Thyroid disorders are the most common endocrine disorder. They are usually mild but sometimes can be life threatening when ignored. They are more common among females than males and affect all age groups starting as early from the mother’s womb to the elderly age group. Majority of the women suffering from the same are in their 20’s -40’s which is the most productive period of one’s life.
In fact 22% of Indian population suffers from thyroid dysfunction out of which 10% suffers from hypothyroidism, thus 1 out of 5 people suffer from some form of thyroid dysfunction. Incidence of thyroid diseases increases with age, however newly born children are also not spared where it is seen in approx. 1 in 3000 newly born infants where if not treated can lead to permanent mental retardation and poor growth which are completely reversible if diagnosed and treated at earliest.
Spectrum of thyroid diseases
Like most other diseases, most women do not develop thyroid diseases in a day, it is preceded by a subclinical stages like obesity, fatigue, inability to concentrate, infertility etc. Thyroid dysfunction can present in various forms like hypothyroidism, hyperthyroidism, thyroid nodule and thyroid cancers.
Hypothyroidism is the commonest thyroid disorder. It refers to a decrease in production of hormones by the gland. Some of the symptoms that could signal hypothyroidism are weight gain or failure to lose weight despite a proper weight loss regime, enlargement in the neck, reduced heart rate, increased cold sensitivity, lethargy, numbness in hands, dry skin and hair, heavy menstrual periods and constipation.It needs lifelong treatment in form of thyroid hormone replacement. Importantly thyroid supplementation should be taken empty stomach in morning at least 20 minutes before breakfast. Also there should be a gap of 4 hours between any calcium and iron supplements as food, iron tab, calcium tablets interfere with its absorption. Also soyabean and its product should be avoided by hypothyroid patients on thyroid hormone supplements.
On the other hand Hyperthyroidism refers to an increase in production of hormones by the gland. Some of the symptoms that could signal hyperthyroidism are weight loss despite a good appetite, enlargement in your neck, bulging eyes, an increase in heart rate, shorter menstrual periods, high blood pressure, increased sweating, frequent bowel movements, nervousness and trembling hands. It can be treated with tablets, radio-iodine or surgery as per need.
Both hypothyroidism and hyperthyroidism can cause menstrual irregularity, infertility, abortions, premature delivery and permanent developmental abnormalities in children born to untreated mothers suffering from these thyroid diseases.
Screening is the key :
Since thyroid diseases are so common now a days it is advised that after the age of 35, one should get screened for thyroid dysfunction once every five years. In presence of symptoms or risk factors like type 1 diabetes, exposure to radiation to head and neck area, thyroid surgery, family history of thyroid diseases, symptoms of thyroid diseases one can be screened more often with T3, T4, TSH levels. Also preferably all newly born children should be tested for thyroid function on 3rd day of birth and all pregnant ladies should be tested for thyroid function.
A pregnant lady with undetected thyroid disease can have poor mental and physical growth of child, abortion of fetus.
High TSH and low T4, T3 suggest hypothyroidism whereas low TSH and high T4, T3 is suggestive of hyperthyroidism.
There are lots of micronutrients which play role in optimal thyroid function, more important ones are iodine, selenium, iron, vitamin A, vitamin D etc. Iodine rich foods are sea food and use of iodized salt, whereas foods like fish, meat, mushrooms, sunflower seeds and soybeans can fulfil selenium requirement.