Dr. Aastha Gupta - Diabetes | Thyroid | Hormones

Diabetes is known as a silent killer and this name is well earned. Research findings have shown that around 20 lakh Indians suffer from diabetes of which 5 lakh are not aware that they are diabetic. Managing diabetes can be a difficult task but definitely not an impossible one. However, if you do not take steps at the right time, diabetes can cause many health complications and emergencies. Read on to know more about this deadly disease.

What is diabetes?

Diabetes is an ailment, which compromises the body’s ability to produce or respond to the hormone, known as insulin. This leads to an increase in the blood sugar levels of the body and causes an abnormal metabolism of carbohydrates.

What kind of complications can diabetes lead to?

Yes, diabetes can lead to emergencies as diabetics always run the risk of suffering from insulin shock and falling into a diabetic coma. Excessive insulin in the body can lead to a low blood sugar level causing insulin shock. This is also known by the term ‘hypoglycemia’. Similarly, if your body has too little insulin then it is known as hyperglycemia where you run the risk of falling into a diabetic coma.

The symptoms of an insulin shock are:

- Rapid pulse
- Sweaty and pale skin
- Odorless breath
- Hunger
- Drowsiness and fatigue
- Rapid breathing
- Trembling
- A headache
- Numbness in feet and hands

The symptoms of a diabetic coma are:

- Nausea
- The shaky or wobbly way of walking
- Dry, warm or flushed skin
- Drowsiness leading to a gradual loss of consciousness
- Quick and weak pulse
- Deep breaths
- Confusion
- The odor of sweet apple of nail polish

How can you deal with diabetes?

Even though diabetes is a very serious disease to deal with, there are a few things you can do that can help you deal with it and keep it at a normal level. Some of these steps are:

- Count your carbs - Even though carbohydrates is an essential nutrient for ensuring a healthy body, too much of it can wreak havoc on your blood sugar levels. It is imperative that you follow a well-balanced diet with the right amount of carbs in it. The best thing you can do is to pair high-fiber carbs with protein, as it can slow down your digestion and you will feel full without your blood sugar being hiked up. Some of the best sources of carbs and fiber are sweet potatoes, dried beans, whole wheat bread, and pumpkins.

- Check your blood sugar regularly - Go for regular blood sugar tests, so that you know where your diabetes stands. If your blood tests come back to normal then you are on the right path but if they do not, then consult a doctor so that he or she can help you come up with a plan to deal with this in a better way.

- Exercise - Exercise is something that does not just takes care of your body from the outside; it can also keep you in good shape internally by lowering your blood sugar levels. Make sure that you work out at least 4 days a week for a minimum of half an hour. Physical activity can also help your body secrete the hormone; endorphins, which can help, boost your mood and emotions.

Even though diabetes is a very unfortunate disease, that does not mean you will have to put your entire life on hold for it. If you take the right steps at the right time and listen to your doctor’s advice, you will be able to beat this disease in no time.

Thinning hair, noticeable bald spots, large clumps of hair in the hairbrush or shower drain are indications of hair loss. This loss of hair is an effect of hormonal imbalance.

Have You Seen these Signs of Hair Loss?

• A widening part of the scalp
• A ponytail becomes noticeably thinner
• Large clumps of hair in the hairbrush or shower drain and on your pillow after a night’s sleep

Why does it happen?

