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Phenytoin

Prescription vs.OTC: Prescription by Doctor required

Phenytoin is an anti-seizure medication. It is used to prevent partial seizures, tonic-clonic seizures, but not absence seizures. It may also be used to treat certain heart arrhythmias or neuropathic pain. It can be taken intravenously or by mouth.

Common side effects include nausea, increased hair growth, stomach pain, poor coordination, loss of appetite, and enlargement of the gums. Potentially serious side effects include self harm, sleepiness, liver problems, low blood pressure, bone marrow suppression and toxic epidermal necrolysis.

Phenytoin should be used with caution in patients having low blood pressure, heart failure, liver disease, suicidal tendencies, kidney disorders, vitamin D deficiency, diabetes and porphyria. It should not be used in people having allergy towards Phenytoin or other ingredients in the medicine or people suffering from certain heart conditions. There is evidence that use during pregnancy results in abnormalities in the baby. It appears to be safe to use during breastfeeding.

Take this medication orally as per your doctor’s prescription, with plenty of water. Avoid consumption of alcohol during the treatment. If for some reason you cannot take the medicine orally, it may be administered by a healthcare professional as an injection into a muscle or a vein, or by diluting it and giving it as a drip into a vein. The intravenous form generally begins working within 30 minutes and is effective for 24 hours. Blood levels of the patient can be measured to determine the suitable dose of the medicine.

Information given here is based on the salt and content of the medicine. Effect and uses of medicine may vary from person to person. It is advicable to consult a Neurologist before using this medicine.

Not recommended in the patients with known allergy to Phenytoin.
In addition to its intended effect, Phenytoin may cause some unwanted effects too. In such cases, you must seek medical attention immediately. This is not an exhaustive list of side effects. Please inform your doctor if you experience any adverse reaction to the medication.
Nystagmus (involuntary eye movement)
Double vision
Peripheral neuropathy (tingling and numbness of feet and hand)
Gingival hyperplasia
Increased hair growth
Is It safe with alcohol?
Phenytoin may cause excessive drowsiness and calmness with alcohol.
Are there any pregnancy warnings?
Phenytoin is unsafe to use during pregnancy.
There is positive evidence of human fetal risk, but the benefits from use in pregnant women may be acceptable despite the risk, for example in life-threatening situations. Please consult your doctor.
Are there any breast-feeding warnings?
Phenytoin is safe to use during lactation. \nHuman studies have shown that either the drug does not pass into the breastmilk in significant amount or is not expected to cause toxicity to the baby.
Is it safe to drive while on this medicine?
Phenytoin may make you feel dizzy, sleepy, tired, or decrease alertness. If this happens, do not drive.
Does this affect kidney function?
Phenytoin is probably safe to use in patients with kidney disease. Limited data available suggests that dose adjustment of Phenytoin may not be needed in these patients. Please consult your doctor.
Does this affect liver function?
Phenytoin should be used with caution in patients with liver disease. Dose adjustment of Phenytoin may be needed. Please consult your doctor.
Missed Dose instructions
Take the missed dose as soon as you remember. If it’s almost time for your next dose, skip the missed dose. Do not double your dose to make up for the missed dose.
Overdose instructions
Seek emergency medical treatment or contact the doctor if any symptoms of the overdose like uncontrolled body movements, slurred speech appear.
India
United States
Japan
Below is the list of medicines, which contains Phenytoin as ingredient
Biochem Pharmaceutical Industries
Intas Pharmaceuticals Ltd
Swati Spentose Pvt Ltd
Swati Spentose Pvt Ltd
Phenytoin is an anticonvulsant which is known to prevent seizures by causing a voltage-dependent block of voltage gated sodium channels. It acts by increasing sodium efflux from the neurons of the motor cortex which reduces the post-tetanic potentiation at synapses. This inhibits the cortical seizure foci from spreading to adjacent areas, thus stabilizing the threshold against hyperexcitability.
Whenever you take more than one medicine, or mix it with certain foods or beverages, you"re at risk of a drug interaction.
Interaction with Medicine
GLYCHEK 40MG TABLET
Serenace 5Mg Injection 1Ml
Paliris 3Mg Tablet
Barbinol 20mg/5ml Syrup
What are you using Phenytoin for?
tonic-clonic seizures
Other
partial seizures
How much was the improvement?
Average
Poor
How long did it take before seeing improvement?
More than 2 days
Within 2 hours
How frequently did you take this medicine?
Twice a day
How did you take this medicine?
With Food
Empty stomach
What were the side effects of this medicine?
Sleepiness
Double vision
Disclaimer: The information produced here is best of our knowledge and experience and we have tried our best to make it as accurate and up-to-date as possible, but we would like to request that it should not be treated as a substitute for professional advice, diagnosis or treatment.

