Take care of your thyroid

http://www.telegraphindia.com/1160118/jsp/knowhow/story_64332.jsp

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Your Health - Dr. Gita Mathai

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The thyroid is a butterfly-shaped gland situated in the front of the neck. It releases hormones that control many functions in the body such as breathing, heart rate, metabolic rate, body temperature, menstrual cycles and the lipid profile (mainly the triglyceride levels). It is under the control of two other glands in the brain, the pituitary and the hypothalamus. A deficiency of thyroid hormones causes weight gain, abnormal menstrual cycles and elevated triglycerides. These changes are usually picked up early both because of the symptoms, the physical changes in the patient and the fact that the thyroid gland is situated in the front of the neck. Changes in the size, texture or the appearance of nodules are visible and palpable.

Thyroid disorders can be diagnosed by doing the thyroid function tests which estimate the level of hormones.

Normal values:

• Serum thyroxine (T4) 4.6-12 ug/dl
• Serum triiodothyronine (T3) 80-180 ng/dl
• Thyroid stimulating hormone (TSH) 0.4-4.2 mcU/mL

Forty two million Indians suffer from thyroid diseases; 80 per cent have low levels of thyroid hormones (hypothyroidism). These individuals benefit from titrated doses of replacement thyroid hormones. The tablets are administered on an empty stomach and the dose is increased every two weeks until it is optimised.

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Unregulated usage in unpurified forms (self administered tonics and health supplements for losing weight or gaining height or an appetite) mean that varying amounts of the hormone are being taken. The dosage may even change from day to day. Also, the person may actually have thyroid glands that function normally. Their obesity may be due to an imbalance between caloric intake and expenditure. In this scenario, taking supplements with varying amounts of thyroid hormone can be injurious to health. The pulse rate may go up and there may be heart beat irregularities. It can be fatal.

India has "goitre belts" where iodine deficiency results in an overworked, enlarged thyroid gland and a swelling in the front of the neck. The body cannot store iodine so the daily requirement (adults require 150 micrograms of iodine a day; pregnant and lactating women require 200 micrograms) has to be provided with salt in the food. It is also found naturally in fish and seaweed. The government has tackled this by selling iodised salt in which 30gm of iodine is added per kilo. On an average, 10-15gm of salt is consumed every day, and this provides most people with the required amount of iodine.

Despite this, hypothyroidism can occur if the body produces antibodies to thyroid hormones, a type of autoimmune disease called Hashimoto's thyroiditis, or the gland has been surgically removed. It can also occur with pituitary diseases, or with certain medications like lithium.

The thyroid gland can also go out of control because of excess stimulation from the pituitary gland, or because of cancerous or non-cancerous nodules secreting excess amounts of thyroid hormone. It can be part of Hashimoto's thyroiditis where the body destroys the thyroid hormones produced so that the gland is stimulated to work harder. It can occur owing to painful or painless inflammation of the thyroid gland. It may be due to extraneous administration of iodine or thyroid as part of tonics or health supplements.

A hyperactive thyroid can be treated with medication or radioactive iodine. Anti thyroid medications can be administered for short-term control. Beta blockers slow and regulate the heart rate. Sometimes, hyperfunctioning nodules or even the gland itself may need to be removed.

The thyroid controls almost all functions of the body. Malfuctions may be subclinical and present subtly. It is important to check thyroid functions as part of the master health check up, especially if you are a woman nearing the age of fifty.

Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her atyourhealthgm@yahoo.co.in

new year resolutions

Out with the bad

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http://www.telegraphindia.com/1160111/jsp/knowhow/story_63168.jsp

Your Health - Dr. Gita Mathai

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Now that all the fanfare that ushered in the new year is over, it is time to introspect. Take a long, hard look at the year ahead - you can make a new beginning, health wise.

Try to quit bad lifestyle habits such as smoking, drinking or overeating. Even if you do not feel the negative effects of "just another" drink, chocolate or cigarette right now, one day the aging body will no longer be able to tolerate the years of abuse. Side effects like hypertension, heart attacks, chronic obstructive pulmonary disease (COPD), and arthritis will suddenly appear to make life miserable.

If you find that quitting smoking cold turkey is impossible, try stopping for one day a week. Increase the abstinence to two days after two weeks. Eventually, you would have stopped smoking for the entire week. The same can be applied to drinking. The cravings will disappear. To make this lifestyle change, it is important that you avoid the company of people who smoke or drink. Otherwise, despite your best intentions, the situation may spiral out of control. The enticing aroma of second hand smoke may make your resolution fly out of the window!

The more public you make your goals, the more likely you are to succeed. You cannot really say "I will control my weight in 2016," and then gorge on cake and ice cream. Your friends are likely to remind you about your resolution, making failure an embarrassment!

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Occasional relapses are common and to be expected. Instead of obsessing over them, think ahead and avoid unfavourable situations so that relapses are less likely to occur. Try to find something to do immediately (like eating a peppermint) to negate the desire when the craving for a cigarette pops up.

There is nothing as satisfying as rewarding yourself. Don't wait for the end of 2016 to do that. If a fortnight goes by without a relapse, reward yourself with a movie or shopping, not a cigarette or a drink!

When it comes to weight loss, it is important to set realistic and achievable goals. One kilo a month works out to 12 kilos a year. It is an achievable target. Five kilos a month is possible but difficult and more likely to result in failure and depression.

If you need to stop three habits, like smoking, drinking and nail biting, it is better to work on them one at a time. Give yourself four months to rid yourself of each habit. That way, you would have got rid of all three by the end of 2016.

Relapses occur most often in the first two months of attempted change. If you can sustain your resolutions till June, consider the battle won. Statistics show that once half the year is over, the old habits die and the new ones become ingrained. There is a positive lifestyle change.

Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her atyourhealthgm@yahoo.co.in