Desai Diabetes & Endocrine Clinic

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

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

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

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

In addition, the eye symptoms are quite diagnostic including:

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

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

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

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

Graves’ disease is not life-threatening and once symptoms are controlled, the patient’s quality of life improves drastically.

Every woman likes to look into the mirror and find not an extra strand of hair on her face, be it the upper lip or near the ears. While it is not uncommon for women to have hair on these and other areas, most women resort to multiple ways to get rid of this. The pattern of this unnecessary hair growth is very similar to the pattern seen in males normally.

This condition of excessive hair growth is known as hirsutism and can be caused by multiple causes, as listed below.

1. Genetic or racial: While the European women have a more clean face that is free of hair, the Mediterranean and Indian women are highly likely to have more facial hair growth. There is also a strong family history relation, and it is hereditary.
2. Androgens (testosterone): This is a male hormone, essential for the development of male sexual characters. Though it is present in very minute amounts in all women, in some, there could be higher than these minimal levels, leading to minor masculine characters, facial hair being one of them.
3. Hormonal imbalances: There are multiple hormonal issues which can manifest as increased facial hair growth. The two most common ones include polycystic ovarian syndrome (PCOS) and adrenal conditions including tumours, Cushing's syndrome, and hyperplasia. In all these cases, there is increased amount of androgens, leading to excessive facial hair.
4. Medication side effect: Some medications like testosterone, cyclosporine, anabolic steroids, and Minoxidil also lead to increased amounts of facial hair in women. Some other medications used to treat migraines, seizures, schizophrenia, and hypertension can also cause hirsutism. This is indirectly due to increased levels of male hormones in the system, producing these effects.
5. Birth control pills: These also affect the hormone levels and lead to increased facial hair.
6. Obesity: Most women with facial hair are also on the heavier side, and most people have a reduction in hair once weight is managed.

Treatment: The underlying cause should be treated for controlling hair growth. If there is an inducing medication, an alternative should be looked at. While hormone levels can be altered, in most cases, not much can be done. These need to be dealt with using one of the following methods - depilatory creams, waxing, plucking, shaving, laser reduction, electrolysis, and weight loss.

When reading through the above, it is obvious that a lot of causes for hirsutism point towards hormones. This also helps identify hormonal abnormalities in the earlier stages. This helps to identify hormonal disorders in their earlier stages, which are managed with lesser complications. The next time you feel there is more hair on your chin or cheeks, get your hormone levels checked. In case you have a concern or query you can always consult an expert & get answers to your questions!​

Do you have an extremely low reading of thyroxine or T4, it means that you are suffering from an under active thyroid disease called hypothyroidism. With this condition, your thyroid glands fail to make sufficient thyroid hormones. The thyroid gland releases hormones, which travel all over your bloodstream and affect all parts of the body. Thyroid controls how the cells of the body use energy from food via the metabolism process, which in turn affects the body’s temperature, heartbeat and burning of calories. Lack of thyroid hormones slows down the body’s functions, reduces your energy and the metabolism is disrupted.

Causes of hypothyroidism
The primary cause of this condition is Hashimoto’s thyroiditis. Thyroiditis refers to an inflammation of your thyroid gland. Hashimoto’s thyroiditis is an autoimmune disorder in which extra antibodies are produced which destroy the thyroid gland. Viral infections may also lead to thyroiditis.

Other causes of the condition are as follows:

1. Radiation therapy to the neck region for the treatment of several cancers like lymphoma may damage the cells present in the thyroid gland. Hence, the gland cannot secrete hormones properly.
2. Radioactive iodine treatment is undertaken by people having an overactive thyroid gland. Radiation destroys the thyroid gland cells and leads to hypothyroidism.
3. Certain medicines used to treat heart problems, cancer and psychiatric diseases may affect the thyroid gland and lead to hypothyroidism.
4. Surgeries undertaken for removing the thyroid also lead to hypothyroidism.
5. Iodine is required by the thyroid gland to produce hormones. A low amount of iodine in your diet and body may lead to hypothyroidism.

