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

Vitiligo is a skin disorder which results in the loss of skin pigments in different parts of the body due to the destruction of the colour producing cells called the melanocytes. Vitiligo can affect any part of the skin present in different parts of the body. Vitiligo is a disorder in which the immune system of the body gets overactive and destroys these colour producing cells on it's own, therefore resulting in white patches which are generally much fairer than the original skin colour of the human skin. In this article we are going to talk about some more facts and details about Vitiligo.

Facts about Vitiligo

Here are some important facts about vitiligo which should be kept in mind:

Vitiligo can affect an individual of any skin colour, gender, age and ethnicity. There is no particular set of people, only who gets affected by it.
Vitiligo cannot be cured completely even though a few treatments are there. Usually it is a lifelong disorder and once affected stays with the person forever.
Thankfully, in spite of being a harmful disorder, vitiligo is not at all contagious. Vitiligo cannot be spread to others when they come in contact with a person suffering from vitiligo.
After reading these few points we hope you now know about vitiligo in a much better way.

Symptoms of Vitiligo

One of the common symptoms of Vitiligo is that the skin will have white patches in the affected areas. The white patches can occur on any part of the body ie hands, legs, lips, mouth and armsarmpit, groin, eyes, nostrils, navel and genitals.

In focal pattern this white patches will be seen only in some few areas and in segmental pattern this white patches will be seen in one side of the body and in bilateral pattern this white patches will be seen different parts of the body. Sometimes vitiligo may be associated with white hair (Leukotrichia)

Sometimes you may have difficulties in understanding whether a particular skin colour disorder is Vitiligo or not. Thus here are the symptoms to look out for:

Vitiligo results in loss of skin colour in different parts of the body in patches.
Early whitening or graying of hair present on your scalp, eyes or even the beard can indicate the onset of vitiligo.
Vitiligo even affects the mucous membrane inside your mouth and nise and therefore you will understand when the inside of the mouth starts losing colour as well.
Vitiligo usually spreads in different skin parts of the body. But it sometimes can also affect only one side of the body and is known as segmental vitiligo.
So here are the important symptoms that can be observed to understand whether a person has vitiligo or not.

Vitiligo - Signs You Need To Be Aware Of!

Tummy tuck or abdominoplasty is a frequently performed cosmetic procedure which is meant to improve the looks or appearance of your abdominal region. The primary goal of this procedure is to remove excess skin or fat from the abdominal region and then reconnect the tissues with sutures to get a more toned and flat look.

The requirement for abdominoplasty
The tummy tuck surgery is for someone who has folds of fat or skin on their abdominal region that results in an unsightly appearance and causes body image issues. These problems may be caused by multiple factors, some of which are mentioned below:

1. Significant weight loss: Men or women who have lost a lot of weight tend to have excess loose skin on their bodies as a result of the skin being stretched over a long period of time.

2. Pregnancy: Many women who have gone through multiple pregnancies also have similar problems as the skin in their abdominal region tends to stretch over multiple times which may result in the skin becoming flabby.

3. You have a weak lower abdominal wall: Some patients tend to generally have a weak lower abdominal wall which over the years tends to protrude and hang. This results in a misshapen body which they want to correct for body image issues. 

4. To correct scarring from C section: Many women who give birth via C-section tend to have a scar on their body and some abdominal contouring can change the shape and size of the scar, which in turn not only tightens the tummy but also hides the scars.

Considerations before abdominoplasty
Abdominoplasty isn't recommended if you fall under any of the following categories:
1. Still have to lose weight: If you have to lose a lot of weight, then it is advised that you wait till your goal weight is reached and only then consider this procedure. Abdominoplasty isn't meant to reduce weight, but to take out excess skin and flab that remains after weight loss

2. Plan on becoming pregnant again: If you are planning to become pregnant again, then the muscles and tissues in your abdomen might loosen and cause a flabby belly again.

3. If you have heart disease or other conditions: If you have heart related conditions or are diabetic, then abdominoplasty won't be considered as it might put you at high risk of complications after surgery.

Abdominoplasty - An Overview

Eczema is a skin condition that is accompanied by itchy rashes on the skin. They often bleed and give out a foul smell. Eczema usually develops during one's childhood. There are allopath medicines available to treat this condition but their action is only short-lived. These medicines provide temporary relief but fail to cure the ailment completely. However, homeopathic medicines can help an affected person recover completely owing to their ability to work at the core. Today we are going to discuss about some of the components that homeopathic medicines use to treat eczema.

