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

If stressed, consuming certain food and medications can trigger skin rashes. This kind of rash is called hives. It is also known as urticaria. Anyone can be affected by hives, at least 20% of people are affected by hives at some time or the other in their lives. The itching could be severe or mild. It starts as a patch of scaly white skin that develops into red welts over time. To make sure the itching does not worsen, scratching, emotional stress, alcoholic drinks and exercise should be avoided.

Symptoms
1. Itchy bumps that are raised and are either red or flesh coloured
2. If the hive is pressed in the middle, the skin whitens this symptom is called blanching.
3. The hive formation can appear anywhere, disappear and then reappear somewhere else.

Common Triggers
1. Certain food like shellfish, eggs, peanuts and other nuts
2. Certain medicines like antibiotics, ibuprofen and aspirin
3. Insect bites or stings
4. Physical causes like pressure, sun exposure, cold, exercise and heat
5. Latex
6. Blood transfusions
7. Bacterial infections
8. Pet allergens
9. Viral infections like the common cold, hepatitis and infectious mononucleosis
10. Certain plants like poison ivy and poison oak
11. Pollen

Treatment
There is no distinct cure for hives. But you can control its symptoms in the following ways:
1. Antihistamines help in blocking histamines, which cause the allergy symptoms. Non sedating or low sedating Antihistamines will be mostly recommended by your doctor.
2. If episodes of hives are several, it may require limited treatment with prednisone. Prednisone will be able to lessen the symptoms.
3. If the symptoms get severe enough so much so that it swells up your tongue and you have problem breathing, then the doctor might prescribe an epinephrine. However, these symptoms can mean another thing, an anaphylaxis shock. Epinephrine is the only treatment for an anaphylaxis shock.

Prevention
If what caused hives to break out is figured out, then measures should be taken to avoid or eliminate the triggers.
1. Avoid eating food items that triggered the symptoms in the first place
2. If harsh soaps, frequent bathing cause hives, they should be avoided
3. Tight clothing should be avoided
4. If cold triggers hives, then wear warm clothing, wrap a scarf and do not swim in cold water.
5. Avoid sun exposure and wear sunblock
6. If a specific medication is causing the hives, inform your doctor.

All About Hives

Atopic Dermatitis is a specific type of eczema which occurs when the epidermal layer of the skin is affected by eczema causing bacteria and other microorganisms. These eczemas are treatable and homeopathy finds a simple and natural solution to this disease. It not only helps to contain the disease from spreading it to other parts of the body but also helps in curing it of the root itself. There are some quick and effective remedies towards atopic dermatitis through homeopathy. Some of these are explained below.

Antimonium Crudum: People who have eczema which manifests as thick and hard boils are often given this medicine. In fact, it is administered both to children and the elder people. It has been seen that those who show symptoms of irritability in their behavior, get angry very soon and are most likely to be left alone, are the ones who are given this treatment to cure their eczema.
Arsenicum: Sometimes eczema is formed where boils turn thick and hard and have pus oozing out of it. For such skin infections, Arsenicum is the most widely used medicine that the homeopathic practitioners rely on. People who face such kinds of skin diseases are often seen to be depressed or melancholic in their lives. Thus, their mental feelings are often manifested in the form of eczema on their body.
Calcarea Carb: Eczema not only occurs on the body but also on the scalp. There are a few kinds of infections which have their roots on the scalp and then it starts spreading all over the face. For such kinds of infection, Calcarea Carb is the best form of homeopathic medicine which can be administered. In fact, patients with this problem are mostly children.
Graphites: Seems to be a very powerful and effective medicine against eczema which resembles ars. It is given to those patients whose skin becomes very hard and rough and there seems to be pus formation within the infection. Eruptions may be occurring in the eyes, behind the ears, and on the cheeks. Such infections are treatable with graphites.
Thus, if you are showing signs and symptoms of atopic dermatitis, then you should immediately consult your nearest homeopathic practitioner and get the proper medicine prescribed for yourself. Eczema would only spread and cause irritation in the skin if not timely treated and homeopathy offers one of the best types of treatments for this purpose.

Homeopathic Treatment For Atopic Dermatitis!

