by eating gluten rich foods in excess).

Treatment
The treatment for this disorder includes taking anti-histamine medications that help in blocking histamine (organic compounds which help to regulate physiological functioning) in the body. You may also be administered anti-inflammation medications to reduce inflammation. Wear loose clothing and stop scratching away at the affected regions of the body to make sure you do not aggravate the condition.

Hives Rash or Urticuria - 6 Cause Behind Skin Disorder

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

Did you know that milk can cause acne?

Including cheese, milk, and ice-cream etc into your daily meals maybe the reason behind the painful acne on your face. Processed milk and other dairy products negatively affect your skin and trigger the formation of whiteheads, blackheads and pimples. 

Here s how milk causes acne and what you can do to get clearer skin.

How does milk cause acne?

1. Milk contains a growth hormone IGF-1 (responsible for the growth and strength of calves) in large amounts. This has an adverse effect on your skin, and is responsible for its inflammation, which results in acne. In fact, this hormone can even increase the size of the acne.
2. Consumption of milk and other dairy products also result in a sharp rise in the amount of insulin present in your body, which initiates more IGF-1 production by the liver, thereby increasing acne.
3. Excessive sebum (oil) is secreted by your skin due to the consumption of milk, which results in more number of clogged pores, causing an acne breakout. Additionally, an increase in sebum helps the acne bacteria to grow and breed, which further causes skin inflammation.
4. Consumption of milk can render your skin unable to get rid of dead skin cells, causing more acne due to clogged pores. This happens as milk sticks dead cells together inside your pores, interfering with their natural process of falling off.

What can you do to get acne-free skin?

The best way to get acne-free skin is by trying to limit your consumption of milk and dairy products. You can do so in two ways:

1. Discontinue Milk Intake: Stop consuming milk and its products completely for at least 30 days and observe the changes. If your skin improves after 30 days, you can add small amounts of high-quality dairy, like organic yoghurt, to your diet. If eliminating milk does not show any positive effects, try observing other triggers of acne and look for appropriate methods of removing them. 

2. Switch to Organic Milk Products Only - If you find it difficult to totally cut off milk from your diet, try reducing the amount of milk intake and totally avoid processed milk products. Switching to raw, grass-fed dairy products will also be beneficial.

What are the alternatives to milk which can be consumed without harming your skin?

You can also replace milk with the following products in your diet chart to prevent the occurrence of acne.

1. Organic almond milk without added sugar
2. Organic coconut milk containing no artificial sweeteners
3. Natural coconut cream

Warning: Do not consume soy milk as a milk substitute as it contains omega-6 fats, which cause skin inflammation and swelling of acne.

If you would like to consult with me privately, please click on 'Consult'.

Did you know that milk can cause acne?

Vitiligo or Leucoderma is an autoimmune disease. In this type of disease, cells (melanin) that are responsible for skin pigmentation are destroyed, attacked, hence stop functioning, which results in irregular white patches on skin. Vitiligo can affect any part of the body and skin type. Vitiligo is not at all life-threatening, but it can be visible by other people easily.

There are a number of treatment options available for Vitiligo. However, by changing dietary and lifestyle choices, one can prevent the worsening and recurrence of the condition.

Home Remedies That Will Help to Treat Vitiligo Effectively:

There are many treatment options available to treat Vitiligo including creams, oral medicines, skin grafting, ultraviolet treatment, etc. However, these treatments totally depend upon the condition and response of the skin cells. These treatments might have some sort of side effects or risks. This is why one of the most effective ways to treat Vitiligo or Leucoderma is by using home remedies. Here are some of the common and effective home remedies used to treat this skin disease without any side effects:

Paste of Mustard Oil and Turmeric:

Turmeric has a lot of medicinal benefits and is also used effectively for the treatment of Vitiligo. One can lower the effects of Vitiligo by using turmeric. Take one tablespoon of turmeric powder with 2 tablespoons of mustard oil and mix them well to make a thick paste. Apply this paste on the affected area, leave for at least 15 minutes, and then wash it off. For better results, apply this paste twice a day.