Lybrate is a medium to provide our audience with the common information on medicines and does not guarantee its accuracy or exhaustiveness. Even if there is no mention of a warning for any drug or combination, it never means that we are claiming that the drug or combination is safe for consumption without any proper consultation with an expert.

Lybrate does not take responsibility for any aspect of medicines or treatments. If you have any doubts about your medication, we strongly recommend you to see a doctor immediately.

Popular Questions & Answers

My dad has taken phenytoin sodium tablet 100 mg and levipil 500 mg at once. Will this cause over dose?

MBBS
General Physician, Mumbai
My dad has taken phenytoin sodium tablet 100 mg and levipil 500 mg at once. Will this cause over dose?
Overdose will not happen but he needs to take it as per prescription advice only and if necessary doctors give a combination of anti epileptic medication.

Pregnancy ke doran phenytoin sodium tablet lene ka kya side effects h. Ye tablet leni bhi jaruri h.

PG Diploma in Nutrition & Dietetics, M.Sc.in Food & Nutrition
Dietitian/Nutritionist, Ghaziabad
Pregnancy ke doran phenytoin sodium tablet lene ka kya side effects h. Ye tablet leni bhi jaruri h.
You should not use phenytoin if you also take delavirdine (Rescriptor), or if you are allergic to phenytoin, ethotoin (Peganone), fosphenytoin (Cerebyx), or mephenytoin (Mesantoin). If you are pregnant, DO NOT START TAKING this medicine unless your doctor tells you to. Phenytoin may cause harm to an unborn baby, but having a seizure during pregnancy could harm both the mother and the baby. If you become pregnant while taking phenytoin, DO NOT STOP TAKING the medicine without your doctor's advice. Seizure control is very important during pregnancy and the benefits of preventing seizures may outweigh any risks posed by using phenytoin. Prednisone: 12 Things You Should Know SLIDESHOW Prednisone: 12 Things You Should Know Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, depression, anxiety, or if you feel agitated, hostile, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself. Before taking this medicine You should not use this medicine if you are allergic to phenytoin or similar medicines such as ethotoin, fosphenytoin, or mephenytoin, or if you have: a history of liver problems caused by phenytoin; a heart condition called 2nd or 3rd degree "AV block"; a history of slow heartbeats that have caused you to faint; or a condition for which you also take delavirdine (Rescriptor). To make sure phenytoin is safe for you, tell your doctor if you have: liver disease; a history of abnormal heart rhythm found on an EKG (electrocardiograph); diabetes; a history of depression; a history of suicidal thoughts or actions; a vitamin D deficiency or any other condition that causes thinning of the bones; porphyria (a genetic enzyme disorder that causes symptoms affecting the skin or nervous system); or if you drink large amounts of alcohol. You may have thoughts about suicide while taking this medicine. Your doctor will need to check your progress at regular visits while you are using phenytoin. Your family or other caregivers should also be alert to changes in your mood or symptoms. Patients of Asian ancestry may have a higher risk of developing a rare but serious skin reaction to phenytoin. Your doctor may recommend a blood test before you start the medication to determine your risk of this skin reaction. Seizure control is very important during pregnancy. Do not start or stop taking this medicine without your doctor's advice if you are pregnant. Phenytoin may cause harm to an unborn baby, but having a seizure during pregnancy could harm both mother and baby. Tell your doctor right away if you become pregnant while taking this medicine. If you become pregnant while taking phenytoin, your name may be listed on a pregnancy registry. This is to track the outcome of the pregnancy and to evaluate any effects of phenytoin on the baby. Phenytoin can make birth control pills less effective. Ask your doctor about using non hormonal birth control (condom, diaphragm with spermicide) to prevent pregnancy while taking this medicine. Phenytoin can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using this medicine.
1 person found this helpful

Hello Dr. mera baby 7 nd 1/2 month ka hai abi 1 week pahle usse 102 fever loose motion nd vomitings thi jiske wajah se use hospitalised krna pada after 3 day uska fever nd vomiting kam hogyi thi tab rat me 11 oclock achanak use bahot thand lgne lgi nd wo bahot rone lga nd and eyes close kr k hi ro rha tha nd uska badan b akadne lga nd thoda nila b ho gya tha tb use Dr. ne DILANTIN enject kiya after that use 102 fever ho gya to Dr. ne use treat kiya now he is normal but Dr. said ki DILANTIN use 5 years tk deni hogi. Aisa kyu hua ye jhatka kis karan aaya. What is use of dilantin.

