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Overview

Warfarin

Prescription vs.OTC: Prescription by Doctor required

Warfarin is an anticoagulant and is used to help reduce the formation of blood clots. As it is a blood thinner, it works by preventing the formation of blood clots in arteries or veins, thus reducing the risk of heart attack, stroke, or other serious conditions.

Do not take Warfarin if you have a blood cell disorder, if you have a bleeding disorder, if you have high blood pressure, if you have a history of stomach bleeding, bleeding in your brain or an upcoming surgery. Before using Warfarin tell your doctor if you are using any prescription drugs, non-prescription drugs, or other herbal and dietary pills and supplements, if you are allergic to certain food items or substances, if you are pregnant and/or breastfeeding, if you have a blood cell disorder, of if you have a history of kidney diseases.

Warfarin is administered either orally or intravenously, depending on the patient and the specific condition he is being treated for.

Common side effects of Warfarin include nausea, stomach pain, vomiting, gas, bloating or an altered sense of taste.

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 Hematologist before using this medicine.

deep vein thrombosis
pulmonary embolus
.
In addition to its intended effect, Warfarin 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.
Bleeding.
Is It safe with alcohol?
Are there any pregnancy warnings?
Warfarin is highly unsafe to use during pregnancy.
Human and animal studies have shown significant adverse effects on the foetus. Please consult your doctor.
Are there any breast-feeding warnings?
Warfarin is probably safe to use during breastfeeding. Please consult your doctor.
Is it safe to drive while on this medicine?
There is no data available. Please consult doctor before consuming the drug.
Does this affect kidney function?
There is no interaction between renal impairment and consuming this drug. So dose alteration is not needed.
Does this affect liver function?
There is no data available. Please consult doctor before consuming the drug.
Are there any missed dose instructions?
If you miss a dose of Warfarin, skip it and continue with your normal schedule. Do not double the dose.
Below is the list of medicines, which contains Warfarin as ingredient
Lupin Ltd
Hindustan Latex Ltd
Zydus Cadila
Aristo Pharmaceuticals Pvt Ltd
Eskag Pharma Pvt Ltd
Mylan Pharmaceuticals Pvt Ltd
Eris Life Sciences Pvt Ltd
Aristo Pharmaceuticals Pvt Ltd
Pfizer Ltd
Celon Laboratories Ltd
Ovral G 0.5Mg/0.05Mg Tablet
Pfizer Ltd
Alembic Pharmaceuticals Ltd
Macleods Pharmaceuticals Pvt Ltd
Serum Institute Of India Ltd
Organon (India) Ltd
Deys Medical
Unichem Laboratories Ltd
Cipla Ltd
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
Zydol 50Mg Suspension
Nolvadex 10Mg Tablet
Zathrin Redimix Suspension
Pratham 200Mg/5Ml Rediuse Suspension
Warfarin is an anticoagulant which prevents the regeneration of vitamin K1 epoxide which in turn inhibits the formation of Vitamin K dependent coagulation factors like Factor II, VII, X and IX as well as the anticoagulant proteins S and C.
What are you using Warfarin for?
Other
deep vein thrombosis
pulmonary embolus
How much was the improvement?
Poor
Average
Excellent
How long did it take before seeing improvement?
More than 2 days
Within 2 days
How frequently did you take this medicine?
Once a day
Not taking on daily level
Four times A Day
How did you take this medicine?
With Food
With or without food
What were the side effects of this medicine?
Other
Bleeding
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

Hi. It is being 6 years of marriage I am not able to conceive, I have gone through through ivf treatment but no response, I also have a very heavy flow of period, please guide me.

DNB (Obstetrics and Gynecology), MBBS
IVF Specialist, Delhi
Hi. It is being 6 years of marriage I am not able to conceive, I have gone through through ivf treatment but no respo...
Hello, heavy bleeding during menses may be due to hormonal imbalance, uterine polyp, pelvic inflammatory disease, fibroid of uterus, ovarian dysfunction, Certain medications, including anti-inflammatory medications, hormonal medications such as estrogen and progestins, and anticoagulants such as warfarin (Coumadin, Jantoven) or enoxaparin (Lovenox), can contribute to heavy or prolonged menstrual bleeding. If,you will get exact reason for infertility then you got proper treatment. So,first ask your Doctor for cause of your infertility. Visit to Doctor personally and consult.