Risks factors of hypothyroidism

Usually women, especially older women are more likely to get hypothyroidism than men. The factors which determine if you are at a risk of acquiring the condition are as follows:

1. Race
2. Age
3. Premature graying of hair
4. Autoimmune disorders like type 1 diabetes, rheumatoid arthritis, vitiligo, celiac disease, Addison’s disease and many more.
5. Bipolar disorder
6. Turner’s syndrome
7. Down’s syndrome

The symptoms of hypothyroidism are as follows:

1. Changes in menstrual cycle
2. Constipation
3. Hair loss and dry hair
4. Fatigue and tiredness
5. A slow heart rate
6. Depression
7. An increased sensitivity towards cold
8. Swelling of the thyroid gland or goiter
9. Gaining weight unusually or great difficulty in losing weight
10. Carpal tunnel syndrome

If you observe the symptoms of hypothyroidism, you should consult a doctor who will prescribe several blood tests, such as the thyroid stimulating hormone test and the T4 or thyroxine test. Based on the results, a treatment method is adopted.

type diabetes

The body is controlled by chemicals known as hormones. These are produced in minute quantities by minute organs, but have great control on almost all body functions. There are different hormones, each determining different functions like how tall a person will grow, how strong the bones will be, how well a person can react to stress and the reproductive ages. There is also a master gland called the pituitary which is situated somewhere deep in the brain, which controls all these organs. Small variations in the amount of these chemicals in the body produce significant effect on their respective control organ.

Thyroid is one such major gland, which produces a hormone called thyroxine or T4 as it is commonly called. This controls metabolism and emotional health to a large extent. Reduced amounts of T4 is very common in women, and with altered metabolism, there is increased musculoskeletal pain in various joints.

Here are some of the best ways to reduce Joint Pain from Hypothyroidism:

1. Step Up to Low-Impact Aerobics: Twenty to 60 minutes of near-daily aerobics — really any exercise that gets your heart pumping — can help speed up your metabolism and counter weight gain, a common hypothyroidism symptom and a contributor to joint pain. But if you have joint or knee pain, choose low-impact aerobics. Swimming is the ideal low-impact aerobic exercise — the water buoys your body and cushions joints.
2. Strengthen Your Muscles: Strength- or weight-training exercises build muscle mass, which uses more calories than fat even at rest. That promotes weight loss and can ease the strain on your joints. Stronger muscles also directly help protect nearby joints. For example, strengthening exercises such as squats, lunges, and leg lifts develop the muscles that support the knees. Start slow with 15 repetitions of each exercise. Then build up to three sets of 15 reps each.
3. Get Plenty of Sleep: Sleep is the time for muscles and joints to recover. If you're not sleeping well, you are not recovering as fast as you could be. What's more, when you're sleep deprived, you're likely to crave junk and comfort foods that can contribute to weight gain, which adds stress to your joints and increases joint pain. Aim for seven to eight hours of quality sleep each night.
4. Stick to a Healthy Diet: Replace the junk food that can lead to weight gain with choices that enhance your health. For example, add fatty fish to your diet. It's a good source of omega-3 fatty acids, known to decrease inflammation, which may be contributing to your muscle and joint pain. Coldwater fatty fish such as salmon, mackerel, and tuna have some the highest amounts of omega-3s. Also be sure to get lots of fresh fruit and vegetables high in antioxidants, which may counter inflammation, too.
5. Practice Yoga: Yoga poses are a great way to provide relief for joint pain while also increasing flexibility. For shoulder pain, look for poses that open your chest, like this simple pose: Sit with your feet flat on the floor. As you inhale, stretch your arms over your head. Clasp your hands together over your head and then turn your palms up toward the ceiling. Drop your shoulders and straighten up as if pushing through your head. Hold for 30 seconds. Release your hands, bringing them down behind you. Next, clasp your hands behind your back and lift your arms. Hold for another 30 seconds.
6. Don't Let Fatigue Win: Fatigue is one of the most common hypothyroidism symptoms. Even though you might feel listless, you'll benefit from exercise because it will rev your metabolism and help you maintain flexibility despite muscle and joint pain. If you're too exhausted to complete a full exercise routine, break it up into several short bouts — even 10 minutes done three times a day will be effective. Also, stretching and relaxation exercises within two hours of bedtime may help you sleep better.
7. Meditate for Stress Relief: Having a chronic condition such as hypothyroidism can be stressful, and that stress can actually contribute to pain and tension. That's why it's important to find ways to reduce stress, such as the practice of mindfulness meditation. This form of meditation teaches you how to distract yourself from what's bothering you by refocusing your attention, often on your own breathing. 

