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Business News/ News / Business Of Life/  Understanding the thyroid gland
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Understanding the thyroid gland

Know the difference between hyperthyroidism and hypothyroidism and why medication is not enough to help shed weight

Both hyperthyroidism and hypothyroidism have been linked to mood disorders. Photo: iStockphotoPremium
Both hyperthyroidism and hypothyroidism have been linked to mood disorders. Photo: iStockphoto

NEW DELHI :

A New Delhi-based dermatologist didn’t notice the changes, but her friends did. She had become restless, was lethargic all the time, felt muscle weakness, and despite following a healthy diet and regular exercise routine, was gaining weight. She ignored these changes, attributing them to work-related stress. When she got some blood tests done, she found out that her thyroxine levels were imbalanced. At 30, she had hypothyroidism, a condition in which the body lacks sufficient thyroid hormone.

She’s not alone. More and more young people are getting afflicted with thyroid issues.

Thyroid is a butterfly-shaped, walnut-sized gland located at the base of the neck, just below the Adam’s apple. The gland secretes two hormones—T4 (thyroxine) and T3 (triiodothyronine)—which drive the function of almost every cell in the body. It is controlled by the pituitary gland, which makes thyroid-stimulating hormone (TSH). “All aspects of metabolism, from the rate at which the heart beats to how quickly calories are used up, are regulated by thyroid hormones. As thyroid plays a critical role in the body’s metabolism, metabolic disorders occur when the gland secretes too little or too much of thyroid hormones. If there is not enough thyroid hormone in the bloodstream, the body’s metabolism slows down. This is called hypothyroidism (underactive thyroid). If there is too much of thyroid hormone being produced, the metabolism becomes too fast. This is called hyperthyroidism (overactive thyroid)," explains Roshani Sanghani, consultant endocrinologist, PD Hinduja National Hospital, Mumbai. “Women tend to suffer from thyroid imbalances more often than men. Yet most people remain unaware of the diagnosis for some time because often the symptoms—anxiety, fast heart rate, increased perspiration, etc.—are subtle and overlapping with other conditions," she adds.

A 2013 study of 5,376 adults in eight Indian cities, published in the Indian Journal Of Endocrinology And Metabolism, put prevalence of hypothyroidism at 10.95%, of which 3.47% had not even been detected before. This means almost one-third were unaware of fact that they were suffering from hypothyroidism until tested. In women, hypothyroidism was three times more common than males. The prevalence of hypothyroidism was the highest in the age group of 46-54 (13.11%) and the lowest in 18-35 (7.53%), according to the study.

“This study tells us that hypothyroidism is a disorder which not only affects women but also men, albeit less commonly," says Vineet Surana, consultant, endocrinology and diabetology, Paras Hospital, Gurgaon, near Delhi.

Are you at risk?

Hereditary: You are at increased risk if a close relative has a thyroid problem. “Heredity plays a role in both underactive and overactive thyroid. There are thyroid antibodies that can be checked, although not everyone with a positive antibody necessarily develops abnormal hormone levels. The antibodies may play a role at the time of pregnancy, so it is best for this to be evaluated before planning a pregnancy if there is a family history of thyroid disease," says Dr Sanghani. Another important point is that the thyroid problem may skip generations; someone with an underactive thyroid may have healthy parents, but his/her grandparents might have had thyroid troubles.

Hormones: “Abnormally early or late onset of puberty and menstruation, and irregular, very light or very heavy, menstrual periods, or absent menstrual periods could be signalling an undetected thyroid problem," says Sheetal Agarwal, senior obstetrician and gynaecologist, Apollo Spectra Hospitals, New Delhi. “Hypothyroidism’s symptoms often mimic those of PMS (premenstrual syndrome), including bloating, weight gain, mood changes, changes in libido, sleep disorders, fatigue and constipation," she adds.

A review published earlier this year in The Obstetrician And Gynaecologist journal reported that the thyroid problem can have significant effects on a woman’s reproductive health and suggested thyroid screening for women with fertility problems. “Thyroid disorder could also be the cause of fertility problem, as an overactive or underactive thyroid may affect ovulation," says Dr Agarwal. She says that women who suffer from PMS or are having trouble conceiving should consult a doctor so that their thyroid function can be evaluated.

Too tired or stressed: Usually the symptoms of mild hypothyroidism are non-specific, change gradually, and are often written off as stress or overwork. “Most women suffering from hypothyroidism go to the doctor because they are fatigued. If you sleep all night and still need an afternoon nap, get your thyroid checked and if that is normal, then get tested for sleep apnoea," says Dr Sanghani.

Abnormal weight changes: In hyperthyroidism, a person loses weight for no apparent reason, and in hypothyroidism, weight gain is a perpetual problem, leading to a battle of the bulge that does not respond to even the most rigorous weight-loss effort. But once a person is put on the right medication, the weight gradually gets back to normal. “Often a patient gets the false notion that their thyroid is the culprit for weight gain when it actually isn’t. If someone is taking thyroid medication and their TSH is normal, then their inability to lose weight cannot be ascribed to thyroid. If their TSH is raised but in the sub-clinical range, even then the weight gain is not from hypothyroidism. There is a lot of misunderstanding in society about how often thyroid issues cause weight gain," says Dr Sanghani.

Depression and anxiety: Research has found links between an increased risk of depression and both over- and underactive thyroid glands.

“Both hyperthyroidism and hypothyroidism have been linked to mood disorders and decreased sexual desire (libido). Mood swings may be the first sign of an overactive or underactive thyroid. The nervousness, anxiety and hyperactivity of hyperthyroidism often interfere with a person’s ability to function in normal daily activities," says Dr Surana.

“A lot of women come to me with symptoms like proneness to excessive crying, withdrawal from people, feeling lousy all the time, not wanting to get up in the morning—all classic symptoms of depression. But antidepressants don’t work on them at all. In most of the cases, a thyroid test reveals hypothyroidism, and the patients respond well to thyroxine and get off antidepressants," he adds.

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Published: 30 Nov 2015, 07:41 PM IST
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