Dear sir, my wife 34 years & 3.5 month surgery delivery & become DVT in left leg with swelling and pain, please tell us helpful treatment.

MBBS
General Physician, Mumbai
Dear sir, my wife 34 years & 3.5 month surgery delivery & become DVT in left leg with swelling and pain, please tell ...
She needs rest and Apart from taking symptomatic treatment we will have to start with warfarin medication after clinical examination.

I am having a tooth decay so I want to know the procedure and risk of having tooth extraction as I am also a heart valve operated patient.

B.D.S, M.D.S Endodontist
Dentist, Delhi
I am having a tooth decay so I want to know the procedure and risk of having tooth extraction as I am also a heart va...
You should visit a dentist, dentist will check your teeth and tell you whether the tooth requires extraction or it can be saved by rct.

I have problem erectile dysfunction and premature ejaculation. I regular take medicine are serlift-50, prolomet xl-25 and warfarin sodium continue for life long. So please advice me medicine for my problem.

MD-Ayurveda, Bachelor of Ayurveda, Medicine & Surgery (BAMS)
Sexologist, Haldwani
I have problem erectile dysfunction and premature ejaculation. I regular take medicine are serlift-50, prolomet xl-25...
Hello- A weak erection tends to be a common problem among men combating premature ejaculation. Weak erections and P.E. Problems occur together with varying causes. Most cases, men with both weak erections and P.E. Suffer from a common issue sexual exhaustion. Excessive sexual practices whether from masturbation, sex or both can leave the body tired and depleted of nutrients and hormones, both of which help power the sex drive. You can try our dual action package. It contains powerful natural botanical components such as Atractylodes, Os Draconis, Butea Superba, Schisandra and Panax Ginseng that rejuvenate and repair the ejaculation nerves to stimulate the production of nitric oxide for quality erections and prolonged ejaculations.
1 person found this helpful

Bypass surgery done in2011 after the surgery warfarin pentids 400 ecosprin 75 and fol 5 medications .red and brown spot on body.

MBBS, MD - Internal Medicine, DM - Cardiology, Cardiac Device Specialist (CCDS - Physician )
Cardiologist, Delhi
Bypass surgery done in2011 after the surgery warfarin pentids 400 ecosprin 75 and fol 5 medications .red and brown sp...
Your question lacks details of bypass, reason for warfarin and quite a few other things. It will be best that you consult either a cardiologist or your treating surgeon for evaluation and further medical advice.

Popular Health Tips

Nose Bleeding - Things That Can Cause It!

MBBS
General Physician, Mumbai
Nose Bleeding - Things That Can Cause It!

Nosebleeds can be frightening and dramatic. Luckily, most cases of nosebleeds can be dealt with fair ease. Nosebleeds can be classified into two types depending upon the origin of the nose bleed, namely anterior and posterior.

  • Anterior bleed is the most common, and the bleeding is from a blood vessel which is present in the front part of the nose. These bleeds can be easily controlled by simple measures taken by doctors or at home.
  • Posterior nose bleeds are usually indicative of something more complicated and occur mostly in adults or elderly. The bleed can be caused by a rupture in arteries in the posterior part of the nose. These nosebleeds can get severe and may require admission to a hospital for treatment and management. They are the most common in kids in the range of 2 to 10 years and adults older than 50 years.

What can cause nosebleeds?

  • The most common cause of a nosebleed is probably trauma or an injury to the nose. External trauma includes a sharp blow to the nose, whereas internal injury comprises of injury from picking your nose continuously or irritation from cold.
  • Less frequently, an underlying condition can also result in nosebleeds. These conditions include diseases that make clotting difficult. The inability of blood to properly coagulate and clot can be contributed by blood-thinning agents like aspirin and warfarin.
  • Disease in the liver can also cause problems in the clotting of blood. Rarely, cancer in the nose or abnormal blood vessels present in the nose can contribute to bleeding. Another cause of nosebleeds can be high blood pressure, but it is rarely the only reason.