Diploma in Child Health (DCH), MBBS
Pediatrician,
Hello Dr. mera baby 7 nd 1/2 month ka hai abi 1 week pahle usse 102 fever loose motion nd vomitings thi jiske wajah s...
As you describe it may be Febrile Convulsion, convulsion (which is also called as "Kheech" Mirky" or "Zatke ki bimari") after high grade fever. Febrile convulsion is common in children age 6 months to 6 yrs. If there is not loss of consciousness or other complication, no need do any further investigation. DILANTIN is anti-convulsion medication. It is not recommended to give long term anti-convulsion medication like DILANTIN (Phenytoin) for simple febrile convulsion. Advice to Consult Pediatric Neurophysician.

Hello, I am having this psychological/neurological problem since 2011 after I met with a serious accident which caused internal-bleeding and blood clotted in my brain but it got fine with medication and no surgery was required. Then my doctor prescribed me 'Epsolin tablets for around a year. The composition of tablet is Phenytoin Sodium (100 mg). To be frank, It took me 8-9 months to fully recover physically and mentally. Then during that time-period I faced this problem which is explained below: It happens for one full day. On that day, When I wake up in the morning I am totally depressed and my head feels heavy. Thoughts of death come to mind so often. Then a memory blinks in my mind which is always related to some adventurous nightmare I saw previously. When this memory blinks, my heartbeat fastens and feel dizzy for 9-10 seconds and then recover. This keeps happening until I go to sleep at night and wake up next morning. It totally takes me two days to fully recover from this state of mind. Facts: 1. Intensity of the effect which occurs after blink is reduced since starting. 2. Frequency of the problem is also less now. As I mentioned in the description it happens once a month now. 3. Nightmares which blinks in my mind are always those which I saw on the same day previously. It is full of adrenaline rush for example someone chasing me, hanging from an aeroplane etc. 4. I have never explained this to anyone. I tried once but none could understand it. I couldn't even find out that whom should I consult. 5. I have tried sleeping during day to see if it goes away after that nap but it was not working. It still remains until night sleep. Please help me. Tell me something. I am so confused. Thank you in advance.

Diplomate of the National Board (DNB), MBBS, Diploma in Psychological Medicine, MNAMS (Psychiatry)
Psychiatrist, Bangalore
Hello, I am having this psychological/neurological problem since 2011 after I met with a serious accident which cause...
These are all symptoms of anxiety, which might even be related to your handling of the stress of the accident. Try simple methods like yoga and meditation, and a daily walk to soothe your mynd and exercise your body. If this fails, meet a Psychiatrist.

My wife is 52 years old having epilepsy and taking EPILAN tablets since 30 years and now the EPLILAN is banned no more available in the market. Hence could you suggest substitute of epilan tablet. Thank you.

MBBS
General Physician, Mumbai
epilan is a combination of phenobarbitone,and phenytoin. you can purchase the drug separately in desired strength and have it if the combination is not available in any other brand. please see your doctor for the same.
1 person found this helpful

Popular Health Tips

Brain Aneurysms - Key Treatments That Can Help With It!

MCh - Neurosurgery, MBBS
Neurosurgeon, Chennai
Brain Aneurysms - Key Treatments That Can Help With It!

Are you experiencing excruciating headache? you probably didn't know but you could be suffering from brain aneurysms. It is described as bulge formation in the blood vessel in the brain. It is a totally asymptomatic condition as one does not display any symptoms until the bulge vessel ruptures which may result in blood releasing in the skull which may further lead to a stroke. The bulge is often formed in the gaps between the tissues covering the brain and brain itself.

Most common treatment options for ruptured aneurysm
There are two common treatment options for a ruptured brain aneurysm endovascular coiling and surgical clipping. Both these procedures have certain risk factors, therefore it is best to discuss the details with a neurologist. The endovascular coiling is a less invasive process where the surgeon inserts a hollow tube or catheter into an artery and threads it through the body to reach an aneurysm. Then a guide wire is sent to push a soft platinum wire through the catheter. This coils up and disrupts the flow of blood into the aneurysm and leads to blood clotting. The clotting is essential in sealing off the aneurysm from the artery.

