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

The skin is the largest organ in the body and is one of the five sense organs, helping us with  touch.  The first outer layer is called the epidermis and the underlying layer is called the dermis. The skin has a protein known as keratin, which protects it from various external toxins and infections.

In some people, due to unknown reasons, there could be pile up of this protein in the deeper layers, producing small bumps, which feel like sandpaper. Literally, the term keratosis pilaris (KP) refers to piling up of keratin pigment. It can block the hair follicle that would normally open into the skin. When there are multiple blocks in the same area, there could be a sandpaper-like rough feeling to the touch. This gives this condition other names including goosebumps, chicken skin or chicken bumps. Though it is a cosmetic issue, it is medically a benign and very common condition.

Cause

KP, as it is popularly known as, is believed to be a genetic disorder with faulty genes leading to excessive accumulation of keratin. These appear as red, small bumps that are usually seen on the hands, arms, thighs, buttocks, and rarely on the face. The surrounding skin may be inflamed if there is a buildup of skin under the pile of keratin.

The onset of KP is usually in the first decade of life, worsens during puberty, and reduces during adulthood. There are, however, instances where the onset happens during adulthood. Twins and people with atopic dermatitis are more likely to have KP.

KP is more common in people with dry skin as oily skin seems to offer some protection.

There are also studies that give it a correlation with weather, with winter seeing more of this condition than summer. This is because our skin tends to dry more in winter than in summer. There could be some people who are completely normal during the summer months but will develop these bumps during the winter, which again subsides with the season.

Signs and Symptoms

As noted above, KP is a medically benign condition. There is a cosmetic concern if it is in the visible areas like arms and hands. Also, the area could feel rough and dry, but the affected person may not experience any itching or other harm. People with atopic dermatitis and eczema are more likely to develop KP; hence these other skin conditions require proper management.

Management

Patient education is the most important. This disease does not require any treatment and is usually self-limiting. It is very rare for KP to affect the whole body. Creams containing alpha hydroxy acid, salicylic acid, lactic acid, or vitamin A may be required to remove dead skin cells and to prevent clogged follicles from the bodies of the affected people.

Keratosis Pilaris: Signs, Causes, Treatment, and Prevention

How many of us know that a deficiency of Vitamin B6, also known as pyridoxine can make you susceptible for heart disease, brain degenerative diseases like Alzheimer s as well as muscle pain, depression and dragging fatigue?

Vitamin B6 is one of the most crucial vitamins for health and it s a part of the vitamin B complex family. Now, all B vitamins, including vitamin B6, play an important role in a number of life-altering physical and psychological functions. All of them have a vital role to play in helping to maintain a healthy metabolism, nerve and liver function as well as skin and eye health, as well as good amount of energy levels.

Role of Vitamin B6
Vitamin B6 or pyridoxine has a number of derivatives, including pyridoxal, pyridoxal 5-phosphate and pyridoxamine. And all of these are involved in major body functions like movement, memory, energy use and blood flow. This is the primary reason why a vitamin B6 deficiency can show up in a range of symptoms from physical to psychological, temporary to chronic and serious.
Vitamin B6 also helps your body to

Maintain a healthy nervous system

To make more hemoglobin, blood cells that carry oxygen in blood
To provide energy from our food
To balance blood sugar levels
To act as a natural pain relief
To boost mood
To create antibodies for self-protection
Preventing a Vitamin B6 Deficiency
The recommended amount of vitamin B6 for an adult under the age of 50 is 1.3 milligrams. Normally, this amount is easy to get from your diet, assuming you are eating a balanced diet with enough calories. However, the amount the body s requirement for vitamin B6 jumps up as you age. Experts recommend that adults over 50 get up to 1.7 milligram daily of this vitamin.

As this requirement is not met, older people get more prone to a vitamin B6 deficiency and so do malnourished children and adults. Foods like poultry, pork, nuts and beans contain high levels of vitamin B6 and you can include more of these to get the recommended dose of vitamin B6. However, since vitamin B6 is a water-soluble vitamin, so you need to replenish your body with it daily as it doesn t get stored in the body.

