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

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

Psoriasis can be defined as a skin condition, which is caused due to autoimmune disorders within the body. This is a condition where the skin on the body develops raised and dry areas which are reddish in colour while also being bordered by silvery scales. 

Treatment of psoriasis in ayurveda
Ayurveda has a different slant to conventional medicine with regards to the treatment of psoriasis. According to ayurveda, it is the impurities in the blood, which cause the immune system to react adversely and cause this condition. Ayurveda concentrates on treating the underlying problems through the combination of changes in diet, home remedies and certain medications to treat this disorder. Some of them are mentioned below:

Changes in diet which will help purify the symptoms: 
Some advice that is usually given to patients to clean up their diet and include certain other items are as follows:
1. Avoid spicy food and try to eat food, which can be easily broken down within the digestive system
2. Inclusion of more fruits and fruit juices in your diet
3. Also include vegetables and also have a mix of boiled vegetables daily.
4. It is better to avoid animal products such as animal fats, eggs, canned and processed foods from your diet.
5. Regular consumption of butter milk and curd are known to be very good in blood purification and thus should be consumed in large quantities. 

Some ayurvedic tips and ingredients, which can help treat psoriasis: 
Other tips that can be implemented as skin applications to treat psoriasis are as follows: 
1. Use avocado oil to rub on the affected areas as it is known to be an effective treatment when applied long term.
2. Ensure that the skin is always moisturized by applying a soft, cream or gel.
3. Periodic baths in sea water if possible is also good for lessening the symptoms of psoriasis.
4. Aloe vera cream applied specifically on the patches is known to also lessen them overtime.

Few other tips to follow
1. Get into deep breathing and meditation to ensure that your body and mind are relaxed as this is very important during the healing process
2. Expose the affected areas of your skin to mild sunlight for about half an hour daily as it is known to improve symptoms. 


Ayurveda and Psoriasis

Have you tried one product after another during the dry weather and are still left with dry and itchy skin. Then your skin care product is to be blamed. Creams, lotions and oils all essentially perform the same job of moisturizing your skin. The difference lies in just how they do it. There is a wide range of choices available in the market for all three products with individual variants in ingredients, including types of oils like coconut, lavender, jojoba etc., types of value proposition like 24-hour moisture lock, or intense hydrating care and flavours like rose, strawberry and even chocolate that leave you smelling great.

The main difference between cream and lotion: 

The main difference between the two, besides additives, is their oil to liquid ratio. Lotions and creams both contain oils and water. In lotions the proportion of water is more compared to oil. So it is more liquid in nature and easier to spread on the skin. Creams on the other hand are thicker because of their higher oil content. They can typically be lot greasy in nature because of their consistency.

Choosing between the two: 

Lotions and creams will both do the trick, but it will depend on what you need and when you use it. Give a good thought to your skin. Is it always dry or only during certain times of the year? If you skin dries easily and you can see a white line if you scratch the skin with your nail, you'll need a cream that absorbs more slowly and the benefits stay longer. Applying cream then creates a layer of oil that locks the moisture in your skin. The water does not evaporate, and your skin stays hydrated. Lotions are easy to spread on skin. If your skin is already soft and supple and you simply need a layer to keep the dryness at bay, a lotion is a good choice for you.

Use both lotion and cream:
 
Morning, before bed, after baths or repeatedly throughout the day? The time you plan on using a moisturizing product will play an important part in determining which type you choose. Creams are great to use right after a bath when the skin is soft after absorbing moisture. The cream then creates a protective layer of oil which allows the skin to stay hydrated for longer. Creams are also great to use during bed time when you don't have to worry about getting an oily look on your face or body. Lotions are best if you need to reapply during the day after, say, you wash your hands and face and need to dab on some quick moisturizer.

Should I Use a Lotion or a Cream for Dry Skin?

Athlete's foot is a common form of a fungal infection. It most commonly occurs between the toes and is medically known as tinea pedis. The most common cause are sweaty feet which when enclosed inside a tight-fitting shoe for a prolong time leads to this condition. The most common symptom of athlete's foot is a scaly rash which causes itching and burning on your foot. It is a contagious disease and is most commonly spread through towels or clothing of people who have that disease. It can also be spread through the floors which people with athlete's foot walk on. Here is everything you need to know about athlete's foot.

Causes
1. Dirty wet socks inside covered shoes
As mentioned earlier, athlete's foot is a contagious disease which originates from wearing dirty wet socks inside covered shoes. 
2. Infection
You may also get it by coming into contact with an infected person or their towels and/or clothing. Even walking on the same floor as they walk on may cause an infection.

Symptoms
1. Scaly red rash
There is usually a scaly red rash in between the toes when you have athlete's foot.
2. Itching
There will be severe itching throughout the persistence of this disease especially when you first take off your shoes.
3. Blisters and ulcers
This is not a very common symptom of athlete's foot. However, blisters and ulcers do occur on certain types of athlete's foot.
4. Chronic dryness and scaling
This occurs on the soles of the feet and then slowly starts spreading upwards. These symptoms only occur on the type of athlete's foot known as moccasin. Due to this, athlete's foot is often mistaken for eczema and sometimes even dry skin.
5. Spreading to the hand
Athlete's foot always starts in your legs and in some cases spread to your hands as well. The likelihood of athlete's foot spreading to your hand is increased if you scratch or pick at the areas of the foot infected.

Treatment
There are three stages of treatment and these depend on the severity of the infection.
1. Over-the-counter medicines
In the first stage of treatment, the doctor will simply prescribe over-the-counter antifungal ointments, sprays or powders.
2. Prescription medications
In the next stage of treatment, prescription medications need to be applied to your feet.
3. Antifungal pills
If nothing else works, only then should antifungal pills be prescribed.

All About Athlete's Foot

It is common for skin to get dry and the condition is marked by less than the required water in the epidermis (the topmost skin layer). Males and females are equally affected by it. With age, the incidences for having dry skin increases. Elderly people tend to have less amount of natural lubricants and oil in the skin. Areas like the hands, lower legs and arms are more prone to have dry skin. Atmospheric humidity also affects the dryness of skin. It is called xerosic dermatitis or xeroderma.

It might be temporary and mild and may last for some days. In some cases, it can become a severe long-term problem. Dry skin symptoms encompass itching, discomfort and skin tightness. Winters and dry, cold air also affects your skin and the result is dry skin.

Why it normally occurs?
Individuals who wash or sanitize their hands more often can experience a greater degree of dry skin.

Medications may also induce this condition.
The epidermis layer of the skin normally has protein and fat, which prevents dehydration in the skin. When the fatty oils in the skin are removed, the moisture and protection of the skin is lost. The skin becomes more sensitive and breakdowns easily when it gets dried. It might cause the skin to become powdered or may be invisible.
Red rash may appear if dry skin is left untreated. Simple treatment and prevention measures have been effective in dry skin treatment.
Avoid chemical cleansers and harsh soaps is an effective way to prevent dry skin. Moisturisers and bland emollient application on a regular basis have shown effectiveness for treating the condition.
Cellulitis, bacterial infections and eczema might be complications arising from dry skin. Thankfully, dry skin generally is mild and the remedies are easy.
Generalised winter itching is also called winter itch and can be seen commonly amongst older people. It is mainly caused due to dry skin.
People suffering from eczema may also experience winter itch.
Cold temperature and low humidity can make the dry skin worse in winters.
In case you have a concern or query you can always consult an expert & get answers to your questions!

Dry Skin - Why It Normally Happens?

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