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ANALYSIS
By Dr. Rachna Pande
Thyroid is an important endocrine gland of the body which influences metabolism and reproduction. Hypothyroidism is a condition where the thyroid hormones are less than the body's requirement. Deficient functioning of this gland disturbs the body functioning in many ways.
The person suffers from lethargy, easy fatigability and increased intolerance to cold. There is difficulty in concentration and poor memory, while blunting of intellect occurs in advanced cases. Abnormal sensations like tingling, numbness, etc. occur in hands and feet. There is also associated joints and bodyache. It also affects the cosmetic appearance by causing hair loss, dry and brittle hair, dry skin and swelling over face and body. Goitre, the swelling which develops in front of the neck due to thyroid disturbances itself looks ungainly. Digestion of the person is affected and he/ she starts suffering from chronic constipation. There is also loss of appetite. Hoarseness of voice is another troublesome complaint. It may be associated with difficulty in breathing and swallowing. Women suffer from menstrual disorders and even sterility.
In pregnancy there is a high risk of perinatal mortality. A child born may be mentally retarded(cretin). These children have delayed mile stones of development and intellectual impairment. It is this manifestation which is of utmost concern, because it is a preventable cause of mental retardation.
Functioning of thyroid gland is influenced by pituitary gland which is the master gland of the body. Therefore tumors, infections, trauma, etc. problems of pituitary gland affect functioning of the thyroid gland and cause hypothyroidism. Anti thyroid drugs ( used to treat hyper functioning of thyroid gland) can lead to hypo thyroidism after some time. Ablation of thyroid gland by radiation or surgery can also induce hypothyroidism. Some infections, inflammatory conditions and autoimmune disease like Hashimoto's thyroiditis also cause hypothyroidism. If somebody is taking treatment for hypothyroidism for a long time and stops the drug suddenly, he can also develop hypothyroidism.
Apart from these, the most common cause for hypothyroidism is deficiency of iodine in diet. In areas where the soil or water lacks iodine, people are prone to develop deficiency of thyroid hormones, producing a condition known as endemic goiter, because it is prevalent chronically in that area. People living in area around rift valley in central and eastern Africa are said to be susceptible to hypothyroidism.
Specific blood tests are done to assess the level of thyroid hormones in the blood, which help to confirm the diagnosis and also help to evaluate the treatment.
Treatment of hypothyroidism is by hormone replacement therapy. Deficiency of endogenous thyroid hormones is replaced by the hormone externally in form of tablets. Treatment has to be evaluated at regular intervals to avoid development of the opposite condition, i.e. hyperthyroidism.
Diet rich in whole grains like oat, rice, wheat is useful in hypothyroidism as it helps in synthesis of thyroid hormones by providing different components of vitamin B. complex. Lean meat like fish provides iodine and helps in correction of this disorder. Fresh fruits particularly bananas are also helpful in this regard. Certain substances like cabbage, broccoli, red meat should be avoided, because these interfere with thyroid hormone synthesis and induce goiter.
Fiber rich food helps in synthesis of thyroid hormones and also helps in reducing the weight gained due to hypothyroidism. Person suffering from hypothyroidism is advised to eat small frequent meals, as this can be very well absorbed in face of low metabolism of the body.
Table salts fortified with iodine are available for correction of endemic goiter. Hypothyroidism not only affects individuals but productivity of the society as whole. People need to be sensitized about it because it is a cause of preventable morbidity.
Dr. Rachna Pande is a Specialist in internal medicine
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