Symptoms of Vitamin B6 deficiency:
Lack of energy and chronic fatigue: Vitamin B6 helps supply your body with energy by improving your metabolism. It has a vital role to play in protein metabolism   it helps your body break down the protein that you eat and produce energy quickly. So one very important pointer that you have a vitamin B6 deficiency is when you get fatigued quickly during exercise.
Brain function decline: Vitamin B6 vitamin helps your brain communicate with other parts of the body more efficiently. So, if you have a decline in muscle efficiency it could be a sign of vitamin B6 deficiency.
High Levels of amino acid Homocysteine: High levels of amino acid Homocysteine do not cause any symptoms that you can detect by yourself but tests can tell you if you have high levels of this amino acid in your body. And these high levels are directly linked to vitamin B6 deficiency. What high levels of homocysteine can do is cause heart attacks. But vitamin B6 helps keep a check on these levels to reduce your risk for a cardiovascular event.

Other symptoms of vitamin B6 deficiency are:

Changes in mood, such as depression, irritability, and anxiety
Confusion
Muscle pains
Fatigue
A worsening of PMS symptoms
And worsening of symptoms of anemia
As vitamin B6 is so important for nerve function, a deficiency is linked with neuro-psychiatric disorders like seizures, migraines, and chronic pain.
An increased risk of heart disease and rheumatoid arthritis
Higher risk for Alzheimer s disease and other forms of dementia.

Vitamin B6 Deficiency- Signs You Are Suffering From It!

Asperger's Syndrome or Asperger's Disorder is a neurotypical condition that affects the development of the child the effects of which continue into adulthood. This condition typically shows up as difficulties faced by the patient when it comes to social interactions as well as other nonverbal means of communication. It should not be confused with autism as the patient has no speech and cognitive development delay. 

Asperger's syndrome can show up as restricted and repetitive patterns in the behaviour of the patient. It lies at the higher end of the autism spectrum and the signs are usually less obvious. Here are a few ways with which you can effectively deal with someone who is suffering from this disorder.

1. Routine: The patient suffering from this condition will need a certain kind of stability as it is very difficult to predict what will happen in the near future or to even plan for it. The best way to tackle this scenario is with the help of a proper routine that can help the patient achieve some kind of control over the situation surrounding him or her so that he or she is better equipped and more capable of handling normal functioning and social situations as well.

2. Information: It is also a good idea to help these patients in looking at and in processing information. While normal people may easily be able to discard insignificant or unimportant information, the brain of the patient suffering from asperger's syndrome does not allow him or her to do so. In many cases, the patient is not able to filter the important and the unimportant information. This can debilitate many functions. So, it is important to be present to help the patient in making decisions and processing information that is actually relevant to his or her functioning.

3. Learning: One of the most crucial things to remember with the Asperger's patient is that they tend to understand and process things when they have a visual presentation rather than being told verbally. So showing them things practically in the proper manner is the right way to help them learn and process situations in a correct way. This will prevent them from doing things in the same old way even when their brains tell them that it will lead to wrong results.

4. Physical Abilities: Poor motor skills as well as lack of proper organisation skills are traits that usually characterise these patients. It is important to make them aware of this during games and activities that require management as well as use of social skills. For example, football and other such activities can be introduced in the routine. This will promote interaction with the team in order to play and enjoy the game.

How to Deal With a Patient Suffering From Asperger's Syndrome?

