Dr. Anurag Bajpai

Hypoglycemia, commonly referred to as low blood sugar is the condition of the body, when the level of blood sugar falls down below the normal level. This accounts for clumsiness, feeling shaky, feeling confused, losing consciousness, serious seizure. Severe lowering of blood sugar may cause death. You are likely to feel exhausted and very hungry. The symptoms usually show quite quickly.

Hypoglycemia is commonly caused due to diabetes medicine like insulin, sulfonylureas or biguanides. Starving for long hours, over straining the body or extreme alcohol consumption may lead to hypoglycemia. Failure of the kidneys, liver diseases, metabolism disorders also lead to hyperglycemia.

Fall in the the blood-sugar level must be taken very seriously and never be ignored. If you feel the symptoms of lowered blood sugar, it is advised that you immediately take a sugar test. You must also indulge in high calorie food items such as sweets or chocolates. You need to increase the glucose intake, so that the blood-sugar level rises up.

Here are some steps you should follow to control hyperglycemia.

Keep away from the practices which lead to hyperglycemia: The best way of keeping away from hyperglycemia is by taking all measures which would avoid the condition to develop. The medical schedule of diabetic patients should be closely monitored and optimized by the patient's caregivers. Their lifestyle should be kept under check. It should be ensured that the patients do not skip meals. Insulin should be avoided as much possible.

1. Discuss problems with the patient: Patients and their guardians must be properly educated about the disease, and what important steps they should take, in spite of all kinds of prevention treatments they take. Teach them about the symptoms and the steps to be taken in case of any emergency. Use of glucose tablets should be encouraged. They must know that the process is ongoing. Every patient is different from another and hyperglycemia differs from person to person.
2. Use glucagon: Glucagon is basically a hormone which stimulates the liver to release pre-stored glucose all over your bloodstream in case your blood-sugar level falls down steadily. Glucagon is usually injected, and kits are available. Prescribed by doctors, glucagon can be used to treat a person who has fallen unconscious after a fatal reaction due to insulin. You should consult an expert before buying a glucagon kit.

Hypoglycemia is a serious problem. Lowering or fall in your blood-sugar level must never be ignored, and measures must be taken to regain your sugar balance immediately. For more information regarding hypoglycemia, comment in this section.

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

Cushing syndrome or round face syndrome, as some like to call it, is a hormonal disorder that is relatively uncommon. It is all about the stress hormone called Cortisol and how it can throw off the body systems. Read on to know the causes and symptoms of this disorder. But first of all, let us know what exactly is the Cushing syndrome?

When an individual's body is exposed more to a particular hormone called Cortisol, he/she may develop a condition called as Cushing syndrome. This can lead to unusual and uncomfortable symptoms. However, this condition of hypercortisolism is completely curable and the patients can continue to lead a normal life. Cushing syndrome is more common in women than in men and occurs mostly between the age of 25 to 40.

Symptoms of cushing syndrome

1. Excessive weight gain and obesity
2. Fatty deposits that tend to accumulate in the midsection, face (causing moon facies) or between the shoulders and upper back causing a hump
3. Fatigue and muscle weakness
4. Thinning skin that is prone to bruises easily
5. Purple stretch marks on the arms, thighs, abdomen and breast
6. Cognitive dysfunction with increased anxiety, irritability and depression
7. Women can experience extra facial and body hair with irregular or absent periods
8. High blood pressure and high blood sugar levels
9. Low sex drive and erectile dysfunction
10. Weak bones and osteoporosis
11. Children with this ailment tend to obese and experience slow growth rate

Causes of Cushing Syndrome
As mentioned above the major cause of Cushing syndrome is the high production of Cortisol. This hormone is produced by the adrenal gland that sits on top of your kidneys. The prime reasons of over-production of Cortisol can be:

1. High-stress levels
2. Malnutrition
3. Alcoholism
4. Depression, panic disorder and high levels of emotional stress
5. Athletic training

Also, another prime cause of this syndrome is the use of corticosteroid medications, such as prednisone, in high doses for a long period. These prescriptions are often given for conditions of asthma, organ transplant, lupus and rheumatoid arthritis. A tumor in the pituitary gland that is located at the base of the brain or a tumor in the adrenal glands can also lead to excessive production of Cortisol, thereby leading to Cushing Syndrome.

