Hypothyroidism - Overview

Hypothyroidism - a condition that affects almost 10 % of women world wide and almost 3-5 % of the general population. A condition that afflicts millions of people yet goes so unnoticed in so many cases. More common than you would believe it to be, Hypothyroidism is one of the commonest causes that can make you feel persistently weak and tired.

When your thyroid gland is unable to make the required quantities of thyroid hormones, you end up having 'too little thyroid hormones' and this is what the condition is about. The thyroid gland is a butterfly-shaped gland situated in the front of the neck and it produces certain essential hormones. The thyroid hormones affect growth and development and also control the way your body uses energy. Hence deficiency of the same can have widespread consequences on the whole body making you feel weak and tired besides a host of other symptoms.

The good news is that once detected, Hypothyroidism can be effectively treated and the disease can be kept under control. Conventional medication entails taking supplements of the hormones whereas homeopathy stimulates better functioning of the thyroid gland so that it can produce the hormones on its own. At Dr. Batra's, we have the experience of treating this condition for over 35 years and with this expertise, we have got good results in many cases. Successful treatment can reduce the dependency on external supplementation of the hormones and ensure good health in general.

What is Hypothyroidism?

Before we get to understanding Hypothyroidism, let us first understand the normal functioning of thyroid gland:

The thyroid is a butterfly-shaped gland situated in the front of the neck and it weighs about 20-25 gms in an adult person. This gland takes up the iodine from the foods we eat and converts it into hormones namely Thyroxine (T4), Tri-iodothyronine (T3) Calcitonin. These hormones affect growth and development and also control the way body utilizes energy. The levels of thyroid hormones are in turn controlled by TSH (Thyroid stimulating hormone/ Thyrotropin) that is secreted by the pituitary gland situated in the brain.

About hypothyroidism:

Hypothyroidism is a condition in which less than normal levels of thyroid hormones are circulating in the blood. This can be due to a problem with the thyroid gland itself (Primary hypothyroidism) wherein it cannot produce sufficient hormones due to certain reasons or due to a problem with the pituitary gland (Secondary hypothyroidism) wherein the basic stimulus for the hormone secretion is lacking. In either case, the end result is that there are widespread consequences on the whole body due to lack of T3 and T4 hormones.

Normal hormone levels:

T3 (Tri-iodothyronine): 80-220 nanograms/dl
T4 (Thyroxine): 4.5 to 12.5 micrograms/dl
TSH (Thyroid Stimulating Hormone): 0.5-6 micro International units/ml

Almost 3-5 % of the world population suffers from hypothyroidism, the incidence being much higher in women (almost 10%). The incidence increases with age. This is one of those conditions which sometimes exist for many years before being diagnosed and treated properly.

Anyone can get hypothyroidism though it tends to affect older adults especially women above the age of 50 years. The condition can even affect infants and can present in a severe form known as Cretinism.

Due to its inherent nature, the condition tends to be very subtle in the initial stages and can often be missed for ageing or symptoms of menopause. However, the good news is that sufficient and precise tests are now available for diagnosing it thus paving a way for timely treatment.

Causes of Hypothyroidism

Hypothyroidism can develop due to a number of reasons and these may vary from patient to patient. Some of the common causes have been listed here:

Severe iodine deficiency:
A diet that is persistently low in iodine (such as that seen in certain geographical areas of the world like India, Chile, remote mountainous regions of Himalayas, Andes, etc.) can lead to Hypothyroidism.

Hashimoto's Thyroiditis:
This is an inherited auto-immune condition which causes the body’s immune system to inappropriately attack the thyroid gland. It is 5-10 times more common in women as compared to men. The patient usually presents with am enlarged thyroid gland (goiter) which has diminished ability to produce the hormones T3 and T4. Hashimoto's Thyroiditis is the commonest cause of Hypothyroidism in USA.

Pregnancy:
In some women, there is production of antibodies to the thyroid gland during or after pregnancy leading to hypothyroidism. This can lead to complications during the pregnancy or childbirth and can also have effects on the growing fetus.

Lymphocytic thyroiditis:
Inflammation of the thyroid gland caused by a particular type of blood cell - Lymphocyte - is called Lymphocytic Thyroiditis. This condition is particularly common after pregnancy and the patient usually experiences a phase during which there is excessive production of thyroid hormones from the thyroid gland followed by reduced production of the same. The condition usually resolves within 6 months in most cases though in some cases the patient may continue to remain hypothyroid.

Radioactive iodine treatment or surgery:
Treatment with radioactive iodine or surgical removal of the thyroid gland (while being treated for hyperthyroidism) may lead to reduced production of the thyroid hormones.

Pituitary or Hypothalamic disease:
When the thyroid gland does not receive adequate stimulus for the production of the hormones, it cannot function normally. This is what happens when the pituitary or the hypothalamus are afflicted by disease or injury.

Certain drugs:
Some medicines used for treating hyperthyroidism such as methimazole, propylthiouracil; lithium containing psychiatric medications, etc. can lead to hypothyroidism.

Congenital absence of thyroid gland or a defective thyroid gland:
This can lead to congenital hypothyroidism which needs to be detected in time to prevent complications in the infant.

Symptoms

The symptoms of hypothyroidism are often so subtle that they go unnoticed especially in the initial stages. People often mistake these for symptoms of normal aging. Occasionally, some patients may have no symptoms at all. However, most patients have a varying combination of the symptoms mentioned here - the severity of symptoms may depend on the duration of the illness and its gravity.