The surgical clipping is a process used for closing off the aneurysm, and a section of the skull is required to be removed for assessing the affected part. It also helps in locating the blood vessel that is responsible for the problem. Finally, a metal clip is placed on the neck of the aneurysm to stop the flow of blood. Though endovascular coiling is less invasive and said to be safer, adequate post-treatment care is necessary to minimize risks.
To treat larger aneurysms, a treatment called flow diverters may be useful. Since, the treatment is decided based on the size, location, apperance and your health condition, your doctor will be the best person to take the final call.

Other procedures to treat symptoms
Other than the surgical procedures several treatments might be prescribed to treat the symptoms and to manage complications. A few commonly advised treatments are:

  1. Pain relievers: To manage headaches
  2. Calcium channel blockers: One of the most common complications that may arise with an aneurysm is calcium entering the walls of blood vessels which may result in narrowing of walls. Calcium channel blockers are medications may be prescribed by the doctors to deal with the complication
  3. Anti seizure medications: Medications such as levetiracetam, phenytoin, valproic acid, and others are prescribed to treat seizures associated with aneurysms
  4. Procedures to prevent stroke: An insufficient blood flow may result in a stroke and to prevent it, the drug vasopressor is injected intravenously, or angioplasty is performed.
  5. Rehabilitative therapy: Damage to the brain may require the patient to undergo several physical and occupational therapy.

If you suffer from the condition, it is advised to keep a check on the blood pressure and quit smoking as they can help in reducing the risks associated with aneurysms. 

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

3671 people found this helpful

All About Acne Vulgaris

MBBS, DHMS-Harvard, Masters in Clinical Dermatology
Dermatologist, Chandigarh
All About Acne Vulgaris

Acne vulgaris is a common chronic skin disease involving blockage and/or inflammation of pilosebaceous units (hair follicles and their accompanying sebaceous gland). Acne can present as noninflammatory lesions, inflammatory lesions, or a mixture of both, affecting mostly the face but also the back and chest.

Acne vulgaris has a multifactorial pathogenesis, of which the key factor is genetics. Acne develops as a result of an interplay of the following four factors: (1) follicular epidermal hyperproliferation with subsequent plugging of the follicle, (2) excess sebum production, (3) the presence and activity of the commensal bacteria Propionibacterium acnes, and (4) inflammation.

Acne occurs through the interplay of 4 major factors:

  • Excess sebum production
  • Follicular plugging with sebum and keratinocytes
  • Colonization of follicles by Propionibacterium acnes (a normal human anaerobe)
  • Release of multiple inflammatory mediators

The most common trigger is

  • Puberty

During puberty, surges in androgen stimulate sebum production and hyperproliferation of keratinocytes.

Other triggers include

  • Hormonal changes that occur with pregnancy or the menstrual cycle
  • Occlusive cosmetics, cleansers, lotions, and clothing
  • High humidity and sweating
  • Associations between acne exacerbation and diet, inadequate face washing, masturbation, and sex are unfounded. Some studies suggest a possible association with milk products and high-glycemic diets. Acne may abate in summer months because of sunlight’s anti-inflammatory effects. Proposed associations between acne and hyperinsulinism require further investigation. Some drugs and chemicals (eg, corticosteroids, lithium, phenytoin, isoniazid) worsen acne or cause acneiform eruptions.
  • Acne results in a variety of lesions. The most common acne locations include the face, neck, chest, and back, where the most sebaceous glands are located. Along the jaw line is a common location in adults. "Blackheads" (open comedones) and "whiteheads" (closed comedones) are follicular plugs that are either sitting below the skin surface (whitehead) or oxidized from being exposed to the air (blackhead). Papules are small pink to reddish-brown bumps, pustules are pus-filled lesions, and nodules or cysts are deeper pus-filled lesions.
  • Mild acne consists of a few papules/pustules and/or comedones. Moderate acne has an increased number of lesions. Severe acne has numerous comedones, papules, pustules, and may have painful nodules.
  • Acne can result in permanent scars, which can appear to be depressions in the skin or hyperpigmentation, which is dark red or brown flat marks where the acne lesions were.

Treatment

8 people found this helpful

Thyroid Disorders - Everything You Wanted To Know!

MD - General Medicine, DM - Endocrinology, MBBS
Endocrinologist, Delhi
Thyroid Disorders - Everything You Wanted To Know!

Thyroid gland is a butterfly shaped gland in the front of the neck. 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. Thyroid disorders are conditions that affect the thyroid glands. It plays an important role in regulating numerous metabolic processes throughout the body. The Thyroid gland is located below the adam’s apple wrapped around the trachea.

