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

Causes of Hairfall and Solutions to Treat Them

In general, you lose about 50-100 strands of hair each day, but the loss is not visible as new hair grow in their place. However, if you lose more than a 100 strands in a day and more than 200 strands on the day you shampoo, you may be suffering from what is known as excessive hair fall. 

Certain factors or reasons may cause you to lose hair at an alarming rate, which are,

1. Thyroid problems
Your thyroid is responsible for your body?s overall functioning. The hormones (primarily T4 and T3), which it produces help in regulating metabolic activities. Problems with your thyroid gland can cause your hormone levels to rise or fall to unhealthy levels, which can result in hair fall. You can improve the functioning of your thyroid gland through a diet rich in calcium, iodine, magnesium, protein and Vitamins A, B and C.

2. Scalp infections
Infections of the scalp can also be one of the factors that may cause your hair to fall at an alarming rate. Of the different scalp infections, the ringworm scalp infection is the most common. Although this fungal infection can occur in any part of your body, when it develops on your scalp, you end up losing clumps of hair. Alongside the use of anti-fungal medications, even anti-fungal shampoos and creams can provide you with respite from the problem.

3. Poor diet
Gorging on unhealthy foods or going on a crash diet can result in the lack of essential nutrients in your body, which are required to maintain healthy hair. Furthermore, since hair is made of protein, having a balanced diet consisting of proteins and vitamin- rich foods is a must.

4. Stress
Stress gives rise to certain conditions such as alopecia areata, telogen effluvium (hair loss caused post-pregnancy or surgery) and trichotillomania (an impulsive need to pull your hair out), which can cause you to lose significant amount of hair. To avert a hair loss crisis caused by stress, make it a point to do some simple stress-reducing exercises, such as meditation or breathing exercises.

5. Hair styling products
Using hair styling products like hair colours and straighteners can cause you to experience hair fall problems. Your hair not only becomes dull and dry due to their use, but also becomes weak and brittle, leading to a gradual loss of hair. Regular oiling and use of homemade hair masks are some of the ways you can try to counter the negative effects of these hair styling products.

6. Cancer treatment
The drugs that are used in the treatment of cancer not only destroy the fast-growing cancer cells, but also the healthy blood cells in your body. For this reason, consuming foods that possess cancer-fighting properties (like oatmeal, tomato, almonds, garlic etc) is a sure-shot way of fighting the disease as well as averting any side-effects that may arise because of the treatment.

7. Alopecia areata
Lastly, hair fall can also be caused by alopecia areata, which is a kind of hair loss that takes place when your body?s immune system erroneously attacks your hair follicles, and prevents growth of new hair.

8. Genetics
The origin of your severe hair fall or baldness can be traced back to your ancestors. So, your genes can be a factor behind your hair fall problem. If this is the cause, your body then becomes unable to produce new hair.

Apart from the changes that you can make in your lifestyle to address the causes of your hair fall, there are also techniques out there that you can employ to permanently treat your problem, such as platelet rich plasma, mesotherapy, stem cell therapy, ozone activated platelet rich plasma & hair transplant.



8 Common Causes of Hairfall + How To Overcome Them

Breast augmentation surgery increases or restores breast size using silicone gel implants, saline implants or in some cases, fat transfer. One of the most popular and frequently performed aesthetic surgery procedures, breast augmentation has a long and successful track record in satisfying women who wish to enhance, regain or restore balance to their figures.

When to Consider Breast Augmentation-

If you want a better proportioned or more appealing figure.
If you wish your clothes fit better.
When pregnancy, weight loss or aging has affected the size and shape of your breasts.
To restore symmetry if one of your breasts is smaller than the other.
Breast enhancement surgery is mainly done using:

Implants: While performing breast surgery using implants, the surgeon will make an incision, lift up the breast tissue, create a pocket in your chest, and place the implant there. Generally, the breast implants are of two types, namely silicone and saline. Although both implants consist of an outer shell made of silicone, the difference lies in the internal content of the implant. Saline implants contain sterile or saline water, whereas silicone breast implants are generally filled with silicone gel.
Fat Transfer: For breast enhancement techniques using fat transfer, liposuction is used to take fat from a part of your body that generally has a higher content of fat. This includes the abdomen or the thighs. This extracted fat is processed and then inserted into the breasts.
The safety of the type of breast enhancements depends on:

Ruptures: Ruptures are risks with both forms of breast implant. The ruptures may result due to surgical error or a fall. Rupture of a saline implant only results in the leakage of harmless and absorbable saltwater. On the other hand, rupture of silicone implants causes leakage of silicone that tends to remain in the body and sometimes, may spread out of the breast and into the nearby lymph nodes.
Aesthetic Results: The look and feel of silicone breast implants is given more preference because they are similar to real breast tissues. Saline implants tend to cause rippling of the skin.
Surgical Differences: Saline implants can be filled after implanting. Hence, they require a smaller incision as compared to pre-filled silicone implants. Additionally, adjustment of saline implants after surgery is possible. However, the standard size of pre-filled silicone implants cannot be altered.
Eligibility: Age criteria for women undergoing breast enhancements using saline implants is 18 and above, while for silicone implants, the minimum age is 22.
Aftercare

The individual is kept under observation for a few days post the breast enhancement surgery. The breasts are covered in gauze dressings for a week before the patient is discharged.
After discharge, one is advised to wear a support bra for the first few weeks till the implants set in.