Honey and Margosa Leaves:

Another amazing home remedy that can do wonders in this skin disorder treatment is the use of honey and margosa leaves. Take one tablespoon of honey juice and mix it well with a few crushed margosa leaves. Have this concoction to get rid of Vitiligo.

Bakuchi Paste:

To prepare Bakuchi paste, one needs Bakuchi (Psoralea carylifolia) and vinegar. Mix them well to make a thick paste and apply it over the white blotches and patches. This is also one of the most popular remedies to treat Vitiligo.

Ginger Juice:

Since ancient times, ginger is used as a medicine for the treatment of many diseases. One such disease is Vitiligo. Ginger is very much effective for the treatment of white patches. To make this home remedy, take a piece of ginger and blend it with water to make a thin liquid. Pour this juice in a cup with the help of a strainer. Drink this juice twice a day to heal Vitiligo.

Ghee and Pepper:

This is another most effective home remedy used to treat Vitiligo. For this remedy, heat 10 pepper in 10 gm of ghee. Remove the pepper and mix this ghee with normal ghee. One can use this ghee while cooking daily food. Regular consumption of this ghee will purify the blood and improve immunity.  

Final Words:

There are other home remedies available to treat this skin disorder like neem paste, tamarind seed paste, pomegranate powder, goosefoot vegetable juice, black gram paste, etc. However, it is always advisable to consult a doctor before opting for any of these remedies. The condition may vary from patient to patient; this is why consulting a physician is always a great idea.

5 Best Home Remedies To Treat Vitiligo Diseases

The goodness of water is known to all and sundry. Another fluid to watch out for is the coconut water. Coconut water will leave you with a mouth open awe with its health benefits. From small kids to pregnant women to elderly people, everyone can drink coconut water (unless asked to avoid on doctor recommendation) without any tension. The sweet, nut-like taste of coconut water is indeed very refreshing and soothing, a great respite in the scorching summers.

Positive effects of coconut water on the health

A low-calorie drink: Coconut water is an ideal and healthy substitute for processed fruit juice, aerated drinks, and beverages. Some of the amazing health benefits of coconut water include;
Improves Digestion: Coconut water is an excellent source of phosphatase, diastase, folic acid, and other enzymes that aids in the digestion of food.
A person with dehydration (an outcome of dysentery, diarrhea or cholera) can benefit immensely from coconut water. The coconut water works by restoring the lost electrolyte and plasma balance in the body.
Keeps skin aging at bay: Cytokines and lauric acid are known to have anti-aging properties. They maintain the pH balance of the skin. Coconut water is a rich source of lauric acid and cytokines. As expected, coconut water helps to restore the natural glow of the skin. Coconut water greatly nourishes and protects the skin from rashes and skin infections.
Drink coconut water, forget depression forever: Riboflavin, pathogenic acid, and thiamine are the triple healing vitamins that help to lower depression and stress in a person. With these important vitamins present, coconut water will lift your mood and spirits effortlessly.
Weight management: Being a low- calorie drink, coconut water is a healthy option for people who are on a diet and want to lose few extra kilos.
Healthy bones the natural way: An excellent source of calcium, coconut water will keep your bones strong and healthy.
Kidney stones a thing of the past: A natural way to deal with the problem of kidney stones is indeed a great news. Potassium is present in abundance in coconut water. Thus, it not only helps in dissolving the kidney stones, but also ensures that there is no recurrence of the condition (kidney stones).
A healthy blood pressure: Coconut water comes as a much-needed blessing for people with high blood pressure. The minerals (Potassium and Magnesium) along with Vitamin C ensure that the blood pressure is within healthy limits.
The magnesium present in coconut water comes as a savior for people with migraines.

A rich source of potassium implies coconut water helps to lower the instances of muscle cramps.
Having long, healthy, and lustrous hair is no longer a dream, all thanks to the coconut water. It hydrates the scalp, thus providing the necessary nourishment to the hair.
Being low in sugar and calories, coconut water is an excellent remedy for diabetic patients.

Coconut Water - 9 Reasons You Must Start Drinking It Today!

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