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 urticaria, is characterized by an outbreak of swollen red bumps on the skin. It may cause symptoms of itching, burning or stinging. The disorder can affect any part of the body including the tongue, throat and face. The size of the bumps can vary, they may join together to form plaques. The bumps or plaques appear and disappear until the disorder runs its course. In case of chronic hives, the bumps can last up to six weeks.

Symptoms
The symptoms of this disorder are formation of bumps on the body, severe itching and pain resulting from the bumps. The symptoms can get aggravated by stress, heat and exercise. You may also experience dizziness, chest pain and a swollen throat.

Causes
Chronic hives can be caused when specific cells in the body release histamine in the blood. The exact cause of this disorder is not known. This reaction of releasing histamine in the blood can be triggered by factors like: 
1. Insects
2. Medications to control pain
3. Scratching
4. Exposure to cold and heat
5. Excessive consumption of alcohol
6. Heavy exercise

Being a female and being young raises your risk of being affected by this disorder.


Ayurvedic Treatment
The first line of treatment for hives is the use of home remedies. The doctor will aim to treat any underlying condition, if any. Ayurvedic remedies for hives are holistic and free from side effects. They are based on natural ingredients that do not cause any adverse effects on the body.

The Ayurvedic treatment for this disorder are

Herbs: Certain herbs like turmeric are very effective to treat this condition. It is known for its anti-inflammatory properties that help relieve its symptoms. A mixture of rock salt and mustard oil can be applied on the affected part to foster speedy recovery.
Diet: You need to follow certain dietary guidelines so that the symptoms do not get aggravated. Avoid taking foods that are sour and salty. Include plenty of buttermilk as it has a cooling effect on the body.

Chronic Hives - How Ayurveda Remedies Helpful in Treating it?

Men also suffer from breast enlargement, medically called gynecomastia. This usually happens when the levels of female sex hormones, in the affected male, overshadow the male sex hormone levels.

Gynecomastia is different from fat accumulation in the male upper chest. It is typically characterised by an increase in the glandular tissue, which can produce milk.

Lots of adolescent boys suffer from male breast enlargement due to the adolescent hormonal surge, though, the condition can present in men at any age. Adolescents lose the breast enlargement typically in periods ranging from 6 months to a year. Beyond this period, a man with enlarged breasts has to seek medical intervention for treatment.

Typically, gynecomastia occurs due to certain medications like for renal failure and hypertension. It can also be caused due to conditions like hyperthyroidism or kidney failure, liver cirrhosis or problems with testes which causes changes in hormones in the male body.

Treatments-

Whatever be the reason, gynecomastia is a deeply distressing condition for men of all ages. Treatments are available, both surgical and medicinal and they help especially surgery.

Male Breast Reduction Surgery- Facts

Surgery for male breast reduction can be performed safely and successfully on teenagers and adult men alike.

In male breast reduction surgery, the surgeon makes an incision around the nipple and removes the excess glandular tissue and fats causing the appearance of the breast. This is the only effective treatment for gynecomastia that has long-lasting, if not permanent, results. Male breasts may also appear due to excess fat in the upper chest. Liposuction is generally very effective in treating this. The surgeon removes fats and some glandular tissue and then sculpts a new chest contour that looks natural for your body.

More severe cases of gynecomastia may require more than this. The surgeon has to then go for something called  surgical tissue excision  to achieve optimal results. Older males with gynecomastia with sagging skin also require tissue excision. This technique allows the surgeon to remove a major chunk of glandular tissue and/or skin that cannot be successfully removed by mere liposuction.

If you are planning to go for breast reduction surgery, find the best cosmetic surgeon. This will go a long way in you getting the best results and minimise scars.

Also be prepared for the after-effects of the surgery. Even though it is typically performed as an outpatient procedure using general anaesthesia or local anaesthesia with sedation, you must be prepared for soreness and swelling. Recovery time is usually a week and a patient is often given a compression garment to wear for the first few weeks after surgery to support the healing breast tissue. Also, be prepared to be off exercise for a month or so after surgery.

Can Surgery Help Reduce Enlarged Breasts In Men?

Hair loss or alopecia is a problem common to both men and women. It can leave you feeling very miserable. But rather than getting upset knowing the cause will help you tackle the problem efficiently. 

The following are few shocking causes of hair loss that you may not be aware of:
1. Hair loss can be a hereditary problem for some people. It can be common to both men and women. Males may encounter male pattern baldness and females can encounter female pattern baldness.
2. Women can face hair loss problems for using hair styling tools. You must avoid hair strengtheners, curling irons and dryers in order to control hair loss.
3. Hormonal imbalances can lead to hair loss. Thyroid problems or levels of estrogen getting reduced in cases of women can cause hair loss.
4. Lack of protein in your diet can also result in hair loss. Insufficient protein intake according to your age may trigger hair loss.
5. Intake of too much steroids like birth control pills can also be a contributing factor.
6. Stress is also a major contributing factor for hair loss. Any form of prolonged anxiety or trauma can lead to hair loss problems.
7. Sudden and excessive weight loss also sometimes may be the cause for uncontrolled hair fall.