Thyroid hormones help all your organs work well. They control how your body uses food for energy.

What Do Thyroids Do

Thyroid hormones affect your metabolism rate, which means how fast or slow your brain, heart, muscles, liver, and other parts of your body work. If your body works too fast or too slowly, you won’t feel well. For example, if you don’t have enough thyroid hormone, you might feel tired and cold. Or, if you have too much thyroid hormone, you might feel nervous, jumpy, and warm.

What hormones does my thyroid gland produce?

The thyroid gland produces thyroxine (T4), which is a relatively inactive prohormone and lower amounts of the active hormone, triiodothyronine (T3). Collectively, T3 and T4 are referred to as the thyroid hormones. Twenty percent of the body’s triiodothyronine is made by the thyroid gland; the other 80% comes from thyroxine converted by organs such as the liver or kidneys.

The thyroid gland also produces calcitonin from cells called C-cells. Calcitonin is understood to play a role in regulating calcium levels in the body, but its exact function in humans remains unclear. Thyroid hormone is one such chemical which has effect on all organs of the body including the joints. Vague pains may be due to thyroid disorders. They are easy to manage with treatment. In case you have a concern or query you can always consult an expert & get answers to your questions!

When you are suffering from Diabetes, your first concern would be is to keep your sugar level in check. For this, you need to measure your dietary needs and keep your sugar level in control. Carbohydrates are the main source of sugar in your body. While making your diet chart, make sure that you do include carbohydrates, but only those which would not tamper with your sugar levels randomly. There are certain foods which would shoot up your sugar level to an undesired amount. This would in turn cause various other health problems. The question that arises here is, how would you distinguish between good carbohydrates and bad carbohydrates for your body? Well, the easiest way to differentiate is the use of Glycemic Index (GI).

What is Glycemic Index (GI)?
Glycemic index is a measurement of how soon the body changes carbohydrate foods into glucose. It is usually mentioned in the nutritional information segment behind every packaged food. This would help you to understand whether it can be consumed by you or not, keeping in mind your stage of diabetes and other dietary restrictions that your medical practitioner might have asked you to follow. The lower the number is, say fifty and lower, then it is usually safe for consumption as it takes a long time to convert to glucose. But, if the food has a higher number, say, seventy and above, then it becomes difficult for you consume it as it can harm your body. A Glycemic index is important information that you need to check before buying your food in case you suffer from diabetes.

The index can change from individual to individual:
This is an interesting yet unnerving fact that the index may change from person to person. The statistics mentioned on the packaging is just a starting point. Depending on how the food item is later cooked and what ingredients go into it, the Glycemic index may go down or go up. Some of the important factors for the changing index are the time the food is eaten, the way it is prepared as well as other foods that are consumed along with it. Foods break down into chemical compounds within our body. So, it is nothing but a chemical reaction which might increase or decrease depending upon the other variables.

Thus, these are some essential facts that you need to know about the Glycemic index. It is important to check GI, even at a base level, before purchasing your food; so that later on it does not create an imbalance in your diet schedule.

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

While cold and cough are common, diseases like Addison’s disease are rare. It is also known as chronic adrenal insufficiency or hypocortisolism as it is a result of insufficient production of hormones like cortisol and aldosterone by the adrenal glands. This disease can affect men and women of any age.

There are two types of Addison’s disease. These are:

1. Primary adrenal insufficiency: In this case, the adrenal glands themselves have a problem.
2. Secondary adrenal insufficiency: If the hormone production in the adrenal glands is restricted by a problem that has started somewhere else like the pituitary gland, for example, it is known as secondary adrenal insufficiency.

Primary adrenal insufficiency is more common of the two. This could be triggered as a result of autoimmune diseases or a long lasting infection such as HIV, tuberculosis and some fungal infections. Cancer can also cause this type of Addison’s disease.

