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

Eczema refers to any kind of superficial inflammatory process that primarily involves the epidermis, and is characterised by itching, redness, vesicles and sometimes crusting and oozing. Another term for eczema is atopic dermatitis. This kind of skin infection can start during infancy and continue until many years. Though there are some people who outgrow the condition, others may have it all their lives.

Causes:

The factors that play a role in causing eczema are:

Genetics is one of the factors that may affect the proper functioning of your skin as a barrier against harmful substances. Therefore, if either one of the parent or both suffers from the condition, it is very likely that their children too will suffer from it.
Abnormal functioning of your body's immune system can also lead to this skin condition. This is because it's your body's immune system that fights off infections as well as harmful intruders.
Dry skin brings down your skin's ability to fend off irritants as well as allergy causing substances from entering your skin, resulting in an inflammatory condition.
The presence of the bacteria called Staphylococcus aureus, which brings about sweat buildup, inflames the skin considerably, leading to this condition.
Even environmental factors like pollen, cigarette smoke lead to the flaring of eczema.
What are the symptoms of eczema?

Atopic dermatitis is commonly seen as dry patches appearing on the skin and sometimes these patches are extremely itchy and cause discomfort. In the case of infants, the rashes appear on the scalp and cheeks and often bubble up before the liquid oozes out. Rashes commonly appear on the backside of the creases of the elbows and knees in the case of kids above two years, and other places on the body may also be affected. In adults, the rashes can make the skin dry and cover maximum area of the body. It may also lead to further skin infections, skin irritation, and may also cause eye problems.

How can eczema be treated?
Though there is no overall cure for eczema, but the treatments can heal the affected skin as well as prevent flaring of the symptoms. Doctors often suggest a plan of treatment on the basis of the age of the patient, symptoms, and the present state of health. You can opt to take warm baths on a regular basis and apply moisturiser within three minutes. You will have to avoid harsh soaps and instead use the mild soap or non-soap cleansers while washing. It is important to keep your fingernails short so that you don t scratch the affected area which would further aggravate it.
If you are unable to keep eczema under control with all these preventive tips, then it would be best to consult a dermatologist for curing it.

How can you prevent an eczema outbreak?

It is very common for this skin condition to flare-up from time to time. But you can avoid such outbreaks or reduce their severity by following these very simple ways:

Sudden changes in temperature can cause the skin condition to break out. So, when the weather is hot, keep yourself cool but during cold weather, use a humidifier to prevent the skin from drying out.
Keep sweating in check as it can cause an outbreak very easily
Keep your skin well-moisturized so that it doesn't dry out causing further irritation.
Avoid the use of harsh detergents and soaps, woolen materials as well as the consumption of foods that may lead to flare-ups. 

Eczema - Causes, Symptoms and Treatments

Primarily common among middle-aged women, rosacea is a disorder which is characterized by redness and pus-filled bumps and blisters on the chin, cheeks and the forehead. As time progresses, these red bumps can get aggravated and result in other complications. It may also affect other parts of the body such as the back, neck and the chest. If the eyes are affected, then they might appear to be watery and bloodshot. It can also lead to formation of bumps and pimples on the face.

Causes
The exact cause of rosacea has not yet been ascertained. However, certain factors have been known to act as catalysts in the development of this disorder, such as problems of the blood vessels. It may also be caused by fungus and microscopic skin mites. Though more research needs to go into it, but psychological factors are often considered to be important reasons behind this disorder. Some other risk factors of rosacea are:

Gender: It is more common among women
Complexion: People with fairer skin are at a higher risk
Symptoms
The symptoms of this disorder can vary among individuals, but they all share a few common symptoms. The major symptoms of this disorder are:

Bumps and pimples: Similar to pimples, pus filled bumps and pimples are a few common symptoms.
Flushing: A flushed face or a face that appears reddish is one of the most common symptoms indicative of rosacea.
Visible blood vessels: The blood vessels on the face tend to become visible.
Thickening of the skin: The skin tends to thicken and enlarge, caused by the presence of excessive tissue.
Stinging and burning: One may experience burning sensations and inflammation on the face.
Treatment
There are two primary methods of treatment and the required type is decided upon after a through diagnosis of the symptoms. They are-

Medications: Topical and oral medications can be administered to treat symptoms of pimples, bumps and the reddish hue on the face. Medications help you manage the symptoms and prevent them from aggravating or resurfacing.
Surgical procedures: Surgical procedures for rosacea are aimed at reducing the excessive facial redness, remedying blood vessels that are visible and correct other deformities if required.
There are certain preventive measures that you can adopt, them being:
1. Avoid direct exposure to the sun
2. Don t overdo your exercise sessions
3. Avoid eating spicy foods
4. Take steps to minimize your stress levels

Swollen Red Bumps On Skin - Can It Be A Sign Of Rosacea?

