Psoriasis is a durable autoimmune disease defined by patches of irregular skin. These patches of skin are usually scaly, red and itchy. Its symptoms vary greatly in severity, the coverage might be small and focused or it could spread all over the body.

Types
There are mainly five types of psoriasis:
1. Plaque- also called psoriasis vulgaris, is the most common kind of psoriasis (90% of cases). It affects the skin behind the forearms, over the navel, shins and scalp, usually presenting itself in red patches with white- colored scales over it.
2. Guttate- has lesions that are drop-shaped.
3. Inverse- red patches show up in the folds of your skin.
4. Pustular- pus-filled blisters form. They are non-infectious.
5. Erythrodermic- the rash spreads wider. In some people, even fingernails and toenails get affected as pits may form on them or their colour may change.

Causes
Anything from emotional trauma and stress to streptococcal infection can cause psoriasis. Sometimes you might carry predisposition for psoriasis in your genes and stress may aggravate it. Environmental factors may also lead to psoriasis. And then again defects in the immune system may also be the underlying cause. Even after thirty years of research, the exact cause for psoriasis remains a mystery. There is no age limit to psoriasis. It can show up from anywhere between infancy to old age.

Symptoms
Common symptoms include
1. Pink or red scaly bumps that are smaller in size, but become plaques later, show up on the skin. Although these scales can show up anywhere, they are mostly common on sites where there is much friction, abrasion or scratching.
2. Small pinpoint depressions or pits might show up on toenails and fingernails. Distal onycholysis, which refers to large brown/yellow divisions on the nails, shows up as well.
3. Sore throat may follow if it is guttate psoriasis.

Treatment
Psoriasis is not curable. But its symptoms can be managed with steroid creams, ultraviolet creams, vitamin d3 creams and with medicines that act as immunosuppressants. Creams alone can help control symptoms in 75% of patients with psoriasis.

All About Psoriasis

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

5 Unexpected Triggers of Hair Fall

Your genes may be the most common triggers of hair fall, but in certain cases hair fall can be triggered by a host of other reasons you wouldn t have thought about. Sometimes these reasons can range from being simple and temporary (lack of essential nutrients in your diet for example) to something more complex and indicative of an underlying health problem. Read on...

1. Brushing wet hair

Detangling wet hair (easy at it may seem) is probably one of the most common triggers of hair fall. Wet hair is extremely delicate, and brushing wet hair causes the strands to break, leading to excessive hair fall. Repeatedly doing so can cause your hair to become thinner over time, which may result in visibly less hair on your scalp.

2. Food poisoning

Food poisoning can cause an abnormality in your blood circulation, which, as a result, can lead your hair to prematurely enter into a shedding phase. The hair loss that takes place due to this reason is known as  diffuse hair loss.  This type of hair loss usually lasts for a period of 3 months, after which, the hair follicles are replaced by new ones. Hair fall caused by food poisoning is only temporary, and is corrected on its own with time.

3. Car crashes or any other traumatic events

When you go through a car crash or any other traumatic incidence for that matter (divorce, death in the family etc), you may experience an extreme form of shock. This can lead to the development of small bald patches on your head, which is known as Telogen Effluvium. Usually, trauma triggers an autoimmune reaction, because of which the white blood cells attack the hair bulb. This causes the hair bulb to enter into the resting phase, which leads to mildly painful hair loss in particular patches. This type of hair fall is reversible.

4. Food allergies

Different foods (such as dairy, wheat, soy etc) can cause allergies in different people. Such an allergic reaction can cause your immune system to react violently, consequently making your immune system send signals throughout your body to ward off attacks. This, in very rare cases, can give rise to the condition of Alopecia Areata, as your immune system detects the growth of your hair as foreign attack and sends off signals to destroy hair follicles. This type of hair fall ceases once you stop consuming food(s) you re allergic to.

5. General Anaesthesia and Surgery

Hair fall triggered by general anaesthesia and a major surgery usually shows up 3 months after the surgery has taken place. The combination of general anaesthesia and a major surgery can put your body under heavy physical stress, which can cause alterations in the life cycles of the hairs on your scalp, consequently leading to excessive hair fall. Hair fall caused by this reason is temporary too, and usually your hair will grow back over time.
Now that you know about the possible triggers of hair fall, you may be in a better position to control your condition and prevent your hair from falling out. 



