Dr. Neelam Pandey Kukreti

Thyroid disorders are associated with the thyroid gland. A thyroid gland is a butterfly-shaped gland situated right at the base of one’s neck. The role of the thyroid gland is to carry out numerous metabolic processes within the body. The brain regulates the functioning of the thyroid gland through a feedback mechanism. There are a number of disorders, both severe and trivial, which could affect the thyroid gland.

Main symptoms of thyroid disorders:

1. Weight loss and weight gain

2. Changes in heart rate (arrhythmia)

3. Hair loss

4. Frequent mood swings

5. Swollen neck

6. Sudden bouts of moderate to high fever

Other symptoms include:

1. Numbness or a tingling sensation in the hands

2. Constipation

3. Abnormalities or irregularities in menstruation

4. Brittle nails and dry skin

5. Blurred vision

6. Weakened muscle tone and frequent tremors in the body

Treatment Options:

Intake of thyroid hormone pills may prove beneficial. Once you start with the treatment, you may notice significant improvement within the first two or three weeks. Generally, once affected by thyroid disorders, one might have to be on these medications his/her entire life. Over time, this treatment procedure should result in lowering of the cholesterol levels, increased energy; but in certain cases, might throw up side effects in the form of sudden and unexplained weight loss.

Anti-thyroid medications help reduce and regulate the secretion of the thyroid hormone, thus treating certain thyroid disorders (such as hyperthyroidism).

Beta blockers are drugs help in reducing high blood pressure, heart palpitations and controlling heart rate.

In severe cases, such as enlargement of the thyroid gland, surgery is advised by the doctor, in which the thyroid gland is removed. Tumors or thyroid nodules are also treated by this surgical process.

In cases of thyroid cancer, besides the surgical procedure, radioactive iodine therapy (radioiodine) is recommended. This therapy helps destroy the thyroid gland and other thyroid (malignant) cells which may be taking up iodine. However, the side effects of this technique are minimal. This procedure helps to destroy those tissues which may not have been removed by the surgery. If the thyroid cancer has spread to the lymph nodes or to other parts within the body, this particular mode of treatment can be very effective.

Types of Thyroid Disorders:

1. Hypothyroidism: This is a condition characterized by an underactive thyroid gland. In this case, sufficient thyroid hormone is not secreted in the body.

2. Hyperthyroidism: This is characterized by an overactive thyroid gland, that results in overproduction of the thyroid hormone.

3. Thyroid cancer: It is a type of cancer of the thyroid gland.

4. Goiter: This is a disorder wherein the thyroid gland gets abnormally enlarged.

5. Thyroid nodules: This is marked by swelling of the thyroid gland. If you wish to discuss about any specific problem, you can consult a endocrinologist and ask a free question.

Hypopituitarism is defined as a condition in which the pituitary gland is unable to produce enough hormones. Under-secretion of pituitary hormones affects reproduction, body growth and blood pressure. It also results in pre-mature aging.

The pituitary gland is a small bean-shaped gland situated at the base of your brain, behind your nose and between your ears. Despite its size, this gland secretes hormones that influence nearly every part of your body.

In hypopituitarism, you have a short supply of one or more of these pituitary hormones. This deficiency can affect any number of your body's routine functions, such as growth, blood pressure and reproduction.

Few Causes:

1. Head injury

2. Tuberculosis

3. Radiation treatment

4. Stroke

5. Brain tumors

6. Brain surgery

7. Meningitis (brain infection)

8. Hypophysitis (autoimmune inflammatory disorder)

9. Sarcoidosis is an infiltrative (accumulation of cells and tissues in excess of the normal amount) disease which occurs in various organs.

10. Impaired hormone secretion by the pituitary gland is caused by genetic mutations.

11. Sheehan’s syndrome: It is a condition in which the pituitary gland gets damaged due to severe blood loss during childbirth.

12. Hypothalamus (a part of the brain which is located above the pituitary gland) diseases wherein the pituitary activities are directly affected by the hypothalamus.