Corns and calluses are areas of stumpy skin caused by friction or pressure. They usually hurt when you wear shoes or walk.
Calluses generally develop on your feet or hands, and most of the time, don t require treatment.
Corns have a hard or soft inner core. Soft corns are mostly found between the toes, while hard corns form on the top of the toes. Corns that are caused by ill-fitting shoes often reduce on wearing the right shoes.
Causes-
Repeated friction or pressure causes corns and calluses on areas of skin. The pressure leads to the death of the skin, which develops a protective, hard surface. Soft corns develop in a similar fashion. Corns and calluses are not formed due to viruses and are not harmful. They can be formed due to:
Regular usage of any object that puts strain on the hands, such as sports equipment (badminton racquet) or tools (hammer or gardening hoe), usually leads to calluses on the hands.
Pressure from wearing the wrong footwear usually leads to corns and calluses on the feet. Calluses can also form by walking barefoot.
Abnormal structures on the foot, such as hammertoe or bone spurs, can cause calluses and corns.
Repeated pressure from playing certain sports can also cause calluses on the feet.
Symptoms-
Corns and calluses on the feet are easy to spot. A callus is thick, hard and dry, and may appear yellowish or grey in colour. When touched, it will feel bumpy and more insensitive than the skin around it. A hard corn is thick and firm, while soft corns look like an exposed sore. The hard corn may have a grey centre with a light yellow ring around it.
Corns and calluses don t hurt, but it does become painful when you are wearing shoes or walking. Fitting your feet into shoes gets more difficult due to them. Touching or squeezing the corn or callus can also be painful.
Treatment-
Corns and calluses don t require treatment normally, but if they hurt, here s what you can do:
Wearing well-fitting shoes that are roomy with deep and wide toe boxes (the area covering the toe).
Protective paddings, such as moleskin, toe separator, toe sleeves, etc., can alleviate pain.
Soaking the corn or callus in hot water, and then gently wear down the dead skin by using a pumice stone.
Salicylic acid can be used to soften the corn or callus.


All about Calluses and Corns

A number of health problems today are caused by an unhealthy lifestyle. One such condition is a fatty liver or collection of fat in the liver. The buildup of fats in the liver is known as Fatty Liver. The liver processes everything that you eat or drink and filters harmful substances from the blood. If too much fat has accumulated in the liver, this process gets interfered with. These fat cells cause inflammation of the liver tissues which in time can lead to scarring and liver fibrosis. On its own, a fatty liver is relatively harmless but when it reaches this stage, it can be life threatening.

The reasons for Fatty Liver can be alcoholism, incorrect diet, obesity, diabetes, or even excess use of medication.

If ignored or left untreated, many liver diseases will lead to permanent and irreversible damage to the liver and can be a significant threat to your health. But, there is no standard form of treatment for a fatty liver. If diagnosed in its early stages, treating the underlying cause can stop the progression of the disease and even resolve it. Homeopathy addresses the underlying causes of a disease and hence is an ideal form of treatment for a fatty liver. It can reduce the symptoms of this disease, improve liver functioning and even reverse the condition if treatment is started early.

The Homeopathic medicines, which are made of natural substances, are given to patients after studying the unique symptoms experienced by each individual. Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach. Homoeopathy is very proficient in managing all the symptoms of Fatty liver disease and furthermore plays a vital role in preventing relapse of the condition.

Some of the most common homeopathic medicines for fatty liver are

    Chelidonium: This is often used to treat a fatty liver accompanied by right upper abdominal pain. In such cases, the liver may be enlarged and the patient also usually suffers from constipation or experience nausea and vomiting. The patient will also probably suffer from excessive weakness and have a desire for hot food and drinks.

    Lycopodium: A fatty liver accompanied by acidity can be treated with this type of homeopathic medication. In such cases, the patient will also complain of bloating and belching with a burning sensation. These symptoms tend to worsen n the evening and the patient may have an intense craving for sweets and hot drinks.

    Phosphorus: This is used to treat cases of fatty acid which triggers regurgitation accompanied by sour belching. In some cases, the patient may also experience pain in the liver and excessive flatulence. Vomiting may also occur along with weakness while passing stool.

    Calcarea carb: Obese patients suffering from this condition can be treated with calcarea carb. These people often have a distended abdomen, are lactose intolerant and suffer from chronic constipation. They are also overly sensitive to cold air and sweat excessively from the head.

    Nux Vomica: homeopathic remedy for fatty liver with pain in abdomen after eating.

Nux vomica is great for any abdominal problem including fatty liver caused by excessive consumption of alcohol. These patients often suffer from abdominal pain a few hours after eating with sour or bitter tasting belches. They may constantly feel the urge to pass stool but are unable to do so.

Though homeopathic remedies have negligible side effects when taken in low dosages, they should never be self-prescribed. If you suffer from a fatty liver, consult a homeopathic doctor immediately who can diagnose it properly and treat you accordingly.

5 Homeopathic Remedies for Fatty Liver

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