Diagnosis and treatment
Diagnosis is done by your doctor to determine the cause of the excess production of the hormone. Tests can include:

1. Blood Test or imaging scans
2. Dexamethasone suppression test
3. 24-hour urinary free cortisol test
4. Late-night salivary cortisol level

Treatment will vary with the actual cause of the disorder. Medications to decrease cortisol levels or block them can be given.

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

The thyroid is a small gland that controls metabolism and growth. Silent thyroiditis is a common autoimmune disorder that affects the thyroid gland. It causes an inflammation of the thyroid gland and is characterized by mild symptoms of hyperthyroidism and hypothyroidism. It is known as Silent thyroiditis because this condition is not painful in any way. Silent thyroiditis is also known as lymphocytic thyroiditis or subacute lymphocytic thyroiditis.The cause of this condition is unknown and hence it is not possible to prevent it. This is one of the least common disorders to affect the thyroid gland. However, middle aged women are at the highest risk of suffering from this condition. Other risk factors include a family history of thyroid disorders, certain autoimmune diseases, removal of the adrenal gland or treatment for cancer.

Some of the symptoms of silent thyroiditis are:

1. Fatigue
2. Increased sensitivity to heat and cold
3. Erratic bowel movements
4. Irregular menstrual periods
5. Increased appetite
6. Palpitations
7. Irritability and nervousness
8. Unexplained weight loss
9. Excessive sweating

If you notice such symptoms, you must consult a doctor. To determine a silent thyroiditis diagnosis, a thorough physical examination and a few tests are required. The physical examination focuses on the size of the thyroid gland, heart rate and presence of tumors if any. A blood test will also be required to check thyroid hormone levels such as T3, T4 and TSH levels. Your doctor may also ask for an ultrasound of the thyroid gland and an imaging test to determine iodine radioactive uptake.

Silent thyroiditis has a good prognosis and patients usually recover within one year. The acute phase typically lasts only three months. Most patients do not require any form of treatment for this condition but regular checkups are advised to keep track of the disease. In rare cases, medical treatment may be required. For example, if the patient complains of increased heart palpitations or excessive sweating, beta blockers may be prescribed to lower the heart rate. The patient is advised to get plenty of rest and avoid any stressful situations.

In some cases, silent thyroiditis may lead to permanent hypothyroidism. In such cases, medication may be prescribed to normalize the thyroid hormone levels. In some cases, thyroid hormone replacement therapy may also be advised. Surgery and radioactive iodine treatment a not required to treat silent thyroiditis. However, even after the symptoms subside, a close follow up is required to check thyroid hormone levels. In case you have a concern or query you can always consult an expert & get answers to your questions!

Diabetes is a chronic condition where glucose level of your body rises too high. There are two types of diabetes type 1 and type 2. In case of type 1 diabetes, the body fails to produce insulin and people suffering from this condition have to depend on insulin injections for the rest of their life. In case of type 2 diabetes the body produces less amount of insulin which is not enough for the proper functioning of the body. This type of diabetes can be kept under control by following a healthy diet and practicing exercise regularly.

Why diabetic wounds can cause severe problems?
Diabetes can cause a number of complications that makes it harder for certain wounds to heal. These include:

1. Nerve damage: Until a cut or blister worsens and becomes inflamed, in case of neuropathy, you will not experience the pain. Diabetics often suffer from neuropathy, making it difficult for wounds to heal.
2. Weak immune system: A minor wound may even get severe and become infected if your immune system fails to exercise its natural defenses.
3. Narrow arteries: Blocked arteries may cause severe wounds which becomes difficult to heal. Clogged arteries make it difficult for the blood to flow to the affected area which slows the process of wound healing.

Treating a diabetic wound
You can follow the methods mentioned below to avoid getting infected:

1. Taking care of the wound immediately. If the wound is not cleaned and taken care of, letting bacteria to build up, it can lead to infection.
2. Avoid using soaps and hydrogen peroxide to irritate the injury. Use antibiotic lotions to prevent infection and use a sterile bandage to keep the affected area covered.
3. Consult your doctor before any minor problems turn to larger ones
4. Since the bottom of the foot is a common place for developing blisters and calluses in case of diabetic people, try to keep pressure off the wound as it slowly heals.

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

One of the major risk factors for cardiovascular disease (CVD) is diabetes. Uncontrolled diabetes can lead to major heart problems. It is thus pertinent to take timely actions to control the insulin-related issues and save ourselves from CVD.

It is important to understand how diabetic patients are more prone to CVD than others to take pre-emptive actions to control it.