What are the symptoms of nosebleeds?

  • Nosebleeds usually occur from one nostril. Sometimes, if the bleeding is excessive, the nostril can get filled with blood and it can cross the nasopharynx and overflow into the other nostril and result in bleeding from both nostrils. The blood can also go into the throat and one may spit out blood from the mouth or vomit out blood (hematemesis).
  • Excessive blood loss can cause dizziness, confusion, lightheadedness, and can also cause fainting. Excessive blood loss from nosebleeds is not very common.

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

3365 people found this helpful

Pulmonary Hypertension - What Type Of Treatment Is Given?

MD , MBBS
Pulmonologist, Delhi
Pulmonary Hypertension - What Type Of Treatment Is Given?

Pulmonary hypertension mainly occurs due to narrowing of the arteries of the lungs as a result of which the flow of blood is restricted. In this kind of condition, blood fails to carry oxygen to your heart and thus your heart gets adversely affected. The blood pressure of your body will get increased to a great extent if this situation remains untreated, thus leading to bdreadful consequenses, specifically situation like heart failure, serious pulmonary diseases, blood clots in lungs and congenial heart defects, etc.

There are certain forms of pulmonary hypertension, which are serious in nature and worsen with time, so much so that they are even fatal at times. It also includes forms which are non curable in nature, however, in order to improve the quality of life, symptoms can be reduced with proper treatment. The treatment for pulmonary hypertension is often complex and it takes some time to find the most appropriate treatment and requires extensive follow-up care. Your doctor might also need to change your treatment if it's no longer effective. However, when pulmonary hypertension is caused by another condition, your doctor will treat the underlying cause whenever possible.

Common Treatments for pulmonary hypertension:

Medications:

  1. Blood vessel dilators (vasodilators): Vasodilators open narrowed blood vessels. They are one of the most commonly prescribed vasodilators for pulmonary hypertension is epoprostenol (Flolan, Veletri). The drawback to epoprostenol is that the effect lasts only for few minutes. This drug is continuously injected through an intravenous (IV) catheter via a small pump that you wear in a pack on your belt or shoulder.
  2. Ventavis: Another form of the drug, iloprost (Ventavis), can be inhaled six to nine times a day through a nebulizer, a machine that vaporizes your medication. Because it's inhaled, it goes directly to the lungs.
  3. Treprostinil (Tyvaso, Remodulin, Orenitram): It is another form of the drug, which can be given four times a day and can be inhaled or can be taken as an oral medication and can also be administered through injection.
  4. Endothelin receptor antagonists: These medications reverse the effect of endothelin, a substance in the walls of blood vessels that causes them to narrow. These drugs may improve your energy level and symptoms. However, these drugs shouldn't be taken if you're pregnant. Also, these drugs can damage your liver and you may need monthly liver monitoring.
  5. Sildenafil and tadalafil: Sildenafil (Revatio, Viagra) and tadalafil (Cialis, Adcirca) are sometimes used to treat pulmonary hypertension. These drugs work by opening the blood vessels in the lungs to allow blood to flow through more easily.
  6. High-dose calcium channel blockers: These drugs help relax the muscles in the walls of your blood vessels. They include medications, such as amlodipine (Norvasc), diltiazem (Cardizem, Tiazac, others) and nifedipine (Procardia, others). Although calcium channel blockers can be effective, only a small number of people with pulmonary hypertension respond to them.
  7. Soluble guanylate cyclase (SGC) stimulator: Soluble guanylate cyclase (SGC) stimulators (Adempas) interact with nitric oxide and help relax the pulmonary arteries and lower the pressure within the arteries. These medications should not be taken if you're pregnant. They can sometimes cause dizziness or nausea.
  8. Anticoagulants: Your doctor is likely to prescribe the anticoagulant warfarin (Coumadin, Jantoven) to help prevent the formation of blood clots within the small pulmonary arteries. Because anticoagulants prevent normal blood coagulation, they increase your risk of bleeding complications. Take warfarin exactly as prescribed, because warfarin can cause severe side effects if taken incorrectly. If you're taking warfarin, your doctor will ask you to have periodic blood tests to check how well the drug is working. Many other drugs, herbal supplements and foods can interact with warfarin, so be sure your doctor knows all of the medications you're taking.
  9. Digoxin: Digoxin (Lanoxin) can help the heart beat stronger and pump more blood. It can help control the heart rate if you experience arrhythmias.
  10. Diuretics: Commonly known as water pills, these medications help eliminate excess fluid from your body. This reduces the amount of work your heart has to do. They may also be used to limit fluid buildup in your lungs.
  11. Oxygen: Your doctor might suggest that you sometimes breathe pure oxygen, a treatment known as oxygen therapy, to help treat pulmonary hypertension, especially if you live at a high altitude or have sleep apnea. Some people who have pulmonary hypertension eventually require continuous oxygen therapy.

