Thyroid in the balance

A tiny gland nestled in your neck can turn your life upside down if you allow it a free run. Ask Juhi Singh, 29, a homemaker, who spent several months trying to remember basic things like whether she'd brushed her teeth. She had for some time been feeling tired and cold, even when others wanted the fan on. Her nails turned brittle and her hair texture changed. She also gained weight suddenly. A medical test finally showed she had hypothyroidism.

The thyroid gland, which lies below the Adam's apple in the neck region, produces the hormones triiodothyronine (T3) and thyroxine (T4), which regulate metabolism and other bodily functions.

An estimated 4.2 crore Indians are believed to have thyroid disorders and nearly 80 per cent of them are women. An alarmingly high number of them are believed to be undiagnosed.

Underscoring the importance of timely diagnosis, actor and mother-of-two Kajol has been the celebrity face of thyroid tests in India for some time now. “During both my pregnancies I made sure that I got my thyroid tests done… I urge all expectant mothers to set aside time to go for thyroid tests. This is for the safety of their babies. Think thyroid, think life,” is her message.

Thyroid disorder has been found to be the most common endocrinal problem during pregnancy. Untreated, it can increase the risk of miscarriage, stillbirth or even premature birth, as well as high blood pressure in the mother. It may also affect the child's IQ and motor skills.

A three-year study conducted at the All India Institute of Medical Sciences, New Delhi, and King George Medical University, Lucknow, from May 2005 to April 2008 found that of the 633 women tested in their second trimester, 6.47 per cent had hypothyroidism and 4.58 per cent had hyperthyroidism.

Globally, hypothyroidism is nearly 10 times more prevalent than hyperthyroidism and it is mainly caused by a malfunctioning autoimmune system.

Symptoms of hyperthyroidism include weight loss in spite of increased appetite, anxiety and tremors, shortness of breath and irritability.

Role of diet?

Unlike diabetes, the most common endocrinal disorder in India, thyroid disorder has not been directly linked to lifestyle or diet.

Nevertheless, doctors stress on the importance of using iodised salt, especially in iodine-deficient places.

“Patients with thyroid disorders should continue with their regular diet. Generally, no modifications are required. In rare situations, hyperthyroid patients are advised to reduce their iodine content,” advises Dr Manoj Chadha, Consultant Endocrinologist at the Hinduja Hospital, Mumbai.

“Patients with goitre should restrict cabbage and flat beans,” says Dr Dharmalingam, Endocrinologist, M.S. Ramaiah Hospital, Bangalore.

Most thyroid problems result from a malfunctioning autoimmune system wherein antibodies attack the thyroid gland. Thyroid problems caused by iodine deficiency can be prevented, although the medical world does not know yet how to prevent thyroid disease caused by the autoimmunity tripping, says Dr Nikhil Bhagwat, Senior Consultant Endocrinologist, Kambala Hill Hospital, Mumbai.

Tests and medication

Hypothyroidism is a lifelong condition that requires a lifetime of medication. However, the hypothyroidism that occurs during pregnancy or ante-natal or among babies may be temporary, often not requiring more than a year's medication. According to Prof R.V. Jayakumar, President of The Indian Thyroid Society, “It is also important to check thyroid functions in patients with lipid imbalance, as this could be an outcome of thyroid dysfunction.”

Myths vs. facts

Misconception : Hypothyroidism is one of the most common causes of weight gain. Fact: Hypothyroidism is associated with mild weight gain of 1-5 kg on average, due to water retention. The commonest cause of weight gain remains a sedentary lifestyle. “All obese people do not have hypothyroidism, but hypothyroidism may cause obesity,” says Dr S.K. Wangnoo, Senior Consultant Endocrinologist, Apollo Centre for Obesity, Diabetes and Endocrinology. Delhi

Misconception : You cannot become pregnant if you have hypothyroidism. Fact: You can, but consult your doctor before you plan a pregnancy.

Misconception : A mother who has hypothyroidism passes it to the child. Fact: Not necessarily. Consult your doctor about your fears.

Misconception : Medication to correct thyroid imbalance, is addictive. Fact: It is not. Some people can get off medication.

Misconception : Wrong diet with too much salt can upset your thyroid. Fact: No diet has been found to play a significant role in preventing thyroid. “None of the stuff you read about including cabbage and brinjal has been proven to prevent thyroid disorders,” says Dr Ambrish Mithal, Chairman of the Endocrinology Department, Medanta – The Medicity, New Delhi. He does advise going slow on soy and its products.