1. Play of Hormones: Hormonal imbalance is seen in women during menopause, perimenopause, pregnancy, and in endocrine disorders, such as polycystic ovarian syndrome (PCOS). Progesterone and estrogen are two important female hormones. Progesterone keeps a check on estrogen levels. When progesterone levels are too low, it leads to a state of hyperestrogenism which triggers excessive hair shedding and hair loss. Dihydrotestosterone (DHT) is a potent form of testosterone that normally leads to hair loss. Women, who produce high levels of male hormones (androgens), have increased testosterone levels which can convert to DHT, leading to hair loss.
2. Stress: When a woman experiences any stressful condition, her adrenal glands increase the release of cortisol (stress hormone). This leads to secretion of adrenaline which leads to increased levels of testosterone and DHT.
3. Under or over performing thyroid: An overactive thyroid and lack of sufficient parathyroid hormone can also result in thinning of hair. Accompanying symptoms are fatigue, unexplained weight gain, aching joints, constipation, dry skin, feeling cold all the time, and poor sleep.
4. Pregnancy and childbirth: Pregnancy and childbirth change a woman’s hormonal balance and can result in hair loss. Therefore, it is normal for postpartum mothers to experience thinning of the hair and even bald patches. Such hair loss is temporary and heals itself within several months.
5. Menopause: Menopause also leads to hair loss. During menopause, a woman’s estrogen levels fall and are no longer in balance with DHT levels. This low estrogen level and high DHT lead to hair loss.
6. Nutrient deficiencies: Low levels of certain nutrients within the body, for example, vitamins A, E, and iron may result in hair loss.

How Can You Help Yourself? 

1. Consume omega 3-fatty acids: Omega-3 and omega-6 fatty acids are kinds of essential fatty acids (EFAs). They increase hair growth. Sources are walnuts, flax seeds, cold-water fish, such as salmon, sardines, herring, and mackerel.
2. Get plenty of sleep: Lack of sleep causes increased stress levels, higher production of cortisol, and ultimately hair loss. Good amount of sleep will lead to harmonious functioning of the body.
3. Take dietary and hair supplements to prevent hair loss: Certain supplements can help minimize the production of DHT, prevent DHT from binding to hair follicles, or stimulate inactive follicles to encourage hair growth.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Irrfan Khan's saddening revelation about his health and diagnosis of Neuroendocrine tumour (NET) has undoubtedly created a rage amongst his fans, which is now being followed by good wishes for speedy recovery from his supporters all across social media.  

The actor shared in an emotional Twitter post that he’s been diagnosed with NET, a rare tumour that develops from cells of the neuroendocrine system and grows predominantly in the digestive or respiratory tract - lungs, appendix, small intestine, rectum, and pancreas - it can occur in any part of the body.

Here is more on Irrfan’s disease:

What is NET?

A neuroendocrine tumor is characterized by a rapid and abnormal growth that happens in the nerve cells which produce hormones. Hormones control how different organs in the body work.

It is a condition wherein, endocrine cells, the hormone-producing cells of the body, develop a tumor in any part of the body - while it can can grow in lungs or the thymus, or more rarely, in the ovaries, kidneys, or testicles - the most common is lung, intestines, and pancreas.

What causes NET?

A neuroendocrine tumour is quite a rare disease, occurs in less than one per million cases. The exact cause is not known.

The Symptoms-

It can cause a myriad of symptoms, depending on where in the body the NET is.

1. If it is in your digestive system, it can cause pain or discomfort in the abdomen area that comes and goes. You may feel sick, nauseated, vomited, or there may be a change in how often you pass stools.
2. If the NET is in the lung, it can cause shortness of breath, chest infections, or you can even have a cough up blood.
3. Weight loss and loss of appetite may also be some common signs of a neuroendocrine tumour.
4. Some NETs may overproduce a hormone-like substance called serotonin. This causes a group of symptoms called carcinoid syndrome. Symptoms include wheezing (like asthma), flushing of the skin and diarrhoea.

Who can be affected with NET?

1. These tumours, depending on the type, are more common in certain age or sex. And few have very strong family history too.
2. People who have a rare condition called multiple endocrine neoplasia 1 have an increased risk of developing a NET.

Did You Know?

Apple founder ‘Steve Jobs‘ died from the same disease in 2011. The tumour affected his pancreas.

Know The Different Types of NET:

Based on the organ that is affected, NET can vary a lot. When the chromaffin cells that produce adrenaline are affected, it is called Pheochromocytoma, and it is related to the stress levels of the body.

When a cell is formed abnormally under the skin and the hair follicles, it is called Merkel cell cancer. This is also called neuroendocrine carcinoma of the skin and the condition can occur anywhere in the body. The commonly occurring places include lungs, gastrointestinal tract, and brain.