In order to combat the problem of hair loss you must consult a doctor and undergo the required treatment. 

The following are few treatments that can prove to be helpful for you: 
1. Many clinics nowadays provide hair transplantation treatment. You may consider hair transplantation if you encounter hair loss at an alarming rate.
2. Increase the intake of proteins in your diet. Include food like fish in your diet which is high on protein.
3. Massage hair oils like coconut oil, almond oil, amla oil as they will help nourish the roots of your hair.
4. Onion juice is proved to be very helpful in growing back hair on your scalp. Apply it on your scalp and it may help you to grow back your hair.
5. Applying henna at home can also increase the volume of your hair and make it look beautiful too.

Along with the above mentioned treatments, eating healthy and sleeping well will also help you to tackle your problem of hair loss. Normally a person sheds fifty to hundred strands of hair per day, but if it is more than that, consulting a doctor is highly recommended.

Shocking Causes of Hair Loss and Treatment

Lupus is an inflammatory disease that is chronic in nature. It occurs when your tissues and organs are attacked by your body's own immunity system. The inflammation that this disease causes can affect the other parts of your body as well, like the joints, kidneys, skin, brain etc. It is often difficult to diagnose because it lacks distinct symptoms. However, one of the most identifiable symptoms of lupus is a ring-shaped rash on the face.

Lupus can be caused by a number of factors like:

Excessive exposure to sunlight
Susceptibility towards infections
Certain anti-seizure, blood pressure and antibiotic medicines
Symptoms
The symptoms are neither distinct nor regular. However, some common symptoms could be-

Fatigue and fever
Pain in the joints, stiffness and swelling
Ring-shaped facial rash
Skin lesions on exposure to the sun
Chest pain and shortness of breath
What else can lupus lead to?

Several complications may arise if lupus is left untreated. Some of them are-

Kidney damage and failure
Hallucination, seizures, strokes and several other problems associated with the brain and the central nervous system
Anemia, blood clotting, vasculitis etc.
Increased susceptibility to pneumonia
Increased risk of heart attacks and other cardiovascular diseases
Treatment
Lupus is a significantly dangerous disease and medical help should be immediately sought if you think that you have symptoms associated with it. Treatment depends on the signs and symptoms of individual patients.

Lupus (Skin Rash) - How It Can Be Treated?

Everyone wants to have a bright and radiating skin. But blemishes and skin abnormalities are common and can occur due to lifestyle, diet or hormonal imbalances. Moles and warts are typical skin issues. But how do you tell them apart?

Moles   What are they?

Hardly ever causing pain, they appear in many different colours and can be bumpy or flat. Most often of red, brown or black colour, they occur as a result of skin pigmentation called melanocytes. They can be caused due to direct exposure to sunlight or due to genetic factors as well. They can appear in any part of the body and form slowly, taking a long time to grow.

Warts   What are they?

Small bumps or rough growth on the skin that appear in hands, legs, fingers, soles of the feet, face or in the genital area manifest as warts. They are white or pale. They occur as a result of harmful virus infection of Human Papilloma Virus (HPV) and hence, can be contagious. As opposed to moles, warts need to be removed quickly since a virus causes them.

How do you differentiate a mole from a wart?
Below are some common characteristics of each that can help you identify the skin problem:

Moles

Either flat or elevated from the skin, they are commonly referred to as beauty marks or birth marks.
At times, they have hair growing from them.
Usually, they have one colour   mostly on the darker side.
It cannot be transmitted between people.
They are generated by a collection of pigment cells in the body and darken during hormonal changes.
They tend to become cancerous and lead to melanoma.
Warts

They are harmless, yet contagious.
They have small black or dark dots in the centre that are tiny blood vessels, which provide them with nutrients.
They grow outwards on the skin with a scaly or bumpy deposit.
They can grow anywhere on the body, but are commonly found in feet, hands or fingers.
How to treat warts and moles?

The good news is that both warts and moles do not pose a grave risk to your health, but they are annoying and can turn dangerous in the long run. Especially with warts, you can give it to someone or acquire from someone, since it is a type of virus infection. So, seek medical assistance if you want them to be removed from your skin.

Be aware of the difference between warts and moles to know what you are dealing with. Consult a dermatologist to decide the right steps to remove it or not.

Warts vs. Moles - All You Need To Know!

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