Everything You Want To Know About Breast Enhancement

Aloe Vera Stops Hair Fall And Helps in Hair Growth

Water and air pollution are the biggest causes of hair fall. And, Aloe vera is the biggest cure for hair fall!  Not just hair fall control it also promotes hair growth. Alkalizing properties of aloe vera improves the pH levels of hair which help in hair growth. Its application also reduces dandruff and itching. 

Take an aloe vera leaf, extract the gel and apply this gel to the hair. Leave it for hours and wash the hair with warm water. Follow this procedure for 3   4 times a week for better results. You can also use aloe gel easily available in markets.

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


Hair Fall Due To Pollution? Here s the only home remedy that will stop it.

Pimples are the most common type of skin issue and almost each one one of us are affected by them. Though these pimples often go away themselves, but when the situation aggravates it is always best to get it check from a doctor. Homeopathic is branch of medicine which offers cure for such type of cases with zero side effects. Homeopathic remedies to get rid of pimples

Psorinum: It is considered to be the best homeopathic drug for acne. Acne indurata, acne simplex and acne pustular are all treatable with Psorinum. In oily skin with over worked sebaceous glands, the skin is left greasy, making it more prone to acne. Psorinum can help reduce secretion of oil and in effect, treat the underlying cause of a pimple outbreak. It is also used in treating acne that gets worse with consuming chocolates, meats, sweets and fat. Itchy winter acne may be treated with this as well.
Calcarea Sulphurica and Hepar Sulph: Calcarea Sulphurica and Hepar Sulph are homeopathic remedies that are very effective for treating pustular acne. Pustular acne means pus filled acne. Often, there is blood staining the pus. Hepar Sulph is effective if the pimples ooze out pus or blood mixed with pus. These pimples may be extremely painful. It is especially useful to treat pimples in teenagers.
Kali Bromatum: Kali Bromatum is a wonder medicine that treats chest, shoulders and facial acne. It is generally marked by a persistent itch. The acne might be indurated, pustular or simplex. The scar forming acne is also generally treated with Kali Bromatum. Purple tinged acne is best treated with Kali Bromatum.
Natrum Mur and Antimonium Crudum: They are very effective in the treatment of facial acne, especially those affecting the cheeks. Cheeks which turn hot due to acne are best treated with Antimonium Crudum. It may be pustular or papular in nature. Another complaint in such cases is a burning sensation. Natrum Mur is a homeopathic medicine that shows maximum efficacy in case of itchy pimples on cheeks. Anemic girls are also benefitted by Natrum Mur.
Sulfur: It is used in extremely itchy acne. People with unhealthy looking and dirty skin are benefitted from the use of this homeopathic wonder drug. The itch generally gets much worse at night or with the application of warmth. For acne that hasn t responded to previously applied topical medicines and ointments, sulfur has shown marked improvement and has even obliterated all signs of acne.
Silicea: Acne affecting the forehead heals fast with the application of silicea. Even pustular acne has shown drastic healing with this homeopathic medicine.

Pimples - 6 Common Homeopathic Remedies!

Facial surgery can be opted for by people for a number of reasons, and these include being born with facial impairments like cleft lip, birthmark or other birth defects, the effects of aging, sun damage, or other facial traumas that are noticeable on the face as well as a sense of general dissatisfaction with your facial features. Depending on these factors, facial plastic surgery can be divided into two categories:  reconstructive and cosmetic.

Reconstructive plastic surgery is performed for correcting conditions that may be present from birth, including birthmarks on the face, cleft lip and palate, protruding ears, and a crooked smile. Conditions resulting from accidents, traumas, or burns are also corrected by this type of surgery.

Cosmetic facial plastic surgery is performed to enhance the visual appearance of facial structures and features which include facelifts, eye lifts, rhinoplasty, cheek and chin implants, and liposuction. 

If you are planning to get facial surgery done, there are certain things you need to do to prepare yourself for it. These are:

Choose a qualified surgeon: It's important to choose a board-certified plastic surgeon or facial plastic surgeon who has experience performing the specific procedure you are considering. You should also ask to see before-and-after photos of the surgeon's previous patients.

Understand the risks: As with any surgery, facial surgery carries some risks, including infection, bleeding, and scarring. Make sure you understand the potential risks and complications of the procedure before making a decision.

Have realistic expectations: While facial surgery can produce excellent results, it is not a magic cure-all. It's important to have realistic expectations about what the surgery can and cannot do.

Follow post-surgery instructions: After your surgery, it's important to follow your surgeon's instructions for care and recovery. This will help ensure that you get the best possible results and minimize the risk of complications.

Schedule a surgery when you are healthy: If you are planning for either of the surgeries, try to schedule it during a period of relatively good health. Your immune system will have the best chance of a speedy recovery. Scheduling the surgery at the year-end is ideal when you can take a few days of paid leaves. 
Get enough essential nutrients: Your diet, before and after the surgery, should be rich in vitamin A, vitamin C, zinc, copper, and selenium. They help the wound to heal quickly and build immunity, thereby reducing the chances of an infection. You can recover from more comprehensive procedures like tummy tuck, facelift or liposuction by including the requisite nutrients in your diet.
Stay hydrated: Consuming 6-8 glasses on the day prior to the surgery is very important to help cleanse and hydrate the body. Since fluid intake is reduced on the day of surgery, water intake is especially important prior to the surgery. To avoid complications during surgery, ensure that you do not drink anything after midnight on the night prior to your surgery unless advised by your surgeon.
Overall, it's important to do your research and consult with a qualified surgeon before making a decision about facial surgery. Good luck!

Related Tip: "Causes and Risks of Craniofacial Surgery"

7 Things To Keep In Mind For Facial Surgery

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