The status of the tumour, cancerous (malignant) or noncancerous (benign), decides the survival rate. Often slow-growing and noncancerous, they can invade surrounding parts of the body and at times, turn cancerous and spread across the body. However, you can still choose to live a good quality life with strict modifications in diet and lifestyle. The changes are made after taking into consideration the symptoms of the tumor. The organ where the tumor is formed also matters.

How Is It Treated?

Treatment depends on the location of the tumour, its type, how severe it is and whether it has spread to other parts of the body. Usually, the first treatment choice is surgery to remove the tumour. And, if the NET cannot be removed, your will prescribed with a treatment that will not only relieve the symptoms but will also improve the quality of your life.

How can a NET be prevented?

The first thing you need to do for the prevention of NET is to curb stress. Stress affects the entire body severely.

Lifestyle modifications:

A healthy lifestyle is what you need to stick to if you want to manage its symptoms during the treatment cycle. Your doctor will prescribe you to do exercises at least 4 days a week for a minimum of 30 minutes. You can also try a walk instead of strenuous exercises.

People with carcinoid syndrome may be advised to avoid food or activities that may trigger flushing, such as eating spicy food or drinking alcohol.

Indulge yourself in therapies that help in gaining more positive energy. If you are already affected by NET, eliminate all the sources of stress and get a good night's sleep every day. Join the support groups that make you grow strong and happy. After all, the mind is devised to do miracles when it is full of life and positive thoughts.

Is Irrfan Khan's tumour curable?

Dr Saumitra Rawat, HOD, Surgical Gastroenterology & Liver Transplant, Sri Ganga Ram Hospital, said, "NeuroEndocrine Tumour is an abnormal growth of Neuroendo cells which are present in bodies. When there is an abnormal growth, then it forms a tumor - Normally seen in intestine, pancreas, lung, thyroid and other parts of the body".

On commenting on Khan's case, he said, "It depends on the location of tumour, its size, and what is its mitotic index".

"Depending on where the tumour is localized, you can take it out surgically and the chances of cure are very high", Dr Rawat explained.

Actor Irrfan, who has been diagnosed with the disease is one of the most versatile actors in India, has also made a name for himself in the west, where he has been an important part of critically-acclaimed films such as ‘The Namesake’, ‘Jurassic World’, and ‘Life of Pi’. At home, the actor has delivered remarkable performances in films such as ‘Haasil’, ‘Paan Singh Tomar’, ‘Maqbool’, ‘Lunch Box’, ‘Piku’, and the most recent ‘Hindi Medium’.

Irrfan Khan is not just a disarmingly natural actor, but also an endearing human being -- honest and humble to the core. It’s time to stand together and pray for him a speedy recovery!

Thyroid is a small gland situated in front of the neck and secretes hormones like thyroxine (T4) and tri-iodothyronine (T3). These hormones control various functions of our body like heart, blood pressure, digestion, metabolism, growth, blood formation, brain function etc. Any fluctuation in the functioning of the thyroid gland can have a great impact on health. The thyroid gland is primarily responsible for energy and metabolism. This gland triggers the genes that make all the cells in the body conduct their specific jobs. But over a period of time, the optimum functioning of the thyroid may reduce because of specific reasons. The gland may start to under-produce or overproduce the thyroid hormone, which may lead to conditions known as hypothyroidism or hyperthyroidism, respectively.

• Patients with hypothyroidism may feel extreme tiredness and fatigue even though they may be sleeping more than before. An unexplained gain in weight, constipation, inability to stand cold temperatures, and constant pain in muscles and joints are some of the other symptoms of hypothyroidism.
• Hyperthyroidism, or overactive thyroid, is an endocrine disorder. Patients with this disorder may experience excessive sweating, fatigue, and intolerance to heat. They may even experience restlessness, puffy or protruded eyes, hair loss, and muscle weakness. Such patients may lose weight and are unable to sleep properly at night. In some cases, palpitations or abnormal heart rhythm may also be experienced.

Complications of Thyroid Disorder

Hypothyroid and hyperthyroid can cause a number of complications if patients don’t take medications. It is important for you to not to ignore any of the aforementioned symptoms and speak to your doctor as soon as possible.

