Hypothyroidism


Guest article by Shwetha Bhatia

Hypothyroidism is a common disorder of the endocrine system in which the thyroid gland does not produce enough thyroid hormone.

Causes:
  • Iodine deficiency
  • Autoimmune condition called Hashimoto's thyroiditis.
  • Less common causes include: previous treatment with radioactive iodine, injury to the hypothalamus or the anterior pituitary gland, certain medications, a lack of a functioning thyroid at birth, or previous thyroid surgery.
The diagnosis of hypothyroidism, when suspected, can be confirmed with blood tests measuring thyroid-stimulating hormone (TSH), T3 and T4 levels. TSH stimulates the thyroid gland to produce T4 and finally T3 (active form). Sometimes a condition called subclinical hypothyroidism may develop where TSH is elevated with normal T3/T4 due to stress, illness etc. Reverse T3: Conversion of T4 to T3 may be affected due to certain medications, stress etc called “non thyroidal illness”. Reverse T3 slows metabolism. Pregnancy leads to marked changes in thyroid hormone physiology. Many women who have normal thyroid function may develop evidence of hypothyroidism before or after giving birth.

Symptoms: Weight gain, lethargy, poor appetite, constipation, decrease tolerance to cold temperatures.

Management:
Treatment with thyroid hormone. Ensure it is taken 30-60 minutes before or 4 hours after a meal as food interferes with absorption. In those with TSH levels between 5-10 mlU/L, no treatment may be needed if antibodies are not detected. Low carbohydrate diet. Adequate selenium and zinc are needed for the conversion of T4 to active T3 in the body. Exercise plays a pivotal role in weight management. It may be harder to lose weight even if the blood levels normalise with treatment; therefore consistency is key. Stress management. Treat underlying cause in case of non thyroidal illness.



Shwetha Bhatia is a registered dietician with the Indian Dietetic Association. She runs her practice under the brand name “Metamorphosis’ in Mumbai. She is also a competitive fitness athlete (IBBF Bronze winner at the State & National Level 2015). She has also set up her own gym and nutrition counselling centre in Goa called Gym & Tonic. She’s also a columnist for the fitness magazine Krunch Today.

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