Cheryl Fernandez*, a 28-year old working professional based in Bengaluru, noticed that she was losing hair and gaining weight quite substantially over the past ten to twelve months. She felt it was a result of stress at work, change in weather conditions and chlorinated tap water, as she had relocated to a new city three years back from her home town in Goa. When the conditions persisted, she decided to visit a physician to seek help. Her doctor prescribed a few supplements and medicines, but that didn’t improve Cheryl’s situation. It was only when the doctor ran some blood tests to check Cheryl’s thyroid hormone levels, that he was able to identify the root cause of the problem.Cheryl was diagnosed with hypothyroidism, the most common form of thyroid disorder in India, affecting one in ten adults.
Studies reveal that as of 2018,over 42 million people in India suffered from thyroid disorders.Thyroid diseases are ten times more common among women than men worldwide.Thyroid dysfunction can have a long-term adverse impact on many organs in the body, and can even result in thyroid cancer if left undetected or untreated. In this article we will look at what are the symptoms and causes of thyroid disorders, long-term implications and suggested treatments.
Thyroid Disorders Explained
Thyroid, a butterfly-shaped gland at the base of the neck, has a critical part to play in the human anatomy. It is responsible for releasing and controlling hormones that regulate crucial physiological functions. The two main hormones created by the thyroid, i.e.triiodothyronine (T3) and thyroxine (T4), flow through the bloodstream and instruct the body’s cells on how much energy to use, which in turn is produced bymetabolism of food.These hormones monitor everything from proper break-down of food to bone health. All bodily functions depend on the thyroid gland working correctly and producing optimum levels of T3 and T4 hormones. When this gland doesn’t function properly, the body is likely to face many issues.
Malfunction of the thyroid gland results in two types of disorders:
1) Hypothyroidism: If the thyroid gland is underactive, it produces lessT3 and T4 hormones. This results in a condition known as hypothyroidism.Some common signs and symptoms of hypothyroidisminclude muscle and joint pain, unexplainable weight gain, high cholesterol levels, dry and flaky skin, puffiness around the face and enlargement of neck glands.
Hypothyroidism is twice more common among women than men in India;specifically, women between the age of 18-35 years. Studies show that women with hypothyroidism specifically are at risk of menstrual irregularities, polycystic ovaries and infertility. Because this condition is more common among women in the more fertile age group (18-35 years), it has a direct impact on the female endocrine system, especially during pregnancy, often resulting in miscarriages, stillbirths, failure of lactation and neonatal complications in infants post birth.
2) Hyperthyroidism: If the thyroid gland is overactive, it produces excess T3 and T4 hormones. This results in a condition known as hyperthyroidism.Hyperthyroidism is also more common in women than men. The most common cause of hypothyroidism is Grave’s disease, an autoimmune condition in which antibodies cause the thyroid gland to become overactive, thereby causing it to produce too much T3 and T4 hormones. Symptoms of hyperthyroidism could be irregular heartbeat or palpitations, larger appetite but unexplainable weight loss, excessive sweating and insomnia.
Some common symptoms of both conditions are severe hair loss, irregular menstrual cycle, excessive or less bleeding during periods, hot flashes etc., among others. The symptoms can sometimes be similar to that experienced during perimenopause or menopause.
Cause and Effect of Thyroid Diseases
The exact causes of thyroid disorders cannot always be identified. There are, however, some factors that increase the risk of developing a thyroid issue:
• Personal or family history of type 1 diabetes, Grave’s disease or other autoimmune disorders
• Lifestyle factors, such as smoking and poor diet (lack of or excessive intake of iodine). Iodine is a critical raw material for production of T3 and T4 hormones. Low levels of iodine in the system can affect the functioning of the thyroid gland, causing it to produce fewer thyroid hormones.
• Among women, it is more likely post pregnancy or near menopause
• Exposure to environmental disruptors such as pollutants and cyanide-laden compounds
Detection and Treatment
Should you experience any symptom stated above, it is best to approach your physician for better diagnosis and treatment. The doctor may recommend a TSH (Thyroid Stimulating Hormone) blood test to learn more about your thyroid functioning. S/he may also ask you to undergo an ultrasound examination of the thyroid gland, to look for any irregularities. If the symptoms persist, you may be referred to an endocrinologist, who is a specialist trained to better gauge the severity levels of dysfunction. The treatment can range from synthetic thyroid hormone injections (for hypothyroidism) to anti-thyroid medication (for hyperthyroidism) and surgery.
Women are four times more vulnerable to thyroid cancer than men in India.After breast cancer, thyroid cancer is the most common form of cancer among Indian women in the 35-60 years age group. Symptoms include abnormal lumps or swelling of glands, persistent hoarse or sore throat and discomfort while swallowing. Any these symptoms should be highlighted immediately to a specialist for prompt detection and timely treatment. Surgical procedure on the thyroid gland might be suggested by an endocrinologist to avoid further deterioration and issues.
Since women are more susceptible to thyroid disorders, it is always advisable to consult your doctor for regular check-ups, to avoid long-term issues. If detected early on, thyroid malfunction can be managed with preventive and attentive care. However, if there is a situation when you require focused medical attention and management of thyroid issues, it would be beneficial to have a cushion that protects you from unexpected and excessive budgetary strain. We are well aware of how expensive any form of medical treatment is these days; not to mention prolonged hospitalization or surgery of any kind. Investing in a health insurance plan that covers you for hospitalization and treatment will go a long way in lightening the financial load on you.
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Wish you a healthy and happy life!