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

300 Calories is the average calorific value of our daily sugar intake. It's no wonder then that dietician and weight loss gurus across the world will advise you to quit added sugar as the first step of a weight loss program. Added sugar refers to processed sugar in the form of cubes, sugar crystals or powdered sugar and does not include natural sugars found in fruits, vegetables etc. Apart from cakes and sweets, we eat added sugar in a number of ways including a number of packaged foods like sauce and salad dressings.
If you consume a lot of sugar on a daily basis, quitting added sugar could leave you with withdrawal symptoms. Quitting added sugar is not easy, but here are a few reasons it is well worth the effort.
1. You'll have fewer pimples
Sugar has inflammatory properties. This can trigger systemic inflammation leading to the acne. Thus quitting sugar can instantly reduce the number of pimples on your face and give you clearer skin.
2. It improves the health of your heart
Added sugar can raise insulin levels. This activates the sympathetic nervous system and increases blood pressure and heart rate. Stopping your consumption of added sugar can lower cholesterol levels and decrease the amount of triglycerides in the body. This lowers blood pressure and boosts cardiovascular health.
3. A friendly weight scale
Replacing toffees with dry fruits will considerably reduce your calorific intake. Similarly switching packaged salad dressing for fresh homemade dressing can also make your salad healthier. Given that we eat added sugar in so many forms, making a conscious decision to quit added sugar can have a big impact on your daily calorie intake. Studies show that this simple step can lead to a weight loss of up to 10 pounds in six months.
4. It'll make remembering names easier
Added sugar can hinder learning and memory. Over time, it can also damage communication between brain cells. Quitting sugar can boost both your short term as well as long term memory. You will also find it easier to focus on will be able to be attentive to something for longer periods of time.
5. A good night's sleep
You don't just need 8 hours of sleep a day; you need 8 hours of restful sleep at the right time. Sugar makes blood sugar fluctuate and the crash that follows a sugar high can make you feel sluggish around mid-day. Many people find that if they have an afternoon nap, it becomes more difficult for them to fall asleep at night. Sugar also releases cortisol that interferes with sleep. Thus quitting added sugar can keep you alert through the day and help you fall asleep easier at the end of the day.

See What Really Happens to Your Body When You Stop Eating Added Sugar

What is Follicular transfer (FT) is also known as follicular unit extraction (FUE).

It is a type of hair transplant procedure which is less invasive than the other types. It is performed when the person has a good hair growth at the back or side of the head which becomes the donor s area.

How is it performed?

The procedure is performed by specially designed instruments under a high powered microscope which provides precision for best and natural results. When the part gets numb the follicles are isolated with a specialized punch device which extracts the follicular units completely with necessary glands. This method is used to separate the surrounding tissue from the follicular unit which results in minimal injury and undetectable scarring.
Then the follicles are removed without any damage to the area. If the scar is left behind it takes few days to heal proceeded by hair growth which takes about weeks.
Then the extracted hair is prepared and sorted for treatment.
Then the follicles are implanted in the scalp by making small incisions by microsurgical needles generally in a group formation of 1-4 to give a natural and recognizable look.
To create a natural hairline transacted hair are used, which will start to grow within weeks naturally. The length of your hair depends upon the follicular units grafts. Approximately 12 months later you will have re-grown hair.
You can get the discharge immediately after the treatment. In 5-7 days the healing takes place after which the redness and swelling disappear.
Advantages of Follicular Unit Extraction

Easy recovery: As there were small incisions made in the procedure which lowers the risk of widening which generally occurs in FUT procedure. This is the reason there are fewer limitations on exercise post-procedure.
Less scarring: FUE doesn t produce linear scarring on the donor's area because it doesn t require any sutures, scalpels; due to which you can wear your hair short too.
Quick healing: As there is less scarring, the time required for healing is very less as compared to FUT where the scarring is more, therefore, the healing is slow.
Disadvantages of follicular unit extraction

It s expensive: As the cost is decided on a number of sessions required for the procedure. FUE requires more sessions than FUT, as this transplants individual follicle units which are more time-consuming.
It s temporary: In most of the cases it doesn t last longer than FUT. because in this the follicular units are taken from a various area which leads to thinning of the donor zone and visible scarring.
Shaving: The one who doesn t like shaving can have a problem. Because FUE requires shaving of donor s area. Only in advanced procedures like long hair FUE, shaving is not required.

Follicle Transfer - Know The Benefits!

Rosacea, a common skin condition, occurs due to a combination of environmental and genetic factors. This condition causes your skin to become red, and produces red, pus-filled small bumps on the skin.

Rosacea can occur in 4 forms-

Erythematotelangiectatic Rosacea- related to facial redness, visible blood vessels and flushing
Papulopustular Rosacea- related to acne-like breakouts
Rhinophyma- leads to thickening of the skin on the nose
Ocular Rosacea- affects the area surrounding your eyes
Rosacea is most commonly observed in middle-aged women with fair complexion between the ages of 30-50.

What causes Rosacea?
Rosacea is often mistaken for pimple or acne, but it is more than just that. The following factors are held responsible for causing this skin condition.