1. Atrial Fibrillation: Atrial Fibrillation means an irregular and rapid heart rate which can increase the risk of stroke, heart failure and other cardiac issues. Individuals with diabetes are at an increased risk of developing atrial fibrillation. This risk is higher among patients with a longer duration of treated diabetes and poorer glycemic control.
2. Hyperglycemia: Hyperglycemia means high (hyper) glucose (gly) in the blood (emia). Your body needs glucose to properly function. Your cells rely on glucose for energy. Hyperglycemia is a defining characteristic of diabetes, when the blood glucose level is too high because the body isn't properly using or doesn't make the hormone insulin.
3. Hypertension: Hypertension in diabetes is considered a major contributor to the increase in mortality from cardiovascular diseases. Diabetic patients, especially those with Type 2, need to always have their blood pressure checked every visit to the doctor. Self-monitoring at home is also a must to maintain and control the rise of blood pressure. The American Diabetes Association recommends a target blood pressure of not more than 130/85 mm Hg to maintain a good level of blood pressure.
4. Smoking: Smoking has been determined dangerous to our health. Studies show that smoking indeed increase risk of premature death and cardiovascular disease in diabetic patients. In case you have a concern or query you can always consult an expert & get answers to your questions!

Androgens, or the male sex hormones are steroid hormones that mainly include Testosterone, Androstenedione, DHT (Dihydrotestosterone), DHEA (Dehydroepiandrosterone), DHEA-S (Dehydroepiandrosterone- Sulfate). These hormones are produced in both males and females, and androgen is responsible for the secondary sexual characteristics in men. Androgen is also responsible for the synthesis of estrogen (a precursor for estrogen synthesis) in females. The hormone is also known to regulate the activities of a host of body organs including the reproductive tract (both in males and females).

In females, androgens (testosterone, in particular) are, however, produced in lesser quantities by the ovaries. The problem arises when the there is an elevated production of androgens in females, a condition termed as Hyperandrogenism. Mentioned below are some of the symptoms and complications indicative of Hyperandrogenism in women.

1. Hair loss and alopecia: This is common in women with Hyperandrogenism. When there is an increased production of androgen, especially testosterone, some of the testosterone gets converted into Dihydrotestosterone (DHT). A healthy hair growth cycle consists of three phases- Anagen (growth phase), Catagen (transitional hair growth phase), and Telogen (resting phase). The DHT produced get attached to the hair follicles, resulting in the hair follicles to enter into the Telogen phase prematurely with increased hair loss and alopecia.
2. PCOS: The elevated levels of androgen also result in the formation of cysts in one or both the ovaries. The ovarian cysts often interfere with the ovulation process as the condition either stall the maturation of the eggs or the release of the matured eggs from the ovary fail to take place.
3. Menstrual problems (irregular periods, heavy or scanty flow) and infertility are common in females with PCOS.
4. Menstrual problems and abnormalities: Research suggests that elevated plasma androgen levels can significantly affect the menstrual cycle in females. Incidences of Amenorrhea (a condition whereby a woman has missed three or more successive menstrual cycles) and Oligomenorrhea (a condition where the menstrual cycle is often lighter and less frequent) are relatively higher in women with Hyperandrogenism.
5. Hirsutism: Hirsutism is characterized by the presence of the excess body and facial hair in females (male pattern hair growth). Androgen plays a pivotal role in the regulation of the pilosebaceous unit along with the modulation of the hair growth. The pilosebaceous unit (the unit mainly includes the sebaceous glands and the hair follicles) is involved in the production of the sebum.

In females with Hyperandrogenism, the elevated androgen level contributes significantly towards increased production of terminal body hair as seen in males (increased facial hair, hair on the chest, arms, legs) resulting in Hirsutism.

Probable complications and problems Hyperandrogenism can cause

1. Hyperandrogenism in females also triggers an elevated sebum production, resulting in acne and related skin problems.
2. As already mentioned, androgen is responsible for secondary male sexual characteristics. Thus, females with Hyperandrogenism often exhibit Virilization or increased male characteristics.
3. With Increased incidences of menstrual abnormalities and PCOS, Hyperandrogenism can eventually make it difficult for a woman to conceive.
4. Females with Hyperandrogenism often suffer from obesity.

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

Cholesterol is a vital component, which helps the body to make healthy cells. This wax like component is found in the lipid of the blood. An increased cholesterol count elevates the risk of heart diseases in a person. It thickens the vessels of the arteries resulting in less oxygen flow in the heart. This, in turn, increases the chances of a stroke. High cholesterol can happen from lifestyle habits and inheritance. It is completely treatable and preventable.