Hypothyroid complications

• Myxedema: This condition is characterized by slowed thinking, swelling of tissues, and accumulation of fluid around major organs like brain, lungs and/or heart. This condition may prove life-threatening if not treated on time.
• Enlarged goiter: This is characterized by enlargement of the thyroid gland because of a constant increase in the TSH levels. High cholesterol and triglycerides: This may eventually pave way for heart disease and stroke.
• Sleep apnea: Sleep apnea is a disorder that affects nighttime breathing where the brain that temporarily stops sending signals to the muscles that control breathing, or by an obstruction in the airway. This may prove fatal if left untreated.
• Low blood pressure: This means not enough blood is getting to capillaries and tissues, particularly in your hands, feet, and brain. You may have chronic nail fungal infections and cold hands and feet if so.

Hyperthyroid complications

• Heart disorders (cardiac arrest): If left untreated, excess thyroid hormones can lead to congestive heart failure and heart rhythm disorders.
• Osteoporosis: Too much thyroid hormones interfere with the body’s ability to use calcium to build bone. This may lead to brittle bones and osteoporosis.
• Thyrotoxic crisis: This is a rare yet life-threatening complication characterized by high fever, vomiting, irregular heartbeat, and agitation.
• Hypertension or high blood pressure: It is a condition in which a patient has high blood force striking the walls of the artery An early diagnosis can help make the treatment of this disorder easier.

Depending on the condition of the thyroid condition, it requires different ways to manage it. The conventional TSH (thyroid-stimulating hormone) and T-4 (thyroxine) blood tests will be advised and the results should provide a reasonable confirmation of the condition. If doubts still persist an ultrasound or scan can also be ordered. 

In case you have a concern or query you can always consult an expert & get answers to your questions!

Diabetes is a metabolic disorder characterized by Hyperglycemia (elevated blood glucose level) due to either reduced production of insulin or the inability of the body to utilize the insulin produced. Today management of diabetes has become a prime concern. Over the winter months, diabetic patients are likely to suffer from higher blood glucose levels than during the warmer months. As the temperature drops and the sugar levels up, thus, diabetic patients should be extra careful about the temperature fluctuations or seasonal changes.The cold weather makes diabetics experience many health problems, besides creating a major change in their sugar levels.

Following are the most harmful effects that diabetic patients may suffer from during the cold weather

1. Change in hemoglobin level: There is a great change in their glycated hemoglobin levels. Whatever the type of diabetes an individual has, the freezing temperature can increase the level of HbA1c or glycated hemoglobin. This is most likely because of decreased physical activity. Cold weather makes it difficult for some people to go out. A little activity each day can help with insulin sensitivity (in all types of diabetes) which can help the body to regulate sugar level in a better way.
2. Prone to diseases: Since the immune system is also not at its best strength in winters, there are increased incidences of microbial infections like cold and flu or in some cases pneumonia. As a result, the body produces counterregulatory hormones (Cortisol, Adrenaline, and Glucagon) to counteract the situation. These hormones affect the utilization of insulin by the body thereby elevating the blood glucose level. Also, conditions like flu and cold tend to make them feel lethargic and stress and can prevent them from taking the diet, which is required, which eventually can lead to an increase in the blood sugar level.
3. Winter blues: It is often seen that people feel low during winters, as they tend to go out less and prefer to stay indoors. Less outdoor activity during winters can sometimes trigger mood swings or in some cases depression, which in turn can shoot up the level of blood sugar in their body. Thus it is advisable that one should spend more time with friends and family, in order to keep these blues at bay. 
4. Other problems: Most diabetic people are unaware of their nerve functions, and are unable to feel the difference between the cold and hot water, which can lead to burn injury. Also, during the winter season, most diabetic patients tend to lose feeling in their toes and feet due to vascular changes. Therefore, it is advisable that people should check their feet frequently, so as to ensure that there is no open wound or pressure area in their feet. One must take very good care of their feet, keep them moisturized, inner fingers clean and dry, prevent any type of fungal growth in toes, etc. By taking required preventive measures before the onset of winters diabetic patients can control their blood sugar level, which enables them to stay away from associated problems. 

In case you have a concern or query you can always consult an expert & get answers to your questions!