I am Dr. Neelam Pandey, consultant endocrinologist. Today I am going to speak upon thyroid disorders. As we all know there are 2 thyroid glands in our neck. They are very essential in production of thyroid hormone which maintains our metabolism. If the gland is producing less hormone then that entity is called hypothyroidism which is more common and if they produce more hormone then it is called hyperthyroidism. First I am going to speak about hypothyroidism which is very very common and in this entity the thyroid hormones are produced less, as a result, we suffer many symptoms and patient complain of weight gain, there can be profound swelling, they can have facial puffiness or leg swelling, period irregularity, females can have miscarriages or infertility complain can be there and they may have menorrhagia like heavy bleeding and heavy clot passage and apart from that there can be extreme lethargy, sometimes there is memory loss, sometimes people say that they have chronic urticaria or because of extreme dryness. So, routinely if you check T4 TSH in these patients especially T4 TSH should be checked and which is a blood test with that the diagnosis can be confirmed and management is very simple.
You have to simply take thyroid hormones which are available in brown colored bottle and if the TSH is 10 and above, doctor prescribes your thyroid hormones as per your body weight and as what is your TSH value. Less than 10, only few special conditions are treated such as pregnancy, infertility, irregular menstrual cycle or some hormonal issues such as hyperprolactinemia otherwise usually 10 and above values are to be treated. When the first term TSH is above 10 then the treatment is being decided and you have to be on medication, 95% of the cases will require medication all their life and on follow up your TSH is being checked and it is maintained in normal range that doesn't mean that you have to stop treatment and 3 monthly follow-up is usually done except in pregnancy and neonatal hypothyroidism when it is more frequent follow up is required with TSH. And you have to be in consultation with your doctor.
Do not increase or decrease your dosage or change brand and there are strict norms to be followed such as it has to be taken empty stomach, take it after a gap of 30 to 45 minutes, do not miss your pill, if you miss you can take your missed pill the very next day but try and avoid such situation and maintain your TSH so that you can restore your well-being. The other aspect is hyperthyroidism in which the hormone is secreted more into your bloodstream. As a result you have a lot of weight loss, palpitations, sweating, sometimes excess bowel movement like the frequent passage of stool and sometimes there is proptosis that is bulging of eyes, neck swelling and they may have tremblessness of hand. So all this can be seen in hyperthyroidism. Primarily there are two entities: one is thyrotoxicosis due to thyroiditis in which gland due to leakage of the hormone, leakage of excess hormone occurs so this entity is self-limiting. The other one is hyperthyroidism which is like autonomous overproduction of hormone in which medical management is done and that therapy is given for 12-18 weeks. Treatment is very much possible, we need not panic. We have to simply see our endocrinologist in vicinity and get routine tests which are advised by them. It is usually a blood test that is free T4 and TSH and thyroid scan which can differentiate between the thyroiditis and hyperthyroidism and accordingly treatment is planned for a patient. So thank you very much for your attention.