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

Most people would panic on seeing slightly red urine being passed. A common urologic condition, this happens because blood cells are leaking into the urine. There are multiple reasons which can cause it, and not all of them are major causes for concern.

Read on to know more about some common causes, and how to manage this.

Urinary tract infections: There could be an infection of the entire urinary tract including the kidneys, the ureters, the bladder, and the urethra. In addition to blood in the urine, there could also be an urge to urinate, pain with urination, fever, and flank pain.
Enlarged or infected prostate: The prostate naturally enlarges with age and can obstruct the urethra, causing pain and blood in the urine. There is a constant urge to urinate and difficulty initiating the stream. Infection of the prostate also produces similar symptoms along with fever and pain.
Kidney diseases: In addition to infections, other kidney diseases including glomerulonephritis, which can also lead to hematuria. Kidney stones, which are quite common, are also another reason, and this will be characterised by the sudden sharp pain around the flank which is very diagnostic of kidney stones. Injury to the kidneys from trauma or sports is another reason for hematuria.
Cancers/tumours: Cancers in the kidney, bladder, or prostate can cause blood to appear in the urine, but this would happen once cancer has reached some advanced stage, not very early in the process.
Listed below are some risk factors for hematuria.

Age: Men older than 50 are more prone to hematuria
Sex: While men are more likely to have stones or prostate infections, UTIs are quite common in women below 50s.
Family history: though not hereditary, if kidney stones or cancers or infections are in the family, chances of developing hematuria also goes up.
Medications: Aspirin, blood thinners, NSAIDs, and some antibiotics increase the chances of hematuria.
Exercise: Long distance runners are shown to be more prone to developing hematuria.
Diagnosis: In addition to a physical exam, blood tests, imaging (CT scans and/or MRI) and cystoscopy might be required to confirm the diagnosis. Identifying the cause is extremely important as treatment would depend completely on the causative agent. Though hematuria is just one of the symptom, the underlying cause could have severe adverse effects on the whole body system.

Treatment: Whether it is an infection or enlarged prostate or kidney stone or tumour, once the cause is identified treatment is customised accordingly. Antibiotics for the infections, laser treatment for the stones, etc. are recommended.

If you see your urine turning slightly pink in colour, talk to your doctor immediately. Identifying the underlying cause and treating it will help solve the problem of hematuria.

In case you have a concern or query you can always consult an expert & get answers to your questions!


Blood In Urine - Is It Actually Serious?

Sweating is a normal and natural phenomenon, which all human beings experience. When the weather conditions are humid or if you have walked for a long duration in the sun, sweat is bound to appear. Some people sweat much more than the normal rate. If you belong to this category, some questions may come to your mind like whether is it abnormal? What can be a possible remedy? Here are some facts you must know about sweating.

1. Sweating is a natural phenomenon, and everyone sweats
It is a normal function of the human body. It involves releasing of fluids from our sweat glands present in the skin. The body maintains its temperature by means of perspiration. Sweating may make you feel uncomfortable,but performs the important cooling function of the body. Composed of water, sugar, salts and ammonia, sweat does not have any smell of its own. The unpleasant smell produced from your skin is a result of sweat mixing with bacteria.

2. The rate of perspiration varies from person to person
If you find yourself to be sweating more than normal people around you, it's natural for you to get concerned. However, do not worry because there is nothing unnatural. Some people produce more amount of sweat than others and that is completely natural. The rate just varies from person to person.

3. Overreaction of sweat glands leads to hyperhidrosis
Some people have sweat glands, which are so over reactive and over productive that they actually suffer from the disease hyperhidrosis. People having this disease sweat abnormally. The rate of perspiration is very severe. There is no such cure for hyperhidrosis. The only permanent solution to fix this disorder is by surgery where the nerves to the sweat glands are cut off.

4. Sweating is psychological in nature
The process of sweating is carried out by the sympathetic nervous system. Once it is stimulated, more sweat is produced. Although it may seem weird, thinking of sweating can lead to more sweating in individuals.