5 Unexpected Reasons Why You Might Be Losing Your Hair!

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?

Vitiligo is a disorder in which the skin starts losing its original color in the form of unequal shapes and sizes. This problem of skin pigmentation means that the melanocytes in the skin get damaged. This leads to the development of the white patches on the skin.

The hairs which grow on the affected area start losing their color and become gray. This problem also causes psychological disorders which related to appearance and many times, the adolescent's high dose of medications if this disorder develops in the visible areas like face, hands, arms or the feet. The adolescents start feeling embarrassed, depressed and worried about what the others might think of them and how they would react to seeing them.

Causes

Though the exact causes of vitiligo are not clear, the researchers assume that this disorder is just like an autoimmune disorder. This means that the pigmentation or the element which gives color to the skin get destroyed by the antibodies of the person s own body.

In some cases, it has also been observed that the initial stage of this disorder relates to an event which causes psychological stress to the person. People whose parents or other family members suffer from this disease are also likely to suffer from the same. This can be said that this disorder passes down the genes from generation to generation.

If people have suffered sunburns, rashes and other disorders related to the skin where the hair turns gray before the person turns thirty-five, are also some of the causes of this disease.

Role of homeopathy in treating Vitiligo

Homeopathy aims at treating the problem from the root, over a period of time yet in an effective manner. This field of medicine works at building the immunity of the patients and restore their health. As per homeopathy, it is important to understand the constitution of the patient before prescribing any type of medicine. Also, homeopathic medicines prescribed to an individual are related more to the constitution of the individual, the symptoms it is indicating and the overall psyche of the patient. 

Further, it is required that the formation of the melanin in the body is improved, in order to treat the problem. Since all patients are different, thus they respond differently to the treatment provided. And, the course of the treatment can only be decided once the underlying root cause is determined. Homeopathy treatment goes beyond the general and medicinal aspects of the vitiligo treatment. 

All these medicines listed above are only suggestive in nature and can change with the change in symptoms. Therefore one should only take homeopathic medicines as prescribed by the doctor. 

Vitiligo - Know Why Homeopathy Is The Best Choice Of Treatment!

When it comes to a man's physique, enlarged breasts can be quite embarrassing. This is a condition known as gynecomastia or men boobs or  enlarged breast in men and affects more men than you would imagine. It may affect one or both breasts. It can result in terrible embarrassment, teasing, and social trauma. Many will try to hide it with thick loose shirts, avoid bare chest activities like swimming, exercises etc and withdraw from public exposure.Though it does not pose a significant health risk, it can affect a man's psychological health and lower his self-confidence. The good news is that men suffering from this condition do not need to live with it. 

Male breast reduction surgery or gynecomastia surgery, aims at reconfiguring the contours of a man's chest by removing excess breast fat & if needed extra gland tissues. The only permanent solution to this condition is surgery. This is because fat tissues are not solely responsible for enlarged breasts. Often glandular tissue is present in excessive amounts as well. Patients need careful evaluation by Plastic Surgeon & sometimes if needed by endocrinologist to determine the source of their breast enlargement. 

Gynecomastia surgery is usually a daycare procedure. It is performed by Plastic Surgeons under local anesthesia with liposuction being the most preferred procedure. This procedure begins when the surgeon makes a small incision on each side of the chest. These incisions are usually placed along the natural contours of the body, around the edge of the areola or near the armpit so as to reduce the visibility of scars. Excess fat and glandular tissue are then sucked out of this incision. Simultaneously, the surgeon sculpts the other tissues in the chest to redefine chest contours. Patients are usually advised to wear a compression garment after the surgery to support the healing tissues and minimize swelling. 

Results of this procedure are visible almost immediately. Recovery from gynecomastia surgery is usually quick and many men find themselves back to their normal routine within a few days. However, vigorous exercising and heavy lifting should be avoided for a few weeks after the surgery. The patient may also experience slight soreness and minimal pain that can be relieved with over the counter pain killers. 

The results of this procedure are generally permanent if there are no hormonal abnormalities. It is important to maintain a healthy lifestyle and avoid drugs that influence your testosterone levels. Regular exercise can also help tone the chest muscles and maintain the achieved good shape of chest. It is really a very simple but rewarding surgery for the male & it definitely boosts his confidence, body image & self-respect.

Enlarged Breast In Men - Causes And Treatment 

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