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

Shingles is a type of skin infection that results in rashes on certain parts of the body. It is characterized by a single stripe of blisters that may occur on either side of the body. The varicella-zoster virus that causes chickenpox is also responsible for causing shingles. Once you have had chickenpox, the virus remains in a dormant state in the body. If the virus gets reactivated, it might cause shingles.

The symptoms of shingles are:

1. You may experience sensations of numbness and burning on the affected area
2. The affected area may be sensitive to touch
3. Symptoms of red rashes on the body
4. Blisters that are filled with fluid
5. Bursting of blisters and crusting
6. You may experience fever and headaches
7. You may have difficulties in vision

The first symptom of shingles is the pain that results from the rash. In some cases, rashes may occur around the eyes.

Causes

Shingles is caused by the virus that is responsible for chickenpox. After lying dormant for certain period of time, the virus may get reactivated and travel through the nerve pathways on the skin. This is more likely to happen if your immunity level is somehow affected, which makes it easier for the body to get infected.
The disease is contagious in nature, so it is advised to stay away from people who have shingles. Remember that if you are not immune to chickenpox, then coming in contact with a person who has shingles, might result in you developing chickenpox.

Shingles may result in certain complications in the body such as:

1. Vision loss: shingles, if present around the eyes, may lead to infections in the eye causing vision problems.
2. Post herpetic neuralgia: in some cases, the pain that occurs from shingles may continue well after the infection has subsided.
3. Neurological complications: shingles may cause inflammation in various nerves, resulting in neurological disorders such as facial paralysis and balance problems.
4. Infections in the skin: shingles may also cause infections on the skin.

All About Shingles

Eczema is a skin condition that is accompanied by itchy rashes on the skin. They often bleed and give out a foul smell. Eczema usually develops during one's childhood. There are allopath medicines available to treat this condition but their action is only short-lived. These medicines provide temporary relief but fail to cure the ailment completely. However, homeopathic medicines can help an affected person recover completely owing to their ability to work at the core. Today we are going to discuss about some of the components that homeopathic medicines use to treat eczema.

Some of the homeopathic supplements use carbon or black lead to treat eczema. Eczema often tends to develop around warm and moist areas like the folds of the elbows, behind the ears, between the toes, behind the knees. Black carbon is a primary aerosol which contains cooling agents. Homeopathy remedies make use of this quality of black carbon to heal eczema.
Eczema undoubtedly develops in areas that mostly receive less air. However, the condition can be aggravated during the winters and cause more irritation. There are homeopathic supplements that make use of a fluid extracted from the vesicle (a component of the cell) of a person affected by scabies to treat eczema. Scabies is another skin condition that occurs when the scabies mites eat into the skin and lay eggs there. This is a condition that is somewhat similar to eczema in that it leads to skin irritation and itchiness.
Petroleum extract is another homeopathic remedy to treat eczema. The medicine made from petroleum works in a similar manner as Vaseline. As has been aforementioned eczema worsens during the winter as the skin gets chapped and incessant scratching leaves lesions on the skin. The homeopathic drug controls this situation by keeping the skin moisturized.
According to the University of Michigan Health System, sulfur is a very important mineral that takes care of the connective tissues, bones, teeth, hair as well as the skin. Therefore homeopathic medicines use sulfur which acts as a sure-fire component when it comes to treating eczema.
Poison Ivy is a component that is used to treat skin conditions. The homeopathic drug made from the extract of the poison ivy plant especially treats eczema that develops on the face, scalp and around the mucous membranes. Severe eczema can also result in stiff joints. The medicine works to heal a person from such botheration.
This is an article that aims at making you acquainted with the homeopathic remedies available for treating eczema. For the best result consult a professional.

Role of Homeopathy in Treating Eczema!

Rosacea is a skin condition that is characterized by redness and the appearance of pus filled red patches on the face. Small bumps that are red in color and filled with pus may also be present on the skin. This condition can last from a few weeks to a few months. However, because of its appearance, this condition may be mistaken for acne or other allergic reactions.

It mostly affects women who are middle aged or have a fairer skin tone. This disorder does not have a cure but treatments can help in limiting the symptoms of rosacea.

The symptoms of rosacea are:
1. Swollen red bumps: Bumps that look like pimple and contain pus can develop on the skin; the skin tends to feel tender and hot.
2. Facial redness: Facial redness is caused by swelling of blood vessels on your cheeks and nose.
3. Problems in the eye: This disorder may lead to problems in the eye such as irritation, dryness and swelling in the eyelids.
4. Enlarged nose: The skin on your nose may become thick and swollen, making it look enlarged.