5. Nausea leads to increased sweating
Nausea or motion sickness is another reason, which accounts for increased perspiration. Nausea stimulates the sympathetic nervous system, which in return produces additional sweat.

6. Sweating can be delayed at times
Suppose you are climbing up a staircase, but surprisingly you notice that even after going up five flight of stairs, there is no sweat. The sweating appears a little later and is quite intense. This is because your body takes some time to react to the thermoregulation which takes place.

Sweating is a very uncomfortable and irritating phenomenon, but it is actually helpful to the body.

Sweating: What's Normal, What's Not

Natural ways to remove your blackheads and whiteheads
 
Blackheads and whiteheads not only make you look unattractive, but also are hard to cure and keep recurring. Fortunately, there are quite a few substances and food items available in every kitchen that can effectively and naturally treat them and can also prevent them from recurring! 

Some of the best natural treatments for whiteheads and blackheads are-

1. Use milk- milk is a natural cleanser. Add a hint of lemon juice to half a cup of milk and mix it well with half a spoon of salt. Apply this mixture while scrubbing thoroughly on the entire surface of your face skin. This method decreases whiteheads and blackheads in a week and also stops them from recurring.

2. Cinnamon &amp; honey- a paste made up of one tablespoon of cinnamon powder and adequate honey is a very effective mixture. Apply it on the face, especially on the affected areas, and keep it on for the entire night. Wash it off in the morning. Continue this every night till whiteheads and blackheads disappear.

3. Baking soda- baking soda is exceptionally good to treat several skin problems. A mixture of baking soda and water must be applied on the face. Once it dries, wash it off. This mixture dries off the whiteheads and blackheads and also removes excessive oil from the skin.

4. Mint &amp; turmeric- extract 4 teaspoons of mint juice and add half a spoon of turmeric making a thick paste. Apply it on affected areas for a while. Once this paste dries off, wash your face with water. Milk can replace mint juice if desired.

5. Lemon juice- squeeze out lemon juice from 2 big sized lemons. Add some water to reduce the acidic effect. Dip a cotton ball in it and rub it across your face. You can do this several times a day. This is the simplest method to treat whiteheads and blackheads.

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

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Everybody Has Them! Remove Blackheads &amp; Whiteheads Naturally.

The term  skin disorders  is used to describe different skin problems- from widespread rashes to red small bumps on certain portions of the skin. While some conditions can be harmless but unsightly, others may be infectious and even life-threatening in rare cases.

Some skin conditions have a genetic component, while others may result from allergic reactions. Allergic skin problems occur when certain allergens stimulate an immune response such as itching or redness. Bacteria, fungi, viruses can also lead to skin problems. The most common types of skin problems are psoriasis, eczema, acne, rosacea, warts etc. Let s take a closer look at these disorders-

Psoriasis- This is an autoimmune chronic skin condition which causes a rapid increase in the number of skin cells. Due to this rapid accumulation of cells, the surface of your skin becomes dry and flaky. The white scales are usually seen in the joints of your knees and elbows. You will most likely notice redness and inflammation around the scales.
Eczema- Eczema is a medical condition that causes your skin to turn red and become inflamed and itchy. Eczema occurs in many forms, the most common among which is Atopic dermatitis. This condition begins usually in childhood, and gradually fades away or becomes milder as you age.
Acne- This is perhaps the most common skin problem particularly prevalent between the ages of 15 and 35. Almost every other person develops small raised bumps known as acne breakouts due to infected or blocked hair follicles. When the skin pores become clogged due to excess oil secretion or accumulation of dirt and dead skin cells, acne can appear anywhere in the skin. Most commonly, these are noticed on the face- cheeks, chin or the nose.
Rosacea- Rosacea is often mistaken as acne because it induces acne-like inflammatory symptoms. But this particular skin condition can occur due to a combination of genetic and environmental factors. Rosacea produces red, pus-filled small bumps on the skin, and usually affects fair-skinned middle-aged women. Visibly broken blood vessels, swollen skin, itchy dry eyes, rough patches on the skin- all these signs indicate you may have rosacea.
Warts- These are slightly raised bumps or patches on the upper layer of your skin caused by the Human Papillomavirus (HPV) infection. Warts come in different shapes and sizes and can occur in any part of your body- hands, palms, feet, knees, or face.
Role of Ayurveda in curing skin disorders-
The Ayurveda school of treatment aims to restore your body s doshic balance- kapha, vata and pitta. Treatment methods include self-care practices such as a balanced lifestyle, healthy diet, exercise and meditation. There are several Ayurvedic therapies including Abhyanga and Panchakarma that are designed to promote healthy skin.