Hives is a very common condition and about 20% of the world has got it at some point in their lives. There are many causes to it ranging from blood transfusions to certain allergic reactions to food. It starts off as an itchy patch of skin but slowly swells and turns into red welts. There are certain factors which makes the itching worse including stress, alcohol and scratching the area of skin which was itchy in the first place. 

Causes
Here are all the causes and symptoms of hives:
1. Food
Allergic reactions to foods such as nuts, eggs and shellfish are a common cause of hives.

2. Medications
Certain medications also have a side effect of causing hives. Penicillin and sulfa are two of the antibiotics, which can cause hives. Ibuprofen and Aspirin are also two other medications, which are commonly known to cause hives.

3. Infections
Both bacterial and viral infections can lead to hives. Strep throat, urinary tract infections, common cold and hepatitis are some of many bacterial and viral infections, which may cause hives.

4. Stimuli
Certain factors such as temperature, pressure, sun exposure and other physical stimuli may cause hives as well.

5. Plants and animals
Dander in animals are the flakes of skin in their fur. Moreover, coming into contact with certain poisonous plants may cause hives.

6. Insects
When insects sting or bite you, you may get hives.

7. Latex
Latex is a type of rubber used in many types of clothing. It has been said that wearing clothing made out of latex can cause hives.

8. Pollen
Pollen is a light powdery substance produced by plants such as oak trees. It travels through the air and may cause hives if it comes into contact with your skin.

Symptoms
1. Bumps
Itchy red bumps appear on the skin when you have hives. Sometimes, the bumps can be skin-colored as well.
2. Blanching
When the bumps turn white after you press them, it is known as blanching. Blanching is the only clear symptom of hives.

Hives: Causes and Symptoms

A woman s body goes through a number of changes during her lifetime and therefore, it is always better to undergo regular health check-ups at proper intervals to ensure that all organs of her body function well.

Endometriosis is something, which every woman is likely to have heard about. However, not many women are aware of what it exactly is. Even fewer know about what they should look out for when it comes to having endometriosis or understanding what it means to be suffering from it. Is it not a lot better to be informed about all of this?


The condition of endometriosis is when the tissue that is supposed to be inside the uterus also known as the womb and lining starts existing outside it. What effectively happens is that the lining of the uterus, known as the endometrium, finds itself to be trapped in the pelvic area.


Some amount of discomfort is usually experienced by women who are menstruating. However, when a woman has endometriosis, the amount of pain is pretty persistent, sometimes extending to a month-long duration. Some women also suffer from excess bleeding.


Unfortunately the symptoms are not only limited to this. Women who are adversely affected by endometriosis usually find having sex painful as well, ironic as it is supposed to provide pleasure.

Also fertility is the primary function affected by it. There are so many complications in this regard. It is said that about 50 percent of women who have endometriosis have trouble getting pregnant and carrying a baby. Effectively, as sad as it is, endometriosis has the potential to take away the entire prospect of motherhood from a woman.


In addition to this, a fair number of cases, show that the symptoms, which are experienced worsen over the course of time. So, what this means is that the lifestyle of the woman may be severely affected as the symptoms get progressively worse; which is just one of the reasons why treatment is something, which should be resorted to sooner than later.


One of the lifestyle changes which may be beneficial in reducing the severity of endometriosis includes a change in your diet. Increased intake of green vegetables and fresh fruits along with a reduced consumption of red meat is definitely worth a try. Regular exercising is also helpful in treating the condition.


Endometriosis - What are the Symptoms and Consequences of it?

Bedtime skin care to prevent acne

Skin repairs and rebuilds at night time while you rest, so it makes sense to follow good skin care routine before going to bed every night.

3 most effective bedtime skin care tips that rejuvenate your skin.

1. Cleanse and moisturize your skin: Your skin is exposed to kinds of pollutants, allergens, makeup during daytime. So cleanse your skin properly. Then apply vitamin E based moisturizer to keep your skin hydrated.

2. Use clean pillowcase: Many pathogens and oil may reintroduce to your skin if you use unwashed pillowcase. Thus make it a habit to use a clean pillowcase, preferably made of silk fiber, which keeps you away from the risks of pimples and other skin infections.

3. Don’t sleep with your phone: Your phone collects many bacteria and other microbes during daytime. Thus it is better to keep your phone away while sleeping to avoid any counter infections.



3 Highly Effective Bedtime Skin Regimen to Prevent Acne and Wrinkles

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