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

Gallstones are bits of solid material that may be formed in the gallbladder. The gallbladder is a little organ located under the liver. You won't not know you have them until they've block your bile duct, causing pain that will need immediate medical intervention, and even hospitalisation in some cases.They may comprise of cholesterol, salt, or bilirubin, which consists of red platelets. Gallstones vary in size. They can be as little as a grain of sand or as even the size of an apricot in many cases.

Women are more likely to develop gallstones than men. Read on to know more:

Causes: There are a number of causes for this condition, especially in women. These causes are as follows:



Intake of anti-conception medication pills, hormone trade treatment for menopause side effects, or pregnancy
Fasting
Malfunctioning of the gall bladder
High cholesterol levels
Gallstones may be created when there is excessive amount of cholesterol in the bile discharged by the liver. This bile normally separates the cholesterol and helps in the normal functioning of the liver and other digestive organs of the body.
Bilirubin: Bilirubin is a substance created when your liver wrecks old red platelets. A few conditions, like cirrhosis of the liver and certain blood issues causes the liver to create more bilirubin than it ought to. This can lead to complicated conditions like gallstones.
Bile: Your gallbladder needs to exhaust bile to be sound. In the event that it discharges its bile content, the bile turns out to be excessively thick which causes stones to shape.
Weight: Being overweight or underweight can also cause a malfunction which can lead to the appearance of such stones. The diet also has a bearing in such cases.
Symptoms:

Fever
A yellowish tint in your skin or eyes, which can demonstrate jaundice
Sickness or retching
Clay coloured stools
Pain in the right upper quadrant of your stomach area
Nausea
Vomiting
Other digestive issues
Treatment:

Numerous individuals with gallstones may be asked to go through surgery to remove the gallbladder. These include the following:

Laparoscopic cholecystectomy: The specialist passes instruments, a light, and a camera through a few little cuts in the midsection.
Open cholecystectomy: The specialist makes bigger cuts in the belly to expel the gallbladder. You may have to spend a couple days in the hospital after the operation.
Without getting operated: If you have a mild condition and your specialist feels you shouldn't have an operation, he may recommend medicines like chenodiol, ursodiol, or both. These medications work by dissolving cholesterol stones. One may experience mild loose motions as a side effect.

Symptoms, Causes and Treatment of Gallstones in Women

Eczema is something which can really blight the quality of the life of a person. Sometimes, even the most mundane of things can cause our skin to have a reaction, resulting in allergic eczema. However, while it is annoying and painful, there are ways to go about treating it.

It is quite important, though, to understand what exactly eczema is. Simply put, it is a condition which occurs when the skin of the person suffering from it is inflamed.

Among the various groups of people who suffer from eczema, a lot of them are actually babies. However, they thankfully are able to grow out of the issue by the time they become adults. While it is true that eczema can strike any part of a person s body, among the places it strikes most often are the face, the neck and behind the sweat spots of the body i.e. the area behind the knees and around the ankles.

What causes allergic eczema?
Eczema is a lot of the time, a condition which is genetic. That being said, there are certain things which can go a long way into making it worse, which include stress and dry climates as well as external materials which irritate the skin touching it, like soaps which are just too strong.

What are the Treatment Options?
When it comes to things, which have the potential to make the situation a lot better, there is a group of medicines which are part of the antihistamine group which can work wonders. An interesting thing when it comes to the treatment of allergic eczema is the fact that a lot of the treatment for the issue involves a management of the inflammation that occurs along with an attempt to take better control and manage the immune system of the person who has eczema.

Depending on the severity of eczema a person has, a possible course of treatment involves making use of corticosteroids, which are strictly a prescription based way to go about treating eczema. Keeping this in mind, it is of the highest importance to make sure that whenever the steroids are being taken by mouth, there is a full adherence to what the doctor has recommended or directed.

As a last ditch resort, if the condition is really bad, there is a possibility of going for Ultra Violet Therapy in order to make it better. However, if one is looking for ways to reduce the intensity of their eczema sans higher doses of medication, stress management in something that can work well. In addition to this, a humidifier can do a lot to improve the situation.

Allergic Eczema - Ways You Can Contact It!

Tennis toe is also known as runner s toe since athletes are mostly runners; skiers and tennis players also get this injury often. Due to its ugly appearance, tennis toe is also known as a black toenail. This injury causes bleeding under the toe along with moderate to heavy pain. Although it is not considered to be type 1 serious injury, it can still force an athlete to abstain from participating in any events. The blood from the toenail might take its own sweet time to get out of the way. As a result, the recovery time for this injury can last for weeks together. This, unfortunately, is also an ideal condition for infection to set in.

How does it happen?
This condition may arise because of the friction between the toenail and the running shoes or constant downward pressure on the toe. In case if the shoe is tighter than normal, it can damage the toenail. If on the other hand, the shoe is very loose, it can result in similar condition due to heavy pressure on the nail. Tennis toe can also arise in a situation, if the toe constantly bangs the shoe from inside. Extreme hot weather may also result in toe swelling. Finally, one may encounter tennis toe if a blow is faced on the toe. Irrespective of the cause, the blood clots inside the nail resulting in swelling and pain. Too much damage might result in falling off of the toenail altogether.