The Panchakarma vidhi uses medicated herbs, natural ingredients like rice, sand, medicated powder on your body to soothe your senses and flush out the toxins from your body. Once your body is detoxified, your skin feels rejuvenated and nourished.
Essential rosemary oil and olive oil act as excellent moisturizers, especially for dry flaky skin resulting from psoriasis.
Ashwagandha, one of the most essential, powerful herbs packed with anti-inflammatory properties, helps remove rosacea puss. To fetch best results, apply or drink extracts of this wonder herb every alternate day.
Fenugreek seeds, or what is more commonly known as  methi , are rich in essential vitamins like C and K, folic acid and iron. This medicinal plant helps remove dry red patches on the skin. It also prevents the formation of rosacea puss and helps reduce itching.
Skin problems can be mild or severe. Sometimes a conventional treatment method that may work for one condition, may not work well for the other. Ayurveda is a holistic approach to treatment and uses natural ingredients to cure the root cause behind the apparent condition.

Psoriasis And Skin Disorders - What All Should You Know

How To Get Rid Of Pimples Using Home Remedies

Pimples are very annoying, especially when they are on your cheeks because then they do twice the damage - hurt your skin and at the same time they also steal away the charm of your looks. Although there are many lotions and creams in the markets that guarantee the removal of this skin inflammation, they are chemicals that eventually start showing its side-effects on your skin. For this reason, a few home remedies with some simple pimple-combating tools work the best and here are some of them:

Use ice cubes and crushed ice to reduce the redness and the heat in the inflammation. Applying ice over the pimples eventually makes them reduce in size and disappear altogether.

Soak a little piece of cotton or rag in fresh lemon juice and apply it over a pimple. Lemon helps a pimple dry up faster.

Soak a rag of cotton in tea tree oil and put it over a pimple. It has anti-bacterial properties which help fight against acne pimples. For even better results, you can also try mixing tea tree oil in aloe vera gel. You can put this mixture on your acne pimples and rinse it after 20 minutes for effective healing.

White toothpaste can work wonderfully with a pimple and reduce it to nothing in a very little time.

Steaming is another foolproof way to get rid of the pimples in the most natural manner. If you expose the pimples to steam, the steam works its way through the pimples and cleans out all the bacteria. It thus helps your skin to breathe and get in contact with oxygen. This ultimately makes a pimple ripen quickly and thus leads to its deterioration.

Use garlic to get rid of pimples. How? Garlic is an antiviral, antifungal, antiseptic and antioxidant agent which is why it is a very good remedy for pimples. Cut a small piece of garlic and rub it over your pimples. After several minutes wash your face with lukewarm water.

Honey is another natural antibiotic that can accelerate the removal of pimples by effective healing. The catch here is to apply honey directly over the affected area. Keep it for several minutes and then wash it off with lukewarm water. Mixing honey and cinnamon and applying its paste on the affected area is also a very dead-sure manner of getting rid of pimples.

Grind a cucumber to make a face mask and allow it to dry. Then wash your face after several minutes. This cleans up the dirt and bacteria in the pimples.

Next time you get those unwanted pimples, you know what to do!

Natural Home Remedies to Get Rid of Pimples Overnight Fast!

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