Thursday, September 20, 2012

The sluggish syndrome

It's the master of your metabolism, the gland that determines not just the way your body functions, but also how alert your mind is. It's a very simple disorder to correct, and yet, hypothyroidism, a condition that is characterized by an underactive thyroid, is estimated to affect 30 million Indians and often goes undetected and untreated You look into a mirror one morning and it suddenly strikes you that your hair is thinning drastically. Your face looks puffy, especially around the eyes. Your skin feels dry and coarse like sandpaper and you've been putting on weight at an alarming rate of 1-2 kilos every month. The worst problem however, is the constant drowsiness. You feel sleepy all day long, despite having had a good night's rest. Sometimes, the tenor of your voice changes. It's easy to assume that all this is just an unpleasant prelude to aging. Some of us may even blame it on a lifetime of stress from a high-powered career or a demanding personal life. And that's how we may completely miss what should essentially serve as a critical wake-up call. For these are all the typical symptoms of a malfunctioning thyroid. Small gland, big deeds "Every cell in our body depends on the action of the thyroxine (one of the hormones secreted by the butterfly shaped thyroid gland situated at the base of the neck) for its optimal performance," says Dr J. Sangumani, Professor of Medicine, Madurai Medical college and HOD-in-charge of endocrinology at government Rajaji Hospital, Madurai. "Without this, all our body functions would become lax." So if the thyroid gland were to secrete too little (hypothyroidism) or too much (hyperthyroidism) of its hormones, the resulting disorder would wreak havoc in our bodies and our lives. "One of the predominant symptoms of hypothyroidism is mental and physical sluggishness," says Dr Sangumani. "Exhaustion, excessive daytime sleepiness, long term constipation, an irregular menstrual cycle in women, all these are common complaints." This condition, if left untreated, could create a pandora's box of secondary problems, ranging from obesity, heart disease, depression, diabetic neuropathy, infertility and even mental retardation. "Detection of the thyroid problem is complicated by the fact that everyone feels anxiety and tension to some degree and that many thyroid symptoms are similar to those of other diseases," says Prof. Dr. U. Gauthamadas, Head of Neurobehavioural Medicine and Stress Management, Apollo First Med Hospitals, Chennai. "Since hypothyroidism usually develops slowly over a considerable period of time, and the early complaints are frequently minor and vague in nature, it is not surprising that the diagnosis is often overlooked." Iodine, the star Iodine is the main ingredient for the production of thyroxine, but we need only a minuscule amount. "Adults require only 150 micrograms of iodine daily. Pregnant and lactating women need 200 micrograms," says Dr Sangumani. However, ensuring this amount completely from one's diet is difficult, unless you're a non-vegetarian who eats seafood every day, since iodine is present naturally in sea water. "That's why we add iodine to salt, but even then, our cooking methods often destroy it. Never add salt to dishes that are boiling and steaming on the stove," says Dr Sangumani. "Always wait for the dish to cool properly before adding salt. Otherwise, the iodine content could easily evaporate." He also recommends storing your salt in airtight containers, ensuring that that it is not exposed to excessive heat and moisture. Mountain Malady The soil in which we grow our fruits and vegetables is often naturally fortified with iodine too. However, in hilly areas, this is subjected to frequent erosion. "Most produce grown in hilly regions (including hill stations and adjoining valleys) is devoid of iodine content," says Dr Sangumani. "That's why people who live here are more at risk to thyroid issues and should be extra cautious." Diagnosis and treatment A simple blood test can tell if your thyroid is healthy. Experts recommend testing for TSH, free levels of T3 and T4 in your blood. Any imbalance is easy to correct. All you need to do is swallow a single tablet (recommended by your doctor) on an empty stomach. Though you may be dependent on the drug, for some patients, dosage can be reduced over time with regular intake. Fighting the depression disease If left untreated, hypothyroidism can also greatly affect your mood and emotions. "Low thyroid hormones play a role in a variety of emotional and behavioral disturbances, including progressive loss of interest and initiative, slowing of mental processes, muddled thinking, lack of concentration, general intellectual deterioration, poor memory for recent events, fading of the personality's colour and vivacity, depression with a paranoid flavour, and eventually, if not checked, (it will lead) to dementia and permanent harmful effects on the brain," says Dr Gauthamadas.
Babies affected by hypothyroidism at birth, if left untreated, will become mentally retarded. But if diagnosed and treated early, the condition can be entirely prevented and the child will lead a normal, healthy life. That's why in the US, all babies are compulsorily screened for thyroid disorders at birth. However, in our country, we just don't have the resources to do this on a national scale yet. There may also be links between hypothyroidism and depression. "Research has revealed that the rate of depression is much higher in people who are hypothyroid than in the general population," says Dr Gauthamadas. "Studies have showed that added thyroxine helps patients with major depression who did not respond to anti-depressant medication." Overlooking thyroid problems can be serious. "When effective thyroid treatment is begun, the general response is quite favourable. Vitality returns and the mental processes become efficient again. Early detection and treatment of the thyroid disturbance, as well as appropriate attention to the emotional and psychological condition of the patient, cannot be overemphasized."

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