Thyroid disease is a common problem that can cause symptoms because of over- or under-function of the thyroid gland. The thyroid gland is an essential organ for producing thyroid hormones, which maintain our body metabolism. The thyroid gland is located in the front of the neck below the Adam's apple. Thyroid disease can also sometimes lead to enlargement of the thyroid gland in the neck, which can cause symptoms that are directly related to the increase in the size of the organ (such as difficulty swallowing and discomfort in front of the neck).

Thyroxine T4 is the primary hormone developed by the Thyroid gland. A small portion of the T4 released from the gland is converted to Triiodothyronine (T3) which is the most active hormone.

Hyperthyroidism: Too much thyroid hormone results in a condition known as hyperthyroidism. Affects about 1 percent of women. It's less common in men.

Grave’s disease is the most common cause of hyperthyroidism.

Symptoms:

Causes:

  1. Toxic adenomas: Nodules develop in the thyroid glands and begin to secrete thyroid hormones upsetting the body's chemical balance.
  2. Subacute thyroiditis: Inflammation of the thyroid that causes the gland to leak excess hormones, resulting in temporary hyperthyroidism that lasts a few weeks but may persist for months.
  3. Pituitary gland: Malfunctions or cancerous growths in the thyroid gland. Although rare, hyperthyroidism can also develop from these causes.

Treatments for hyperthyroidism: destroy the thyroid gland or block it from producing its hormones.

  1. Antithyroid drugs: such as methimazole (Tapazole) prevent the thyroid from producing its hormones.
  2. Radioactive iodine: a large dose of it damages the thyroid gland. A pill is given by mouth. As thyroid gland takes in iodine, it also pulls in the radioactive iodine, which damages the gland.
  3. Surgery: Surgery can be performed to remove your thyroid gland.

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. Since the body needs some amount of thyroid for energy production and drop in hormone production leads to lower energy levels.

Symptoms:

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.

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.

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.
2955 people found this helpful

Hypothyroidism: What You Need to Know About an Underactive Thyroid

MBBS, MD - Paediatrics, FRACP - Pediatrc Endocrinology, SCE, Endocrinology
Endocrinologist, Kanpur
Hypothyroidism: What You Need to Know About an Underactive Thyroid

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.
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How to Know If Your Skin is Acne Prone

DHMS (Diploma in Homeopathic Medicine and Surgery)
Homeopath, Delhi
How to Know If Your Skin is Acne Prone

Acne Prone Skin is so hard to handle. I know how horrible dealing with acne can be. You don’t feel like going out or being seen, and you’ve probably tried every possible remedy. When it comes to our faces, we don’t rely on just anyone to tell us what our skin needs to get that ever-elusive glow. 

The best route to complexion perfection is to get to know your skin type. If you don’t know your skin type, you won’t be able to properly care for your face

Are the dark spots, scars, acne marks and the uneven skin tone making you feel too embarrassed to interact with people in your peer group?

Tired of using cosmetic products to cover those dark spots?

Do not worry; we have come up with a list of home remedies that can help you to remove these dark spots quickly.

Dry skin

This skin type is characterized by a lack of oil and often renders skin flaky, thin and with some redness. Skin that feels tight after you wash it can also indicate dry skin.

Oily skin

When it comes to oily skin, your sebaceous glands produce too much oil creating blackheads, whiteheads and acne.

Tips to cure Acne/Pimples naturally

Acne-Prone-Skin

Vaginal Yeast Infection: Causes, Symptoms & Natural Tips to cure

 

Deeply cleansing oily skin sounds like a great strategy but harsh cleansers can strip skin of its protective barrier, leaving it vulnerable to bacteria.

And soap has a higher pH than your skin, which can over-dry skin and cause oil production to go into overdrive—which you definitely don’t need.

Factors Influence growth of Acne

  • Hormonal changes related to puberty, menstrual periods, pregnancy, birth control pills, or stress,
  • Friction caused by leaning on or rubbing the skin, pressure from backpacks, or tight collars,
  • Environmental irritants such as pollution and high humidity,
  • Squeezing or picking at blemishes, hard scrubbing of the skin,
  • Greasy or oily cosmetic and hair products
  • Certain drugs (such as steroids, testosterone, estrogen, and phenytoin)
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Table of Content

About Phenytoin
When is Phenytoin prescribed?
What are the contraindications of Phenytoin ?
What are the side effects of Phenytoin ?
Key highlights of Phenytoin
What are the dosage instructions?
Where is the Phenytoin approved?
Medicines containing Phenytoin
How does medicine works?
What are the interactions for Phenytoin ?