Surgeries:

  1. Atrial Septostomy: If medications don't control your pulmonary hypertension, this open heart surgery might be an option. In an atrial septostomy, a surgeon will create an opening between the upper left and right chambers of your heart (atria) to relieve the pressure on the right side of your heart.
  2. Lung Transplantation: In some cases, a lung or heart lung transplant might be an option, especially for younger people who have idiopathic pulmonary arterial hypertension.

Reducing Complications:

  1. The complications need to be reduced by taking proper health care. Healthy diet needs to be taken regularly along with proper medications. Smoking should be stopped and exercising sessions should be attended daily without any fail
  2. Overweight or obesity needs to be controlled properly for reducing the complications. Specialized caring strategies need to be maintained for avoiding severe kinds of health complications that are quite annoying. If you wish to discuss about any specific problem, you can consult a Pulmonologist.
2510 people found this helpful

Top Ways To Prevent A Brain Stroke

MBBS, PG Diploma in Clinical Cardiology, Fellowship in Non invasive cardiology
Cardiologist, Gurgaon
Top Ways To Prevent A Brain Stroke

There are two primary factors that are more likely to cause a stroke in a person i.e age and a family history. While both are inevitable, this necessarily doesn’t have to be the fate of a person. Brain stroke is entirely preventable as with the case of other diseases. By working on the potential health risk factors, a stroke can be prevented. Here is a list of few such steps which, when followed can pay rich dividends to a person facing the risk of a brain stroke:

  1. Blood Pressure: Blood pressure is the single most important factor that can increase the chance of a brain stroke. If a perfect blood pressure reading seems too difficult to achieve, a more realistic blood pressure target of 140/190 should be aimed for. Some of the common steps in order to achieve an acceptable blood pressure figure include reducing salt in the diet, exercising on a daily basis, regular intake of fresh fruits & vegetables and fast processed food containing processed fats. Finally, quitting drinking and smoking goes a long way in ensuring that a person is safe from strokes.

  2. Losing Weight: Obesity increases the risk of diabetes and blood pressure subsequently increasing the risk of a stroke. Being overweight, therefore greatly increases the odds of a stroke. A BMI of 25 should be maintained by engaging in activities such as walking, running and playing on a daily basis.

  3. Regular Exercise: Exercise is a clear mandate for people facing an increased risk of brain strokes. A moderate intensity exercise schedule for a minimum of 5 days per week is necessary. Some simple steps in order to achieve this include taking the stairs while climbing, joining a fitness club, 30 minutes of daily walk in a day etc.

  4. Moderate Drink: Surprising as it may sound, moderate drinking on a daily basis can dramatically reduce the risk of a brain stroke. Red wine should be the choice of preference in this case. It should be ensured that the level of drinking does not surpass more than a glass. Regular drinking in excessive quantity can increase the chance of brain stroke.

  5. Check For Atrial Fibrillation: This is a disease that is related to the heart due to an irregular heartbeat. There is a possibility of the clots travelling to the brain causing a brain stroke. Certain possible symptoms of this disease such as palpitation of heart and shortness of breath should be checked with a doctor to negate the chance of brain stroke. Certain blood thinners like warfarin and aspirin can shield against atrial fibrillation. A doctor has to be consulted before starting any medication related to the heart. If you wish to discuss about any specific problem, you can ask a free question.

3573 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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