What causes high cholesterol?
The blood carries the cholesterol which is attached to the proteins. The combination of cholesterol and protein is known as the lipoprotein. Primarily there are two different kinds of cholesterol that the lipoprotein carries:

• Low-density lipoprotein: LDL is the bad guy that carries all kinds of cholesterol present in the body. It eventually rests on the walls of the arteries, making it narrow and hard.
• High-density lipoprotein: This is the good guy which scans the excess cholesterol and take them back to the liver.

Ideally, the body should have low LDL and high HDL. But often the reverse happens, resulting in high cholesterol and cardiac diseases. Factors such as unhealthy diet, inactivity for most of the day and obesity is responsible for the same. Even the genetic set up can play a hand in a high count of LDL in the body. There is nothing that can be done in this case except to seek medical help.

6 factors that put you at risk:

1. Poor diet: Cholesterol levels are dramatically increased when baked products and saturated fats are consumed in an excess amount. Other high cholesterol food products include dairy products, processed fats and red meat. Refraining from this food items will drastically reduce the chances of getting high cholesterol in the body.
2. Obesity: Obesity results from too much of fat storage in the body. It not only fatigues a person faster, but puts a person at high risk of getting cholesterol. The body mass index should be always lesser than 30 to abstain the risk of cholesterol.
3. Waist circumference: A waist circumference of more than 40 inches in men and 35 inches in women can increase the risk of cholesterol.
4. Diabetes: This is one of the major causes of high cholesterol. It not only damages the artery lining, but results in higher LDL and lower HDL.
5. Less workout: Leading a life which is devoid of exercise and jogging can increase the chances of getting high cholesterol. Exercise boost HDL count in the body and mitigates the risk of low HDL.
6. Smoking: The blood vessel walls get damaged with smoking. The blood vessels start accumulating fatty acids thereby increasing the chances of getting high cholesterol. In case you have a concern or query you can always consult an expert & get answers to your questions!

It is important for you to know how pregnancy affects your thyroid gland. The thyroid hormone plays an important role during pregnancy in the development of the baby and also regarding the health of the mother. If you suffer from thyroid problems during pregnancy, you should take medicines and certain thyroid function tests.

How pregnancy affects normal thyroid function?
The pregnancy hormones known as human chorionic gonadotropin or hCG and estrogen lead to increased thyroid hormone levels in your blood. The hCG made by the placenta stimulates the thyroid to produce excessive hormones. Increased estrogen leads to higher levels of the thyroxine binding globulin, which transports the thyroid hormone in the blood.

Because of these normal hormonal changes, thyroid function tests are difficult to perceive during pregnancy. The thyroid hormone is very important for the normal development of a baby’s nervous system and brain. During the first trimester of pregnancy, the foetus depends on the supply of thyroid from the mother via the placenta.

In healthy women, the thyroid enlarges during pregnancy. An enlarged thyroid can indicate a thyroid disease, which should be diagnosed immediately. Thyroid problems are difficult to diagnose during pregnancy because of the increased hormone levels, increased thyroid size, fatigue and other factors.

Hyperthyroidism in pregnancy
Hyperthyroidism may occur in pregnancy because of Graves’ disease where enough thyroid hormones are not produced. Graves’ disease is an autoimmune disorder in which the immune system attacks the cells and organs of the body instead of fighting bacteria or viruses. With Graves’ disease, an antibody is released by the immune system called the thyroid stimulating immunoglobulin or TSI. This causes the thyroid gland to produce excess thyroid hormone. In many cases, the antibody is also associated with eye problems like bulging, irritation and puffiness. Graves’ disease commonly appears during pregnancy, but women with this disease from before may actually observe improvements in the symptoms during the second and third pregnancy trimesters. The remission or the disappearance of the symptoms of Graves’ disease may occur due to the general suppression of the immune system, which occurs during early pregnancy. The disease is likely to recur and worsen in a few months after the delivery. It is important for pregnant women with Graves’ disease to be monitored carefully.

Hypothyroidism during pregnancy may lead to a developmental delay in the child. Sometimes, hormone therapy is given to women who are at the borderline stage in thyroid function during pregnancy or just before pregnancy. The treatment of the condition aims at maintaining a proper and balanced thyroid hormone level in the body.

