Underactivity of the thyroid is called hypothyroidism. When the cause lies in the thyroid it is called primary hypothyroidism; when it is due to a lack of thyroid stimulating hormone (TSH) subsequent to pituitary failure, it is called secondary hypothyroidism. Primary hypothyroidism can be clinical or subclinical. Clinical hypothyroidism is when there are definite symptoms with a raised TSH outside the reference range and low serum thyroxine level.Some patients have few if any symptoms but have a serum TSH outside the reference range but have serum thyroxine levels within the reference range. These patients are said to be subclinically hypothyroid.
Causes of Primary Hypothyroidism
Primary hypothyroidism results from low levels of thyroid hormones
in the circulation as a direct result of an underproduction by the thyroid gland itself. The main causes of primary hypothyroidism are given below.
in the circulation as a direct result of an underproduction by the thyroid gland itself. The main causes of primary hypothyroidism are given below.
1. Hashimoto's thyroiditis is the most common cause of hypothyroidism. It is six times more common in women than men and presents with all the symptoms of hypothyroidism. It may be associated with other endocrine organ deficiencies such as diabetes mellitus or Addison's disease (Schmidt's syndrome).The patients have a rubbery feeling thyroid and the thyroid function tests confirm hypothyroidism. The thyroid scan shows an irregular patchy uptake. Thyroid antibodies in the blood confirm the diagnosis. The condition is potentially premalignant and any suspicious nodules should be biopsied to exclude lymphoma. The thyroid swelling usually regresses on thyroid medication and surgery is very rarely indicated. On Hashimoto's thyroiditis such as postpartum thyroiditis,De Quervains thyroiditis and silent thyroiditis can all cause hypothyroidism.
2. Congenital - Poor development of the thyroid, aplasia, hypoplasia or defective synthesis of thyroid hormone-one in 4000 live births.
3. Drug causes:
• Lack of iodine in diet
• Gross excess iodine in diet
• Enzyme defects in the thyroid (dyshormonogenesis)
• Over treatment with antithyroid drugs in thyrotoxicosis
• Lithium treatment in mental disease
• Amiodarone treatment in heart disease
• Thalidomide
• Sunitinib
• Rifampicin
4. Surgical removal of the thyroid.
5. Radioactive iodine treatment.
Causes of Secondary Hypothyroidism
Secondary hypothyroidism results from an underproduction of thyroid hormones from the thyroid caused by deficient TSH stimulation by the pituitary. The main causes are listed below:
1. Destruction of the anterior pituitary gland due to tumor or surgery.
2. Very rarely isolated deficiency in TSH production by the anterior pituitary gland.
3. Peripheral resistance to thyroid hormones.
Symptoms and signs of Hypothyroidism
The symptoms and signs of hypothyroidism include:
Weight gain and change in appearance with a deep voice
Cold intolerance
Goiter
Mental changes - ranging from depression to madness (myxoedema madness)
Coma
Constipation
Menstrual irregularity
Deafness
Poor libido
Hair loss
Coarse dry skin with puffy eyes
Joint pains
Carpal tunnel syndrome
Leg swelling, due to heart failure
Hypothermia in winter
Muscle weakness.
Diagnosis of Hypothyroidism
The problem with making the diagnosis is thinking of it. The symptoms and signs progress slowly over the years. In primary hypothyroidism the TSH is raised with a low T4 and T3. In secondary hypothyroidism the TSH is low with a low T3 and T4.
Treatment of Hypothyroidism
If there is subclinical hypothyroidism and the TSH ranges from 6 to 10 mU/l and thyroxine levels are within the reference range the management is controversial. It is known that such patients with positive antibodies have a conversion rate to overt hypothyroidism of around 5% per year. Those patients with little or no symptoms can be safely watched with a yearly clinical review. If the antibodies are negative the review can be done three yearly.
If there is controversy about the treatment of subclinical hypothyroidism there is uproar about the treatment of the alleged hypothyroid patient with TSH levels well within the reference range.