Vitiligo is a medical condition, which causes the loss of skin color due to loss of pigmentation. This usually occurs in blotches and looks very unsightly. Vitiligo is very unpredictable and can affect any part of your body. In some cases it also affects the inside of the mouth, eyes, and hair. Vitiligo is more noticeable on people with darker skin tone.

Symptoms of Vitiligo:

Premature graying or whitening of the hair in your eyebrows, eyelashes, scalp, and beard. This usually occurs before the age of 35.
Skin discoloration can also occur from other parts of the body such as hands, feet, abdomen, neck and other areas.
Change or loss of the color of the retina (inner layer on the eyeball).
Discolored patches on and around the navel, rectum and genitals.
What causes vitiligo?

A medical disorder where your immune system destroys and attacks the melanin forming pigments in your skin. This is known as an autoimmune disorder and by far is the most common cause behind vitiligo. An event such as sudden or prolonged stress, sunburn, or being exposed to industrial chemicals. A history of family members or relatives having vitiligo in the past.

Ayurvedic Treatments for Vitiligo:

Mustard and Turmeric Oil: A paste made with mustard and turmeric oil can be applied on the affected area. This is also good for the skin and reduces vitiligo. Do this at least 2 times a day to reduce the patches considerably.
Duckweed: This is a type of water plant and is very rich in a mineral called lignin. It is considered a natural treatment for skin disorders and vitiligo. It will also help to restore your natural skin color.
Sun screen: If you already have vitiligo, exposure in the sun can make it worse, so applying a sunscreen with SPF 30 or above (or an appropriate level of sunscreen protection) can protect your skin from further damage.
Papaya: This fruit is great for restoring and reviving melanin (responsible for skin pigmentation). Drinking papaya juice or rubbing papaya on the affected area can reduce vitiligo to some extent.

Vitiligo - 4 Ayurvedic Preparations for Treating it 

Vitiligo is a disease that causes the loss of skin shading and colour in patches. The degree and rate of colour loss from vitiligo cannot be determined. It can influence any part of the skin on your body. It might also influence one s hair, inside of the mouth and even the eyes. 


Ordinarily, the shade of one s hair, skin and eyes is measured by melanin. Vitiligo happens when the cells that create melanin quit working or die. Vitiligo influences individuals of all skin types; however, it might be more common in individuals with a darker skin. The condition is not contagious or life threatening.


Numerous medicines may be used to restore the skin shading or level out the skin tone. A few medicines might have some serious side effects on some people. So your specialist may propose that you first try to improve your skin by applying self-tanning products or make-up. Here are some of the top ways to treat vitiligo:


Medicines 
Creams that control aggravation: A topical corticosteroid may cause the skin to return to its natural shade (repigment), especially if you begin utilising it right at the start of the disease. 
A type of vitamin D: Topical calcipotriene (Dovonex) is a cream that can be used with corticosteroids. Possible reactions include dry skin, rash and itching. 
Medicines that influence the immune system: Treatments containing tacrolimus or pimecrolimus (calcineurin inhibitors) might be compelling for individuals with little ranges of depigmentation, particularly on the face and neck.
Therapies
Light therapy: This uses a narrow band of UVB light. You may get treatment in a specialist s office up to three times each week. 
Laser treatment: This technique brings the shading back to the patches of light skin by treating them with an excimer laser, which utilises a particular wavelength of UVB light. 
Depigmentation: A solution with monobenzone is connected to the unaffected zones of the skin. This progressively lightens the skin so that it blends with the affected areas.
Surgery
Skin grafting: In this system, your specialist removes little segments of your ordinary, pigmented skin and joins them to regions that have lost colour. 
Rankle grafting: In this system, your specialist makes blisters on your pigmented skin with suction. He or she then removes the highest points of the blisters and transplants them to a range of stained skin. 
Micropigmentation: In this method, your specialist utilises an extraordinary surgical instrument to embed colour into your skin. 
Other treatments
Shield your skin from the sun and UV light. In case that you have vitiligo, especially in case you have light skin, use a wide range of waterproof sunscreen with an SPF of not less than 30. 
Abstain from tattoos that are not associated with treating your vitiligo. 
Make-up concealers may enhance the appearance of the skin and help you feel better about yourself, particularly if your vitiligo patches are on uncovered skin.