  • Fatigue, weakness
  • Weight gain
  • Intolerance to cold
  • Depression
  • Irritability, mood instability
  • Loss of memory
  • Constipation
  • Excessive sleepiness
  • Dry and coarse hair, loss of hair
  • Dry, rough and pale skin
  • Abnormal menstrual cycles - Heavy or irregular menstrual periods
  • Decreased libido
  • Muscle cramps
  • Decreased sweating
  • Goiter

As the disease progresses, the following symptoms may be noticed:

  • Puffiness of face, hands and feet
  • Thinning of the outer third of the eyebrows
  • Slow speech
  • Hoarseness of voice
  • Low basal body temperature
  • Bradycardia (heart rate of less than sixty beats per minute)
  • Shallow and slow respiration
  • Difficulty in swallowing
  • Thickening of the skin
  • Myxedema - marked by dry skin and swellings around lips and nose as well as mental deterioration

Hypothyroidism in children can have a serious impact on the development of the child and can present as follows:

  • Poor growth, short stature
  • Delayed development of permanent teeth
  • Delayed puberty
  • Poor mental development
Diagnosis

The history of the patient and certain clinical signs seen in the patient can give the treating physician clues regarding the disease. Some of the common findings are:

  • Poor muscle tone
  • Sluggish reflexes
  • Signs of anemia
  • Visible skin changes - dry coarse rough skin
  • Goiter - Abnormally enlarged thyroid gland
  • Basal body temperature

The patient's symptoms and the physician's clinical findings can be confirmed with the following investigations:

  • Serum T3
  • Serum T4
  • Serum TSH
  • 24 hour urine free T3
  • Antithyroid antibodies (for evidence of autoimmune disease)
  • Anti-TPO antibodies in the blood (for Hashimoto's thyroiditis)
  • Thyroid scan
  • Chest x-ray (may show an enlarged heart)
  • Serum cholesterol
  • Testing for anemia (including ferritin)
  • Prolactin level
  • If a pituitary or hypothalamic cause is suspected, an MRI of the brain
Complications

Hypothyroidism can lead to a number of health problems if it is left untreated; some of the potential complications that may develop are listed here:

Goiter: A large goiter can interfere with swallowing or breathing.

Myxedema coma: A very severe form of hypothyroidism that is seen in people with untreated hypothyroidism. It is generally triggered by infection, illness, exposure to cold or to certain medications. This is a medical emergency and needs immediate treatment.

Clinical signs of Myxedema coma are:

  • Temperature below normal
  • Decreased breathing rate and shallow respiration
  • Low blood pressure
  • Low blood sugar
  • Drowsiness, unresponsiveness, unconsciousness

Infertility, miscarriage: Impaired fertility, difficulty in conceiving, easy miscarriage are other complications of hypothyroidism. In addition, infants born to mothers with uncontrolled hypothyroidism have greater risk of being born with birth defects. They are also prone to develop serious intellectual and developmental problems.

Cardiac diseases: Hypothyroidism can lead to increased levels of the ' bad cholesterol' (low-density lipoprotein / LDL). In the long run patients are also at risk for developing an enlarged heart (cardiomyopathy), heart failure and accumulation of fluid around the lungs (pleural effusion).

Psychological problems: Depression, slowing down of the mental faculties, etc. may be seen over a period of time.

Homeopathic treatment

At Dr. Batra's we are in possession of the experience and expertise in treating cases of Hypothyroidism for the past 35 years. Many patients have benefitted from our treatment and have been able to take the reigns of their life back into their hands with the help of the same.

Homeopathic medicines primarily work at the level of the immune system and gradually bring the deviation back towards normalcy. The medicines help in stimulating the gland to produce the hormones to the optimum level so that the requirement for external supplementation of hormones is minimal or none.

After starting homeopathic treatment, many patients are able to reduce their dependence on conventional drugs and in some cases may be even stop the same. However, this needs to be monitored very closely by the treating physician and this is what is precisely done at Dr. Batra's. Even in cases where the patient is not able to stop conventional drugs, he can manage his condition better while on homeopathic medicines and there is a general sense of well being that is very essential for a good quality of life. It can also be possible to control the further progress of the condition with the help of homeopathy.

In addition to the supervision by homeopaths at Dr. Batra's, our patients can also avail of the benefits of nutritional advice from our qualified and experienced nutritionist for better management of their condition.

It has to be borne in mind that the treatment for Hypothyroidism is long-term and there is no magical cure for the same. The good part is that the treatment is without any side effects and is non habit forming.

Living with Hypothyroidism

At Dr. Batra's, based on our experience of treating patients of Hypothyroidism for more than 35 years, we have found a few dietary and lifestyle changes can make significant difference to the patients and help them be in better control of their illness. These tips have been clinically verified time and again by our physicians and nutritionists and have been summarized here:

  • Regular exercise: Exercising for at least 30 minutes (four to five times a week) can boost the metabolism thus promoting good health.
  • Regular blood tests to monitor the thyroid levels: Your physician will advise you on how and when you must get the tests done.
  • Take control of stress: Stress has been known to worsen cases of hypothyroidism especially if left uncontrolled. Take charge of your life and find effective ways to get rid of your stress. Try meditation and deep-breathing exercises for the same.

In addition, there are certain foods that are known to stimulate the thyroid and the same can be included in the diet. These largely include foods rich in iodine, niacin, riboflavin, zinc, vitamin B6, vitamin C and vitamin E:

  • Seaweeds (but avoid if you have Hashimoto’s thyroiditis)
  • Strawberries
  • Tuna
  • Salmon
  • Eggs
  • Yogurt
  • Garlic
  • Whole grains
  • Prunes
  • Apricots
  • Potatoes
  • Dates
  • Bananas
  • Parsley
  • Extra-virgin olive oil