Secondary adrenal insufficiency is usually caused by a problem with the pituitary gland or the hypothalamus as they are responsible for the production of hormones that stimulate the adrenal glands. Damage caused to the pituitary gland by tumors or radiation and surgery can also interfere with hormone production. Prolonged and improper use of steroid hormones can also trigger this condition.

Addison’s disease has a very slow progression and its symptoms develop gradually over time. Some of these symptoms are:

1. Weight loss and loss of appetite
2. Extreme fatigue
3. Hyperpigmentation
4. Low blood pressure
5. Craving for salt
6. Nausea and diarrhea
7. Pain in the abdomen and joint pains
8. Irritability
9. Depression
10. Loss of body hair and sexual dysfunction in women

Treatment for Addison’s disease involves hormone replacement therapy. This aims at correcting the hormone levels in the body. Hormone replacement therapy includes oral corticosteroids and corticosteroid injections. The dosage of these steroids could vary depending on the situation. For example, the doctor may suggest a temporary high dosage when the patient is in a stressful condition. Along with this, sodium is also recommended especially during the summer months and while exercising. This medication must be taken regularly as skipping a single dose can be dangerous.

In some cases this condition can become life threatening. An addisonian crisis causes a drop in blood pressure, sugar and a spike in potassium levels in the body. This requires immediate medical attention and can be treated with intravenous injections of hydrocortisone, saline solution and sugar.

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

Keeping the blood sugar at the recommended level can be a challenging task at times. While timely medication is a key prerequisite for controlling diabetes, lifestyle changes plays an important role in keeping the blood sugar under control.

Here is a list of simple yet effective ways of managing diabetes.

1. Food
   • Portion size and carbohydrate count: Carbohydrates are the single most important food element that impacts the level of blood sugar in body. People taking insulin shots should ensure that the portion size of carbohydrates does not exceed the recommended level. Maintaining a diary to keep a check on the carbohydrate count can help in this case.
   • Balanced diet: For people suffering from diabetes, it is necessary to have a good mix of fruits, vegetables, fat, starch and protein in each meal. Carbohydrates should be consumed in the form of fruits and whole grains. A doctor advice in this matter can be of great help.
   • Avoid sweetened beverages: Sweetened beverages with high sucrose and fructose content have high-calorie content that can directly impact the blood-sugar level. Refraining from these sweetened drinks is a must for diabetes patients.
2. Exercise
   • Make an exercise plan: Exercising for half hour on a daily basis is highly beneficial for diabetes patients. It makes sense to consult a doctor about the type of exercise that can be done regularly. The right mix of aerobic, cardio and muscle exercise should do the trick.
   • Stay hydrated: Staying hydrated is very important during exercise. Dehydration can bring down the blood-sugar level drastically.
   • Be prepared: Carrying a small dose of glucose or a snack can come in handy. In case the blood-sugar level drops to an alarming level while exercising, the glucose will ensure that it brings it back to normal quickly.
3. Alcohol
   • Follow the doctor’s instruction: Alcohol is known to cause a lot of complications for diabetic patients. For people whose diabetes is under control, make sure that the doctor gives his go ahead for alcohol consumption.
   • Drink carefully: If you get a doctors nod to drink make sure that dry wines and light beer are consumed. These drinks tend to have lesser calories and carbohydrates. Their impact on the blood-sugar level, therefore, becomes minimal.
4. Stress
   • Pattern: Stress greatly increases the blood-sugar level. While it is difficult to be stress-free, try to look for a pattern by checking the blood-sugar level after prolonged stress. This will help to identify a pattern which can then be addressed with methods such as yoga, hobby practicing, laughter therapy, etc.
   • Get help: Stress management is not an easy task. If stress cannot be controlled with a conventional approached, it makes sense to get professional help to reduce stress. 

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

 

The food we eat contains energy which is stored as glucose in the body. This glucose is then converted into back into energy with the help of a hormone called insulin. A lack of insulin in the body or an inability to use the insulin is known as diabetes. There are two types of diabetes mellitus; type 1 and type 2. These diseases cannot be cured but with medication, correct nutrition and weight management, they can be controlled so as to not affect your quality of life.