Symptoms:

1. Fatigue

2. Reduced sex drive

3. Decreased appetite

4. Anemia

5. Irregular menstruation, pubic hair loss, hot flashes (feverish heat), and inability to breast-feed properly because of low breast milk production).

6. Dwarfism in children

7. Weight loss

8. Increased sensitivity to cold temperature

9. Infertility

10. Facial puffiness

11. Reduction in body hair or facial hair

Treatment Options:

1. Hormone replacement drugs include:

   • Corticosteroids: Adrenocorticotropic hormone deficiency leads to low production of adrenal hormones (different kinds of hormones such as cortisol and adrenalin, produced in the endocrine glands). These drugs act as a replacement of adrenal hormones.

   • Growth hormone: Growth hormone, also known as somatropin, is injected beneath the skin. This treatment method promotes growth, which balances the height in children. Growth hormone deficiency in adults is also cured by these medications to some extent.

2. Surgery: Surgical procedure is needed if the condition of hypopituitarism is the result of a tumor. The doctor will remove the tumor through surgery, thus resulting in normal growth.

3. Radiation: Radiation therapy helps in reducing the size of the tumor which causes stunted growth or pre-mature aging. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.

Here are prevention and management of diabetes.

Here are types, symptoms and diagnosis of diabetes.

Hi viewers I am Dr. Neelum. I am consultant in endocrinology and diabetology. Today I will be briefing you regarding diabetes because it’s a major it’s a big public health problem and it is spreading like an epidemic Diabetes is basically a disorder in which our glucose is not able to get utilized by the body for lack of insulin either or when the insulin is not able to act the way it should act in the body tissues. And in that case we have two major types of diabetes. That is type-1 Diabetes and type-2 Diabetes. In type-1 diabetes there is absolute depletion of insulin and the patients are usually lean and they are requiring insulin for their diabetes control for entire life. And type-2 diabetes patients are usually obese and they have family history of diabetes, diabetes run in their family and they usually have insulin resistance.

They can be well controlled initially with diet, lifestyle modifications and medicines. And subsequently in the late stages or maybe, when it is not controlled with the medicines, they may require insulin. Now there is another variant of diabetes that is GDM; Gestational Diabetes Mellitus which is seen in pregnant females. And why it is important to know that? Because nowadays. Due to screening of diabetes and during pregnancy it is picked and sugar controls have to be in target range because there is fetal development and metabolic programming is done so it is important to have a healthy baby for which sugars should be adequately controlled via lifestyle modification, diet, if not then insulin is also given.

Then the other less type of diabetes are also known which are syndromic diabetes, which I am going to discuss here, because the important ones and the major ones are type-1 and type-2 And the cause of concern is that initially it was thought that type-2 diabetes is seen after 40, but it is not the picture. It was always there in kids, now it is increasing in alarming proportions. The kids are more glued to the screen and gadgets and they are having more type-2 diabetes because they have sedentary lifestyle, their food choices are little, they are more into binging, snacking and they are not that much physically active. And even younger kids in their teens and, adolescence and young adults, they are also having type-2 diabetes. So all this has to be picked because they develop complications first than adults. So how do we pick whether you have diabetes or not? So the symptoms are polyphagia, osmotic symptom typically these may not be in all the patients. You have to have a high index of suspicion.  If you have family members who are diabetic or obesity or hypothyroid or hypertension, their blood sugar should be checked.

Now how do we diagnose diabetes? Well blood tests which are done to detect diabetes are very simple. They are fasting blood sugar and 2 hours pp. we have sudden cutoff. And there is one more test which is called HPA1C. So HPA1C tells you monthly average blood glucose which comes in percentage. If it is above 6.5% and fasting blood glucose is above than 126mg/dl then you are labelled as diabetes. So in this part I’ll be speaking about the diagnosis which I have just spoken and in the next part I’ll be telling you once are diagnosed with diabetes, how can you have control over the diabetes and how can you follow up to have a good glycemic control?

If you want to have online consultation, you can contact me via lybrate website or you can see me in my clinic which is located in Sushant Lok, Gurgaon.