Treatment plan:
1. If the tennis toe is minor, the injury resolves all by itself
2. The toenail should be clipped together to ensure that it does not result in any friction with the shoe.
3. During the injury, it is advised that a person wears bigger size shoes with wider toe space so that it does not result in any further irritation.
4. If the toenail is torn, make sure to tap it up so that adequate protection is there from outside forces.
5. In case the injury is serious a doctor might have to intervene and drain the blood with a surgical instrument.
6. Another medical solution is to remove the toenail surgically, drain the blood and tape it up for a good one week until new nail formation takes place.

Precautionary measure:
1. Running shoes should be at least half a size bigger than the normal size.
2. Toenails should be regularly trimmed in order to avoid any injury.
3. If a person has a tendency of sweating too much, it makes sense to wear a pair of socks at all times.
4. While running, shoe laces should be tightened to avoid sudden friction between the toe and the shoe resulting into tennis toe.

Tennis Toe - How it Should be Treated?

Gall bladder stones can be painful. Until and unless it is surgically removed and cured from within, the pain continues to hinder daily life. The good news is that there are ways by which pain from gall bladder stones could be managed. 

Here is a list of quick, easy-to-follow remedies to counter the pain.

Heat Pack: Applying a heat pack or hot water bottle on to the stomach making sure that the heat is directly passed on to the gall bladder can give instant relief from the pain. The heat should be applied at an interval of half an hour and a layer of cloth should be placed in between the skin and the heat pack.
Over the counter medicine: In most cases, over the counter pain relief meds can make the pain go away. NSAIDs should be avoided until and unless suggested by the doctor. A pain relief medicine with anti-inflammatory properties will perfectly suit the gall bladder condition.
Try vegetable juice: While gulping vegetable juice might sound a little indifferent, it has instant benefits with no side effect. All it needs is to mix beetroot, cucumber, and carrot in equal proportions and extract the juice from it. The juice extracted from this mixture should be consumed twice in a week to flush out the toxins from the system and ease the gall bladder pain.
Citrus fruits: Citrus fruits such as lemon, orange etc. contains pectin that is believed to be a remover of stones and blockages. This is also believed to be a great agent for countering pain originating from the gall bladder. Consumption of 10-12 tablespoon of lemon juice extracted from fresh lemons followed by a glass of water will wither the pain away in few weeks.
A mixture of honey and turmeric: Honey s antiseptic nature prevents infection and the curcumin found in turmeric makes the bile more soluble in the gall bladder. These two herbs in tandem can ease the gall bladder pain and get relief from the stones too. A tablespoon of honey and 1 tablespoon of turmeric should be consumed daily to get the benefits.
Take the herbal route: There are several herbals that are believed to be extremely effective in treating pain origination from the gall bladder. Some of them include goldenseal, quebrapedra, catnip, fennel seed, yellow dock, rosemary, nettle, peppermint herbal tea etc.
Apple Cider Vinegar: Apple cider vinegar is acidic in nature and consumption of a quarter of a glass followed by a quarter of a glass of apple juice can show instant results. It should be consumed daily after breakfast. There are instances where the pain eases out within a matter of 15 minutes.

Gall Bladder Stone Pain - Tips To Help You Manage It!

Eczema is an autoimmune disorder wherein the skin overreacts to certain triggers in or outside the body resulting in inflammation and lesions. Eczema is also known as atopic dermatitis. The skin becomes dry, patchy and rough, and it tends to form itchy and red blisters. Eczema is usually caused due to inflammation; in most cases, allergy triggers eczema. It has been observed that quite often, patients who suffer from eczema have a family history of allergy. In some cases, patients having other allergies, may also develop eczema. Apart from this, low immunity triggers this disease.

Symptoms

Red patches over skin
Dry rough skin with blisters
Intense itching on skin, with occasional bleeding
Formation of a thick leather-like layer over the affected areas of the skin
Discharge of an oozing watery and sticky liquid from the affected area, in case of wet eczema (In case of dry eczema, there is no watery discharge; the skin stays rough and dry.)
Treating eczema with homeopathy
Treating eczema might be possible by taking several medications. But treating doesn't mean curing. People who suffer from eczema know how irritating the disorder is. So they want a cure for eczema, which is possible with homeopathic medicines. Homeopathy is known for curing eczema, from the root. Basically, homeopathy helps to improve the immune system, as low immunity is responsible for causing allergies. When immunity is built, and low immunity quits from overreacting to several reactions, eczema is cured.

Here are five homeopathic medicines suitable for treating eczema:

Graphites: Graphites is one of the finest homeopathic medicines for treating wet eczema, when there is thick, oozing watery and sticky discharge. In most cases, the patient with this type of eczema suffers from constipation and obesity. He or she might be sensitive towards cold. Their usual skin becomes hard and cold, but the affected area remains dry and rough. The remedy is prescribed mostly to women with menstrual disorders.
Mezereum: This is the suitable for patients with eczema, which tends to form a leathery crust on the head. The patient might feel intense itching especially at night.
Hepar sulphur: This is suitable for eczema with formation of pus. The patient is usually too sensitive to cold. Intense itching, sneezing and sensitivity towards cold are the symptoms, which indicate the need for this medicine.
Dulcamara: This is one of the finest homeopathic medicines for eczema, which aggravates in damp or cold weather. Thick formation of yellowish crust and intense itching are the symptoms, which clearly indicate the need for this remedy.
Sulphur: This one is suitable for eczema with burning sensation along with intense itching. Symptoms usually worsen in summer and the skin feels rough and dry.

Eczema - 5 Best Homeopathic Remedies to Treat It

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