Living with hypothyroidism


ROHINI, 35, was experiencing weight gain, tiredness, dry skin, hair loss and joint pain. Like so many others, her hectic schedule made her put off her annual health checkup. When her condition started to deteriorate, she went for a checkup and found that her cholesterol levels had increased, and that she had developed hypothyroidism and high blood pressure. Hypothyroidism may lead to a disturbance in the metabolic system resulting in unintentional weight loss/weight gain, fatigue or irregular heartbeat. If not treated on time, it can lead to cardiovascular symptoms like the slowing of heart rate, constriction of blood vessels, increased blood pressure and cholesterol levels, retention of fluid and oedema.

Hypothyroidism is a common condition where the thyroid does not create and release enough T3 (Tri-iodothyronine) and T4 (thyroxine) into the bloodstream. The gland’s hormone production slows down which, in turn, slows your metabolism.

Age affects the likelihood of getting hypothyroidism; more older people have it than youngsters. According to NHANES III (National Health and Nutrition Examination Survey), the overall prevalence of hypothyroidism is 4.6 per cent globally. In India, it is 11 per cent, compared with only 2 per cent in the UK and 4.6 per cent in the US. Compared with coastal cities (Mumbai, Goa, and Chennai), land-locked ones (Kolkata, Delhi, Ahmedabad, Bengaluru and Hyderabad) have a higher prevalence (11.7 per cent vs 9.5 per cent).

When the thyroid produces less hormone, you may experience symptoms like fatigue, loss of energy, weight gain, intolerance to cold, dry skin, hair loss, pain in joints and muscles, depression, emotional stress, mental impairment, impaired memory, inability to concentrate, constipation, disturbed menstrual cycle, sexual dysfunction, nerve entrapment syndromes, blurred vision and fullness in throat.

The diagnosis of hypothyroidism is based on the symptoms and results of blood tests that measure the level of TSH, or the thyroid-stimulating hormone. TSH tests are the most accurate screening method for primary hypothyroidism and are widely available. A low level of thyroxine and high level of TSH indicate an under-active thyroid. That is because the pituitary gland produces more TSH to stimulate the thyroid gland into producing more thyroid hormones. Further tests may also estimate the total thyroxine (T4) or free thyroxine (FT4) in the body.

Hypothyroidism is generally a life-long condition. It is important that patients take their prescribed medication and do regular thyroid tests and follow-up visits with their doctor. Many patients are afraid that taking thyroid medication all their lives may adversely affect their organs, especially the heart and bones. They should be assured that life-long intake of thyroxine in hypothyroid patients is a natural replacement of the deficient hormone. If given in optimum quantities as prescribed by the physician, it does not affect any organ, but rather improves the patient's quality of life. Patients are also concerned about fertility issues; they should know that these medicines do not cause any harm but rather help in the successful pregnancy of those with thyroid disorders.

Along with medication, a few lifestyle measures can improve the way your immune system functions, and can help control the symptoms of hypothyroidism. Regular exercise can relieve stress, reduce symptoms of depression, and help maintain a healthy lifestyle. It releases endorphins―feel-good hormones―that help one feel physically and emotionally better. Meditation can help one attain mental peace.

The longer hypothyroidism is left untreated, the less the body is able to cope. A severe case, along with precipitating factors like cold weather and infections, can cause myxedema. Usually, it takes years for hypothyroidism to deteriorate into myxedema, which is now rare in developed countries.

Iodine is a crucial nutrient for the body, and since thyroid function depends heavily on iodine, those who consume it insufficiently may also experience hypothyroidism. Adequate iodine intake aids in the proper regulation of the thyroid gland. Good sources of iodine include iodised salt, dairy products like milk, yoghurt and cheese, and seafood like fish, shrimp, tuna, and seaweed.

Vitamin-B complex, selenium and other trace elements play a vital role in hormone production and the overall wellness of the body. Cruciferous vegetables and soya-based dietary products should not be consumed in high quantity.

The writer is senior director and head, department of endocrinology, BLK Max Hospital, Delhi.