Myxoedema Coma
Myxoedema coma is the end result of untreated hypothyroidism. The classical features are that of hypothyroidism but with progressive weakness resulting in loss of consciousness. This condition is common in elderly patients and has a number of precipitating factors. The major factors are listed below:
i. Surgery
ii. Infection
iii. Drugs
iv. Myocardial Infarction (Heart Attack)
v. Stroke
vi. Hypothermia
Myxoedema coma is a medical emergency requiring supportive measures and replacement of iodothyronines.
Diet (Foods to avoid in hypothyroidism)
Here are the foods to avoid eating raw if you want to prevent a goiter:
Vegetables
Broccoli, Cabbage
Cassava root, Cauliflower
Kale, Mustard greens
Radishes, Rutabagas, Spinach, Turnips
Fruits
Strawberries, Peaches, Pears
Legumes/seeds/grains
Millet, Soybeans, Peanuts, Pinenuts
OILS
CANOLA
The successful rate in treatment of hypothyroidism by homeopathy is much higher than any other system of medicine. There are many homeopathic medicines for Hypothyroid disorders. As I always says, a homeopathic medicine is prescribed after a detailed case taking. Your complete physical and mental conditions are took in detail on case taking. After analyzing your symptoms a constitutional miasmatic remedy is prescribed by a homeopath. I am listing out some important medicines which can be given for hypothyroid disorders. In chronic cases you will have to continue the medicines as explained by your doctor.
Repertorial approach to hypothyroidism
1. EXTERNAL THROATGOITRE, exophthalmic
exophthalmic : Aur-i., aur., bad., cact., calc., con., crot-h., ferr-i., ferr., Iod., lycps., nat-m., phos., sec., spong.
indurated : Iod., spong.
painful : Iod., plat., spong.
menses, during : Iod.
on swallowing : Spong.
sensitive : Kali-i.
vascular : Apis., calc.
2. EXTERNAL THROATPAIN pressing, sides
Thyroid gland : Bar-c.
3.EXTERNAL THROATPAIN Soreness
Thyroid gland : Ail., kali-i., nicc.
4.EXTERNAL THROATPAIN, stitching
Thyroid gland : Am-c., iod., nat-c., spong., sulph.
5.EXTERNAL THROATSWELLING,
Thyroid gland : Ail., ars., aur-s., carb-an., caust., clem., kali-i., nat-c., nit-ac., ol-j., thuj.
right : Merc.
sensation of : Mag-c.
6. EXTERNAL THROAT GOITRE: Ail., aloe., am-c., ambr., apis., aur-i., aur., bad., bell., brom., calc-f., calc-i., calc-s., Calc., carb-an., carb-s., caust., cist., con., crot-c., ferr-i., fl-ac., form., hep., Iod., kali-c., kali-i., lach., lap-a., lyc., lycps., mag-c., merc-i-f., merc-i-r., nat-c., nat-m., nat-p., nat-s., phos., plat., podo., sep., sil., Spong., stram., tab., tarent., tub., urt-u.
right sided : Iod., lyc., merc-i-f., nat-c., phos., sep., sil., spong.
left : Lach.
constriction : Calc-s., Crot-c., iod., lyc., spong.
7.EXTERNAL THROAT INDURATION of glands : Alumn., am-c., ant-c., bar-c., bar-i., Bar-m., Bell., calc-f., Calc-i., calc-p., Calc., Carb-an., carb-s., carb-v., cist., Con., cupr., dulc., graph., hecla., hep., Iod., kali-i., lyc., merc., nat-c., nat-m., nit-ac., puls., rhus-t., sars., sep., Sil., spong., staph., Sulph., Tub.
like knotted cords : Bar-i., Bar-m., Calc-i., calc., cist., dulc., hecla., hep., iod., lyc., merc., psor., rhus-t., sil., sulph., Tub.
Commonly prescribed medicines are
Iodum, Baryta carbonica, Spongia tosta
Kalium iodatum, Calcarea iodata, Carbo animalis
Conium maculatum, Mercurius iodatus ruber
Lachesis, Ferrum iodatum, Kalium iodatum , Apis mellifica , Tuberculinum, Pulsatilla, Belladonna, Bryonia
Baryta iodata ,Ntrium muriaticum, Phosphorus, Nux vom, Carcinosin
Read detailed explanation of these medicines here
Read detailed explanation of these medicines here