Consumption of alcohol, aerated beverages
Eating spicy food
Presence of an intestinal bacteria known as Helicobacter pylori
Over exposure to sunlight
Signs that indicate you may have rosacea-

Visible, broken blood vessels
Swollen skin
Sensitivity on the skin
Burning, stinging sensation on the skin
Rough, dry, scaly skin
Raised patches/bumps on the skin
Thickening of skin on the nose, chin, cheeks and forehead
Itchy, dry eyes
Blurred vision
Watery, bloodshot eyes
How does Ayurveda help treat rosacea?
Although there is no definitive treatment for rosacea, the symptoms of each type of rosacea can be treated with Ayurvedic herbs and medicines.

Turmeric- Packed with anti-oxidants and anti-inflammatory properties, turmeric powder helps cure various skin disorders. You can consume a teaspoon of turmeric powder daily to avoid skin inflammation, or you can have it mixed with your food or juice.
Beets and carrots- Beets and carrots contain iron, which is essential for smooth functioning of your skin. The deficiency of iron can cause your skin to become sallow and dry.
Ashwagandha- One of the most essential, powerful herbs packed with anti-inflammatory properties, Ashwagandha helps remove rosacea puss. In order to fetch best results, try applying or drinking extracts of this wonder herb every alternate day.
Fenugreek- Rich in essential vitamins like C and K, folic acid and iron, this medicinal plant helps remove dry red patches from the skin. Also, it prevents formation of rosacea puss and helps reduce itching.
Ayurvedic treatment is absolutely safe and free from side effects. These are the most preferred and effective ways to reduce symptoms and severity of rosacea.

Rosacea - Top Ayurvedic Remedies For Treating It! 

Genital warts are a sexually transmitted disease caused by the human papillomavirus (HPV) and affects both men and women. Genital warts are treatable but can come back if the underlying infection is not treated properly.

Genital Warts appear as soft growths on the genitals and are known to cause itching, pain and discomfort. Although the disease affects both men and women, it causes more complications in women as some strains of HPV can cause cancer of the cervix and vulva.

Warts can appear on the penis, scrotum, groin, thighs, inside or around the anus for men. These can appear inside of the vagina or anus, outside of the vagina or anus or cervix for women. They can also appear on the mouth, lips, tongue, throat of the person who engages in oral sex with an infected person. Sometimes the warts may be invisible to the eye and still cause symptoms like vaginal discharge, itching, bleeding or a burning sensation.

Symptoms of Genital Warts: HPV is very common and nearly 70 pc of the people are infected around the genital area. The Center for Disease control (CDC) says that most sexually active people, are affected by the disease at some point of there life. It is important to note that although the disease is transmittable through skin-to-skin contact, it doesn't spread from the hand to the genitals or vice versa.

Diagnosis: 

Genital Warts can be diagnosed by performing a physical examination of the infected areas by a medical professional. Since some warts can be inside a woman's body, a doctor may have to conduct a pelvic exam. While conducting the test they use a mild acidic solution which makes the Genital Warts more visible.
A Pap smear test may also be conducted, in which a swab of the area is taken from inside your cervix. Apart from that doctors may also ask questions about a person's sexual history as well as health as ask if they have participated in unprotected sex, including oral sex.

Treatment: Visible Genital warts go away with time; however treatment is essential to prevent their return. The virus cannot be eliminated once it is in your bloodstream, which makes it possible that an infected person will have many break outs in their life. Managing the symptoms of Genital warts is important as they can be easily passed on to your sexual partner, even if there are no visible symptoms.

Genital Warts - How They Can be Diagnosed?

Breasts are integral to womanhood. They define a woman s beauty. Well grown, firmer breasts are what every woman dreams of. However, not many women are lucky enough to have the perfect shape and size of breasts. A common belief among people is that bigger the size of the breasts, the better they are. This is a big misconception. The ideal breast size is the one that is in proportion to the rest of the body. Bigger breasts do not look good on women with smaller structure and are also prone to sagging. Apart from a disproportionate figure, many women with larger breasts complain of backache, neck and shoulder pain due to the physical burden born by the upper body. Hence, the need for a medical intervention. Such women can consider breast reduction as a permanent solution to their problem.

Breast reduction or reduction mammoplasty is a procedure that reduces the size of the breasts through surgical removal of tissues, fat and skin, thereby making it ideal as per the body structure. The procedure is performed under the guidance of a trained aesthetic plastic surgeon and takes about three to five hours.

Hospital admission is usually required and a general anesthesia is given to the patient. Healing of wounds may take a few days. Breast reduction surgery also deals with issues of sagging breasts and helps them give an uplifted and firmer appearance. Another advantage of this surgery is that it can reduce the size of areola making the breasts appear younger and better.

Like any other surgery, reduction mammaplasty is not free of side effects. There are risks associated and one has to carefully weigh the risks and benefits before taking this decision. It can cause complications like excessive bleeding and adverse anesthesia reactions. Apart from this, some of the common side effects of this surgery are loss of sensation in the nipples and areola, inability to breastfeed and scarring. Sometimes, the procedure may need to be repeated in case there is a visible asymmetry in the size of both the breasts.

In general, women considering this option are overweight, have no plans to bear children in future and are suffering from heaviness and pain in upper part of the body due to larger breasts. However, many women desire to improve their appearance. Cosmetic market delivers many new gels and creams for breast reduction, claiming them to be simpler and safer than surgery, but their effectiveness is doubtful. Women looking for a more permanent solution may consider a surgical procedure. However, following the surgeon s instructions is important pre as well as post-surgery. If you are worried about the size of your breasts, do visit a plastic surgeon and discuss your options.

Should You Get Breast Reduction Surgery? 

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