Type 1 diabetes is a lifelong condition and usually, begins in childhood. This is an autoimmune condition and makes the pancreas stop producing insulin. Some probable causes of type 1 diabetes are:

1. Family history of diabetes

2. Pancreatic diseases

3. Other infections and diseases that can affect the pancreas.

Between the two, type 2 diabetes is more common. Type 2 diabetes is also known as insulin resistance and can affect a person at any stage in life. However, it is more common amongst men and women above the age of 45. Ethnicity also plays an important role here with African Americans, Latino Americans, Asian Americans and Hispanic people being more vulnerable to this disease. In this case, the body does produce insulin but either this amount is insufficient or the body is resistant to the insulin.

Some factors that can trigger this condition are:

1. Obesity

2. High blood pressure

3. Sedentary lifestyle

4. Polycystic ovary syndrome

5. Family history of diabetes

6. Low levels of good cholesterol and high levels of triglycerides

7. Presence of cells that are resistant to insulin

8. Prediabetes or glucose intolerance

The most common symptoms of type 1 and type 2 diabetes are:

1. Increased urination

2. Excessive thirst and increased appetite

3. Weight loss

4. Fatigue

5. Wounds that are slow to heal

6. Yeast infections

7. Numbness and tingling sensations in the toes

8. Dry skin

9. Blurred vision

10. Nausea and vomiting

Another common type of diabetes is known as gestational diabetes Gestational diabetes affects pregnant women. It is caused by the over or under production of insulin by the placenta. Gestational diabetes can affect the health and growth of the baby is not treated in time. This condition usually resolves itself after the baby is delivered but it can put the mother at an increased risk of suffering from type 2 diabetes. Some factors that can trigger this condition are:

1. Obesity

2. Glucose intolerance

3. Family history of diabetes

4. Pregnancy after the age of 30

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

The thyroid gland influences almost all the metabolic processes in the human body through the hormones it releases. The swelling or inflammation of this butterfly-shaped gland, when triggered by an immune response is known as Silent Thyroiditis. It can lead to hyperthyroidism i.e. the overproduction of hormones followed by hypothyroidism or insufficient hormone production.

The exact cause of this thyroid disorder is unknown but it is known to affect more women than men. Women who have just delivered a baby are also more vulnerable to this disorder. Some of the probable causes for this condition are autoimmune responses, discontinuation of steroid therapy, removal of the adrenal gland and treatment for cancer. A family history of silent thyroiditis can also increase a person’s risk of suffering from this disease.

In its early stages, the symptoms of this disorder are those of a hyperactive thyroid gland. These symptoms can last for as long as 3 months. In most cases, these symptoms are mild. In some cases, people may not experience these symptoms at all and may only notice symptoms of the second stage of this disorder or hypothyroidism.

The most commonly experienced symptoms of this disorder include:

1. Insomnia or difficulty falling asleep

2. Tiredness and weakness

3. Frequent bowel movements

4. Intolerance towards heat and excessive sweating

5. Increased appetite

6. Weight loss

7. Irregular menstruation: this may be short in the early stages and heavy in later stages

8. Muscle cramps

9. Irritability

10. Nervousness and palpitations

11. Hair loss and dry skin

Silent Thyroiditis can be diagnosed by a doctor through a physical examination and a few tests. Some of the signs your doctor will look out for are:

1. An enlarged thyroid gland

2. Faster heart rate

3. Involuntary trembling or shaking of hands

In addition to this test results which indicate Silent Thyroiditis are:

1. A reduced radioactive iodine uptake

2. Increased levels of T3 and T4 thyroid hormones in the blood

3. Presence of white blood cells in a thyroid biopsy

An early diagnosis can help make the treatment of this disorder easier. The treatment of this disease is dependent on the symptoms showcased. Beta blockers are commonly prescribed to relieve the excessive sweating and rapid heartbeat.

In most cases, the acute phase of this disorder will end in three months and the condition will resolve itself within a year. Over time, some people may develop hypothyroidism as a result of this condition. Hence, you should get yourself regularly checked up even after the symptoms have disappeared.   

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