Patients’ stories
I recently met an author in the clinic, who complained of complete loss of creativity and the ability to produce good work. He suffered from writer’s block. He was deeply upset. He repeatedly used the words ‘this is not me’.
A female artist told me that her ability to draw has been severely affected in the last few months.
Another lady complained of significant weight gain over the last one year, despite a good dietary behaviour and regular exercise. She only had basic blood tests done and was made to feel that this was her own mistake, and that a further correction in lifestyle is required.
An elderly lady complained about dizziness and recurrent falls with loss of consciousness.
A young man complained of extreme lethargy after half a day’s work. He said that despite sleeping for 8 to 10 hours a day, he “wakes up tired”.
All these people had one thing in common: an under active thyroid.
What are thyroid hormones?
The thyroid is a gland located in the lower part of the neck. It produces two hormones, which are T4 and T3. These hormones control metabolism in nearly all major organs of the body. It is vital that secretion of hormones is at a normal level. Any imbalance of hormones whether temporary or permanent, can affect the function of organs, and present with wide ranging symptoms. Thyroid hormone receptors are present in the heart, brain, muscles, gastrointestinal tract, etc.
What makes the thyroid gland underactive?
Hypothyroidism is a state where thyroid gland is producing reduce amount of thyroxine (T4). This can be due to a temporary disorder like a post inflammatory condition, a long term condition like iodine deficiency, or the body’s immune system reacting with the thyroid gland.
Role of Iodine.
Iodine is an essential part of the daily dietary intake. It is recommended to take 150mcg of iodine per day. In Pregnancy the requirement increases to 220mcg per day. Good sources of iodine include fish, shellfish, milk, yogurt, cheese, chicken, beef liver, iodized table salt and fortified infant milk formula.
What happens when thyroid gland doesn’t produce enough thyroid hormones?
Symptoms related to an under active thyroid are generalized and variable. This may result in a delay in the patient seeking advice or the doctor doing the correct blood test. It is important to diagnose this condition early as symptoms can be debilitating. The thyroid gland may enlarge which is visible as a swelling in the lower part of the neck. This not just cosmetically unacceptable but may result in obstruction of the airway and obstructive sleep apnea.
Treatment of Hypothyroidism:
Symptoms can be completely reversed with replacement of hormones and necessary dietary changes. Most patients require Thyroxine(T4) while a minority may require Tri-iodothyronine (T3) as well. Both these hormones are available in the form of a tablet. An enlarged thyroid compromising the airway necessitates surgery.
Patients taking thyroxine (T4) or (T3) need regular blood tests every few months to ensure
levels are in normal range. In the first trimester of pregnancy the dose of thyroxine increases to
cater for fetal requirement.
People can live a completely healthy and normal life with the treatment of Hypothyroidism.
Dr Oraizi Jafery
Consultant in Endocrine, Diabetes, Lipids,
Obesity and Medical Specialist.
Bedfordshire, United Kingdom
