Dr. Sudha Kumari

The body has multiple chemicals called hormones, which regulate many of its functions. Increased or decreased levels of these hormones affect various functions including metabolism, growth and sexual functions. Thyroxin produced by the thyroid (situated in the front of the neck) is one such hormone, which has a significant role to play in metabolism.

Graves’ disease is one of the main causes of hyperthyroidism, where there is excessive production of thyroid hormones. Graves’ disease is an autoimmune disorder, wherein the body reacts against its own tissues. It is very common in women than men, especially after 20 years of age. Family history also has a strong correlation in developing Graves’ disease. The high levels of thyroid hormone increase the rate of metabolism, thereby altering weight, mental energy levels, physical stamina, and also mood.

Thyroid hormone is related to metabolism and more amount of it lead to higher metabolism. This causes the following symptoms.

1. Intolerance to heat
2. Excessive sweating
3. Nervousness and anxiety
4. Inability sleep, as the mind is always excited
5. Increased appetite (sometimes despite weight loss) due to higher metabolism
6. Irregular menstrual cycles
7. Palpitations (rapid, loud heartbeat)
8. Irregular heartbeats (tachyarrhythmia)
9. Fine tremors of the extended arms
10. Breast enlargement in men, known as gynecomastia
11. Extreme moodiness, causing irritability and anger
12. Inability to focus and concentrate
13. General fatigue and shortness of breath with any exertion
14. Increased frequency of bowel movements

In addition, the eye symptoms are quite diagnostic including:

1. Protrusion of the eyes (exophthalmos), giving an impression that they are going to fall out
2. Double vision
3. Excessive tearing
4. Increased irritation in the eyes

Diagnosis: The first symptom would be the presence of an enlarged thyroid gland (front of the neck above the collarbone), and the some of the above symptoms would be present.
In addition, tests to check for thyroid gland functioning including T3 and T4 levels would reveal increased amounts of hormone in the blood stream.
As a confirmatory test, the radioactive iodine uptake test also is done, which will indicate increased uptake by the thyroid gland. This indicates that the gland is functioning at an increased pace and requires additional iodine for the production of thyroid hormones.

Treatment: There are two approaches to it, one to control the symptoms and the other to control the thyroid gland per se.

1. Beta blockers are very useful in controlling rapid heart rate and anxiety.
2. Prednisone may be used to control eye irritation and swelling
3. Antithyroid drugs are used to control the production of thyroid
4. Radioactive iodine is given orally to control excessive thyroid production
5. In severe cases, thyroid gland may be surgically removed partially or completely

Graves’ disease is not life-threatening and once symptoms are controlled, the patient’s quality of life improves drastically. If you wish to discuss about any specific problem, you can consult a endocrinologist.

The first trimester of pregnancy (i. E. The first three months) is a very crucial time as this the time when your baby grows at a faster rate than at any other stage. Eating right is what you should be doing during such a time in your life as your body can make use of the energy and nutrients to build the body of your baby as well as to keep you strong. During the first trimester of your pregnancy, you should be including these 6 foods in your diet to provide you and your child with all the vital nutrients.

1. Spinach: High in folic acid, also known as folate (a form of vitamin b), consumption of spinach during these first few months (as well as before pregnancy) is extremely vital. It can help in preventing the occurrence of neural tube defects or birth defects pertaining to your baby's brain and spine.

2. Citrus fruits: Your first-trimester diet should also consist of an adequate amount of citrus fruits. High in vitamin c, you should have at least 1 citrus fruit every day. If you prefer to take these fruits in juice form, you should restrict it to only 1 cup a day. This is because juices are high in calories and low in fibre, and, therefore, do not deliver on the fibre component.

3. Nuts: During this period your protein requirements also increase and it is advised that you have about 60 gm or more of protein every day. Nuts such as walnuts, almonds, cashews and pistachios are known to have healthy amounts of fibre, fats and protein. A study conducted by the Harvard medical school suggests that eating nuts can help in preventing allergies in children.

4. Eggs: In addition to helping you meet your protein requirements, eggs can also be an excellent source of vitamin d and calcium. The last two elements are extremely vital for your baby as they help in developing its bones.

5. Beans: Providing you with necessary protein and fibre as well as helping you to deal with constipation, beans are must-haves during this period. Eating this fibre-rich food will ensure your bowel is functioning properly, thereby reducing your likelihood of developing constipation and even haemorrhoids (swollen veins of the anal and rectal region).

6. Yoghurt: A good source of calcium, having a cup of yoghurt every day will provide your baby with the calcium that it needs to grow and that you need to keep your bones strong. More importantly, by doing so, it'll prevent your baby from drawing calcium from your bones, leading to a deterioration of your bone health.