Causes of rosacea
There is no exact known cause of rosacea. Contrary to popular belief, poor hygiene does not cause rosacea. There are certain factors that trigger increased blood flow to the skin, them being:
1. Exercise
2. Environmental factors
3. Spicy foods
4. Various medications that dilate the vessels that carry blood
5. Chemicals present in cosmetics

Treatment options available for rosacea are:
1. Oral antibiotics: Antibiotics are used to fight bacteria and reduce inflammation resulting from rosacea.
2. Medications that reduce redness: Certain medications which come in the form of gels, when applied on the affected area, help in constricting blood vessels thus reducing the redness.

There are certain measures that you can take to prevent rosacea, some of them are:
1. Use sunscreen: Use a sunscreen to prevent damage from sun exposure, make sure the sunscreen has a SPF count of 25 or more. However, the SPF measure should be determined by your skin texture.
2. Use gentle products on your skin: Use a mild cleanser to clean your skin and make sure to moisturize on a daily basis.

Did You Know Rosacea Can Cause a Swollen Nose?

What are dermal fillers + how different it is from botox?

Dermal fillers are an artificial or naturally-derived material used for directly injecting into the skin. These soft tissue fillers are used with the aim to restore your facial appearance to address issues related to facial aging. Depending on the kind of filler that you opt for, the effects can vary from 6 months to 5 years. Nonetheless, they are used for a number of problems associated with facial aging such as:

  for smoothen out and add volume to creases known as laugh lines

  for enhancing thin lips

  for providing shape and fullness to cheeks so as to provide a youthful appearance

  for enhancing the under eye areas to the point that depressions or hollows are no longer visible

  for merging scars from chicken pox or acne with surrounding skin

  for adding volume to your temple or lower cheek area when shifting of fat pads (masses of tightly packed fat cells) underneath your skin surface occurs.

How are these fillers different from botox?

Even though both these procedures involve the use of injections, they are completely different from one another. Botox or botulinum (a purified, natural protein) works by numbing muscles that contract to create facial lines. It is mostly used around the eye and forehead areas for stopping the movement of muscles that cause wrinkles to form. Moreover, it treats active lines, which are visible when you smile, frown or squint.

Dermal fillers, on the other hand, treat wrinkles that are very deep and static, which you can only be seen when the face is in a restful state. Furthermore, it serves to enhance the skin while lightly swapping the collagen (a protein that helps connective tissue in the body to remain strong) that gets lost as you age. When it comes to swelling and bruising, botox reports minimal effects and dermal fillers a certain amount of swelling and bruising that disappear within 7-10 days.

If you would like to consult with me privately, please click on 'consult'.
Related Tip: 6 Face Washing Mistakes that are Damaging Your Skin, Every day!

For Your SKIN: What are Dermal Fillers + How Different it is from Botox?

Nails are an important part of your physiology, although they are mostly used for either utilitarian purposes such as gripping or for beauty purposes such as nail decorations. Nails themselves can go through infections which need not have underlying causes and thus can cause damage to that part of the tissue. One such disorder of the nail is onycholysis.

What is onycholysis?
This is a disorder where the nail on the finger or the toes starts to separate from the skin below. This happens little by little and usually starts at the tip and then progresses backward. The further back it progresses, the more nail tissue it destroys. While the entire nail may not be detached from the nail bed, parts of it may chip off, showing the tissue underneath.

Symptoms of onycholysis:

Jagged border between the pink flesh of the nail bed and the yellow edge of the nail
Detached nails become opaque, yellow or may turn green in color
Nail may become irregular in shape and size
Bits and chunks of nails can break off easily
Primary causes for onycholysis:

Let's look at some of the primary causes of onycholysis:

Frequent trauma - if you have a profession or work at home where you constantly require tapping away, it might cause minute injuries to build up within the nails and the fingers. Tapping on keyboards is one area where you could get repetitive trauma like this.
Manicure problems - many salons may aggressively try to clean the underside of the nails and in the process, slowly dislodge the nail form the nail bed and cause onycholysis. This has known to be the case with many people.
Water immersion - if you have work where your nails are immersed in water for long periods of time, this could also affect the development of onycholysis.
Skin diseases - certain skin conditions can also end up giving onycholysis. Psoriasis and contact dermatitis are other conditions that may lead to onycholysis as a consequence.
Allergy to nail glue - many makeup artists and customers have complained that certain brands of nail glue can also cause allergies resulting in onycholysis.
Medications - medications meant for the treatment of other ailments within the body can have the unintended consequences of causing onycholysis.
Treatment-
The underlying problems need to be corrected which may cause onycholysis. Once the underlying problem is corrected, onycholysis usually corrects itself. The nail may take some time to re-grow but will grow back on its own eventually and may take 4 to 6 months to cover the entire affected area again.


All About Onycholysis

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