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

Are you suffering from diabetes and are looking for ideal at home management remedies? Diabetes is a health condition, which occurs when the blood sugar level of the body rises. There are several ways following which you will be successfully able to manage your diabetes. They are as follows:

1. Exercise regularly and track your workout patterns. Exercise is the most important lifestyle choice for a diabetic patient, which allows you to maintain a good shape. It boosts your body's metabolism rate and insulin uptake process. By taking notes on your exercising habits, you will be able to make timely and required changes. 
2. Stop consuming fast food. Try to abstain from eating outside food and reduce your intake of sugar, salt and high calorie food. Meal should be prepared at home using light ingredients and less amount of salt and sugar.
3. Quit smoking as it is very harmful, especially if you are a diabetic. Smoking narrows your blood vessels, as a result of which, your blood circulation gets disrupted.
4. Increase your fiber intake. Fiber is beneficial for all diabetic patients and helps in smooth functioning of your digestive processes. It also help in reducing your cholesterol and blood sugar levels.
5. Take care and pay attention to your feet properly. You should wash your feet in lukewarm water regularly and dry them gently. You should moisturize your feet with a lotion. Check on your feet for cuts, sores, redness, swelling and blisters and consult a doctor in case of an unusual foot sore.
6. Get your eyes checked frequently as diabetes affects your vision in serious ways, which may also lead to blindness. Regular eye checkups will help you to prevent retinopathy.
7. Take proper care of your teeth which includes brushing and flossing at least two times every day. This is because diabetes makes you prone to several serious gum infections. Go for regular dental checkups if you have type 1 or type 2 diabetes and in case you observe swollen, red gums, consult your doctor immediately.
8. Avoid stress and adapt ways to eliminate stress. Your body hormones, which are produced in relation to intense stress, prevent insulin from working efficiently, which increases your blood sugar levels and stress levels further. Relaxation techniques are effective for dealing with stress. 
9. Opt for several small meals instead of a few large meals every day. This helps in keeping your digestive processes active, which in turn increase insulin sensitivity. If you wish to discuss about any specific problem, you can consult an Endocrinologist.

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:

1. 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.
2. 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.
3. Surgery: Surgery to remove thyroid gland (for e.g. thyroid cancer treatment, overactive thyroid etc.)
4. Radiation to the neck (to treat cancer in the neck area): The thyroid gland cells are damaged due to the radiation.
5. 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.
6. Certain medicines: Certain medicines used to treat heart conditions, cancer, psychiatric conditions etc. – for e.g. amiodarone, lithium, interleukin-2, interferon-alpha.
7. Pregnancy: Pregnancy (the reason is unclear but it has been noticed that the thyroid may get inflamed after delivery – this is called Postpartum thyroiditis.
8. 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.
9. 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.
10. 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:

1. Primary hypothyroidism: The problem is in the thyroid gland itself and thus there is reduced production /secretion of thyroid hormones.
2. 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:

1. Overt hypothyroidism: Here the patient is having the symptoms. Further the T3/T4 are low and TSH is high
2. 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?

1. Women have a higher risk of suffering from hypothyroidism than men.
2. Older people are at increased risk.
3. People suffering from other autoimmune diseases like Coeliac disease, Type-1 Diabetes Mellitus, Vitiligo, Pernicious anemia, Multiple sclerosis, Rheumatoid arthritis, Addison’s disease etc.
4. People with psychiatric conditions such as bipolar disorder
5. 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:

1. Depression
2. Constipation
3. Hair loss
4. Dry hair
5. Dryness of the skin
6. Tiredness
7. Body pains
8. Fluid retention in the body
9. Irregular menstrual cycle
10. Increased sensitivity to cold
11. Reduced heart rate
12. Increase in size of the thyroid gland – called Goitre. This is due to constant stimulation of the thyroid gland by TSH.
13. Weight gain
14. Carpal tunnel syndrome
15. Hoarse voice
16. Infertility
17. Loss of libido/sex drive
18. 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:

1. 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.
2. T4: A low level of thyroxine indicates hypothyroidism.
3. T3: these levels are generally not needed to diagnose hypothyroidism
4. Anti-Thyroid peroxidase antibodies (anti-TPO antibodies) or Anti- thyroglobulin antibodies are present in 90-95% of patient with autoimmune thyroiditis.
5. Other blood tests include Creatinine Kinase, Serum Lipids, Complete blood picture etc.
6. 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. If you wish to discuss about any specific problem, you can consult an Endocrinologist.