I have tried to make my own little mark in this world. My career as a Medical Educator and Clinician in Gastroenterology (see www.gastroindia.net) and my flirtations with Health Promotion, especially amongst school children (see www.hope.org.in) are shown elsewhere.This blog contains my attempts at creative writing, most being write-ups for Health Adda column of HT City of Hindustan Times (also see www.healthaddaindia.blogspot.com) as well as a few others, and some reflections and thoughts that have struck me from time to time on my life journey.Please leave your footprint on this blog with your comment.


Thursday, October 31, 2013

Thyroid Disorders

One of the three common causes of poor performance of students in schools and colleges has been ascribed to insufficient functioning of a small gland situated in the front of our neck, called Thyroid. While weighing only around 50 grams, the thyroid gland produces a hormone thyroxine which regulates how our body functions, or its “metabolism”.
As the role of the hormone is to pace up the body and mind and keep us active and alert, its deficient production leads to just the opposite effects: dullness, lethargy, sluggishness, drowsiness, lack of concentration and obesity.

Indeed it is this “dullness” and lethargy that makes poor learners and performers of students, when the role of the thyroid is often overlooked and the blame is placed on other factors such as the role of parents, distractions by television, or even the quality of teachers!

There are several ways and phases in which hypothyroidism, or inadequate function of the gland, may present. It presents as cretinism in infants and small children. These kids are stunted in growth, have coarse skin, are retarded mentally and show growth failure. Deficiency of iodine is often the underlying cause.

When it manifests in adults, especially women, the signs are often subtle, with increasing weight, fatigue, heavy infrequent periods, cold intolerance, high blood pressure, increased blood levels of cholesterol, hoarseness of voice, coarse skin, loss of eyebrows, or even depression, in isolation or in combination. Some may also have a “goitre” or prominent swelling of the gland in the neck, due to long term deficiency of iodine.

Thyroid problems are indeed common in adults with 10-30% showing evidence of dysfunction when tested.

Detecting Hypothyroidism is easy. A simple blood test that estimates TSH (Thyroid stimulating hormone) tells you where you stand. In early hypothyroidism, TSH values (normal 1-5) are increased above normal limits, demonstrating that more pressure is required by TSH to flog a tired thyroid gland to produce thyroxine. With further progressive weakness of the gland, thyroxine levels start falling despite TSH levels climbing further.

Once detected, treatment is quite easy and requires the hormone to be taken every day as replenishment. The daily dose, best taken in the early morning on an empty stomach, needs to be titrated by the doctor. Improvement is usually obvious in weeks, with friends often noticing a change in appearance and personality.

A rarer form of thyroid disorder is one in which the gland produces an excess of the hormone, called hyper-thyroidism.  It presents as prominent bulging eyes, rapid pulse rate, weight loss, and excessive sweating. Treatment here aims at slowing down the overactive thyroid gland.

Thyroid disorders are often so indefinable and subtle in their signs, and yet have such far-reaching effects on the functions of our body, mind and personality that experts recommend testing it as a part of general check-up. And with treatment being so simple and rewarding, the stakes of missing it are indeed high.

As published in HT City ( Hindustan Times) dated 5 May, 2013.

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