4 Top Ways You Get Vitiligo Treated

The state of your skin is never constant. The external conditions like pollutants, dirt, grime and changing weather all play a major role in how your skin feels or behaves. You might be born with a certain type of skin, but over the course of time, weather changes can aggravate a skin condition or change its texture. So, one needs to examine his/her current skincare regimen and adjust it to meet the skin s ever changing needs based on shifts in climate and sun levels.

Once you start recording how your skin reacts to the changing weather, you will naturally be in sync and can treat your skin accordingly. Just some minor changes in your face wash, cleanser, moisturizer and sun protection products will help keep your skin perfect and glowing round the year without any special skin care treatments.

Who doesn t enjoy a cup of hot steaming coffee as the rain lashes around, cooling and cleaning everything! Monsoon brings such a sense of freshness. But we cannot say the same for the skin. Monsoon also brings with it a series of skin woes for many, such as open pores, dull skin and infection along the body folds. A bit of moisture is good, but a lot is not. Your skin might feel hot and humid since the pores remain open from summer months and can get further aggravated. Acne and infection along the body folds can also occur.

Here are few tips that will help you enjoy the rains without worrying about your skin and hair much:

Face wash: Use a face wash that lathers, feels fresh, minty and light. Wash your face three to four times a day with cold water.
Toner is optional
Usingscrub: You may scrub your face once a week. Excessive scrubbing can make the skin more sensitive, red, and vulnerable.
Use of creams: Do not use too many creams on your skin. Just a good broad spectrum sunscreen is sufficient during the day. You may choose a gel based sunscreen that will offer you protection without clogging your skin.
Apply skin actives: Vitamins A, C and E in the form of serums or gels. This is because they have actives in water or silicone base which do not add to the oiliness. You may either apply them in the evening or underneath your sunscreen during the day.
Start a De-tan: As the scorching heat of summer is no more a worry now, so you may start a de-tan regimen now. Use special treatment creams that lighten the skin like glycolic acid, kojic acid, and apply it at night so that the tan slowly comes off.
Powder form cosmetics: For this season you must look for the powder form of most things like a compact, deodorants, etc. There are some collagen boosters too, which I would suggest you pick up for keeping your skin in good shape.
When to wash your face: If you happen to get wet, wash your face and feet as soon as possible and keep it dry.
Hair care: Healthy Hair Hair care should not be ignored during this season. During monsoon, hair swells and so is more vulnerable to damage and breakage, so it is advisable not to go for too many salon treatments. Even a simple blow dry can cause more damage.
A good coconut oil massage will work wonders for your hair.
Always dry wet hair with low heat.
Do not brush wet hair.
Use loose hair accessories.
Take sun protection for your hair. Yes, you read it right! Much is spoken about sunscreen for skin, but you would be surprised how much damage the UV rays can do to your hair. There are specific hair care gels and shampoos available for sun protection. Try to use one of that sunscreen hair sprays post shampoo. The best way to protect your hair is to wear a hat or a scarf.
Avoid salon treatments as any chemical treatment will harm the strands since the cuticles are open.
Shower every day: Lastly for your body, just take a couple of showers during the day using a refreshing body wash. Use the sunscreen on your body, as it can burn and tan too.
Some do's and don'ts you must follow:

Getting wet in the rain is fun but change your clothes ASAP. Damp clothes increase the risk of skin infections, especially in body folds. If you notice any rash or irritation in any of body folds, consult a dermatologist immediately.
Dry your hair to remove as much moisture as possible. Blow dry your hair gently if needed.
Keep wet wipes, moisturizer, face wash, and sunscreen in your purse to keep your skin in great condition.
Take multivitamins to boost your immunity.
Skin treatments that are safe during monsoon

Most treatments are safe during this season. You may concentrate on de-tanning treatments like peels and microdermabrasion. You may also start off laser treatments for skin lightening, tightening, or hair removal.

Happy monsoon!

Skin Care In Monsoon - Things You Must Take Care Of!

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