Some of the homeopathic supplements use carbon or black lead to treat eczema. Eczema often tends to develop around warm and moist areas like the folds of the elbows, behind the ears, between the toes, behind the knees. Black carbon is a primary aerosol which contains cooling agents. Homeopathy remedies make use of this quality of black carbon to heal eczema.
Eczema undoubtedly develops in areas that mostly receive less air. However, the condition can be aggravated during the winters and cause more irritation. There are homeopathic supplements that make use of a fluid extracted from the vesicle (a component of the cell) of a person affected by scabies to treat eczema. Scabies is another skin condition that occurs when the scabies mites eat into the skin and lay eggs there. This is a condition that is somewhat similar to eczema in that it leads to skin irritation and itchiness.
Petroleum extract is another homeopathic remedy to treat eczema. The medicine made from petroleum works in a similar manner as Vaseline. As has been aforementioned eczema worsens during the winter as the skin gets chapped and incessant scratching leaves lesions on the skin. The homeopathic drug controls this situation by keeping the skin moisturized.
According to the University of Michigan Health System, sulfur is a very important mineral that takes care of the connective tissues, bones, teeth, hair as well as the skin. Therefore homeopathic medicines use sulfur which acts as a sure-fire component when it comes to treating eczema.
Poison Ivy is a component that is used to treat skin conditions. The homeopathic drug made from the extract of the poison ivy plant especially treats eczema that develops on the face, scalp and around the mucous membranes. Severe eczema can also result in stiff joints. The medicine works to heal a person from such botheration.
This is an article that aims at making you acquainted with the homeopathic remedies available for treating eczema. For the best result consult a professional.

Role of Homeopathy in Treating Eczema!

Having a cosmetic surgery is quite a big deal. It is an expensive surgery, which causes alteration of your body features. Although cosmetic surgeries are usually effective and provide satisfactory results, you should keep several things in mind before a cosmetic surgery. You should know all important facts about cosmetic surgeries, their procedure and results before undertaking one.

Here are the things you should consider and keep in mind:

Cosmetic surgeries are permanent: You would like the idea of perfecting several features of your body using a cosmetic surgery. However, you must keep in mind that such a surgery is permanent and your features would be altered forever. You should not undergo a cosmetic surgery half-heartedly and must think over and over before finalizing.
You should know why you are having a surgery: You need to have proper reasons why you want to undergo a cosmetic surgery. You should consider the exact reason why you feel that a cosmetic surgery is required. There are several physical and emotional changes which occur after a surgery and you should be prepared for the same.
You should know the results you want: Before having a cosmetic surgery, you should know exactly how the results would appear. Having a rough idea will not do and you should know beforehand how you are going to look post-surgery. You must make the doctor understand your requirements and desired results perfectly so that he or she can give the best results. You may use pictures and illustrations to explain your objectives to the surgeon.
You should know about the outcomes: Knowing about all the possible outcomes of the cosmetic surgery, which you have opted for is very important. For this, you need to surf the internet and do some research. Read from trustworthy medical care websites and also consult people who have had a cosmetic surgery before. You should also keep in mind the consequences which may arise if you do not like the results of a cosmetic surgery and be prepared mentally, in case some complications occur.
You should choose the best surgeon: Choosing a capable and efficient surgeon is an important thing to do, before thinking of having a cosmetic surgery. You should consider the location, experience and approach, while choosing the right surgeon. You should also make sure that the surgeon is qualified and registered to practice.
A cosmetic surgery is a serious surgery, which will change the way you look in certain ways, depending upon the type of cosmetic surgery you have chosen. Before deciding on having a cosmetic surgery, you should consider the above-mentioned factors and then only go for it.

Going for a Cosmetic Surgery - Things You Must Consider Before it!

Depending on the way you look at it, a mole can be a beauty spot or a blemish. For most people, facial moles are undesired. Moles can be described as clusters of pigmented skin cells. They appear in the form of dark spots on the skin that vary in size, color and texture. Apart from the face, moles appear commonly on the arms and legs but can affect any part of the body. In most cases, moles are harmless but in some cases, they may turn precancerous and need to be removed. However, most moles are removed for only cosmetic reasons. Moles can be removed through home remedies, surgery or laser treatment.

Mole removal depends on the type, size and location of the mole. When treated with lasers, layers of the mole are removed one by one by evaporating the affected cells. This does not cause any sort of bleeding and does not disturb healthy tissues adjacent to the mole. It is also considered to be a largely pain-free procedure but you may feel a slight tingling sensation. After the laser procedure, a scab forms over the affected area which later falls off. You may also notice slight swelling and redness in the area for a few days after the procedure.

Laser treatment for mole removal has a number of advantages.

As it is a non-invasive procedure, there are minimal chances of infection
Multiple moles can be treated in a single session
Laser beams can reach parts of the face, nose and ears that may be difficult to reach through other procedures.
There are minimal disturbance and injury to the adjacent healthy tissues
Healing is much faster than with other procedures
There is a very low chance of scarring
However, one of the biggest disadvantages of laser therapy is that it can only be used to treat surface moles as the laser beam cannot penetrate deep into the skin. Also, laser treatment, if not recommended in cases where the mole may be considered precancerous as the laser beam will destroy the mole leaving nothing that can be used for a biopsy. Lasers are also seldom used to treat large moles or birthmarks. The cost of removing a mole with laser treatment depends on the size, location and number of moles. In some cases, more than one session may be required and this too could influence the cost of the procedure.

Moles - How Laser Treatment Can Help You Get Rid Of Them?

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