When Amita
Thakkar, 43, a vivacious travel writer, began feeling
uncharacteristically depressed and fatigued all the time, she was
baffled. Another cause for worry was the recent weight gain - despite
being a careful eater - and the unusually heavy periods. When a battery
of pathological tests couldn't nail her problem, Thakkar was chivvied to
a physician who diagnosed her condition as hypothyroidism.
Over 40 million Indians - 60 per cent of them women - suffer from
thyroid-related disorders, according to the Cochin-based Indian Thyroid
Society (ITS). Last month, ITS observed the Think Thyroid month and
launched a pan-India mass awareness campaign to sensitize people about
the largely under-diagnosed thyroid disorders.
"What is most alarming about thyroid disorders in India," says Dr Vinay
Jha, endocrinologist and consultant at Max Healthcare, New Delhi, "is
that they are usually diagnosed very late, if at all. Awareness is very
low and often the symptoms are confused with Chronic Fatigue Syndrome
(CFS) or menopause. In fact, most patients usually come to us after
their disorders have reached an advanced stage."
According to the specialist, women are four times more likely to be
afflicted with thyroid disorders than are men. He advises women to go in
for a thyroid scan every few years after they hit 35. A simple blood
test can measure the Thyroid Stimulating Hormone (TSH). When the thyroid
is under-active, TSH registers low levels and if the gland is
overactive, it records a high. "The optimal level of this hormone is
crucial in maintaining our metabolic rate and determining growth in
youngsters," says Dr Jha.
While the small, butterfly-shaped endocrine gland's primary function is
to convert iodine (which we take in through food) into three thyroid
hormones - thyroxine (T4), triiodothyronine (T3), and calcitonin that
affect the general metabolism; it also regulates body heat and bone
growth. The pituitary gland (located in the brain) and thyroid work in
synergy. If the thyroid emits low levels of the hormones, the pituitary
gland starts secreting more thyroid-stimulating hormones (TSH) in order
to stimulate it.
When a thyroid disorder develops, the body's capacity to use up energy
decelerates or accelerates remarkably. It also increases risk of
degenerative diseases such as heart disease, cancer and arthritis.
A sluggish thyroid gland causes hypothyroidism, which leads to weight
gain, fatigue and hypersensitivity to low temperatures. According to
experts, approximately one in 50 women and one in 1,000 men are likely
to develop symptoms of hypothyroidism at some stage in their lives.
A hyperactive thyroid, on the other hand, manufactures an overdose of
thyroid hormones. The condition is called hyperthyroidism and it
triggers weight loss, a faster heart rate and sensitivity to heat.
"Thyroid disorders," says Delhi-based general physician Dr Satya
Prakash, "could be due to genes or external factors like lack of
iodine."
Because thyroid hormones play a catalytic role in the body's development
process, a malfunction can severely impact a child or teen's growth.
Hypothyroidism patients grow slowly, experience slow sexual development,
muscle weakness, dry skin, hair loss, poor memory and short attention
spans. In women, this condition can alter the onset of periods. Girls
with thyroid problems experience an erratic or decreased/increased
menstrual flow.
Elaborates Dr Anjila Aneja, gynecologist and coordinator, Max Super
Specialty Hospital, New Delhi: "It can play havoc with a woman's puberty
and menstruation. Abnormally high or low levels of thyroid hormone can
cause very light/very heavy or irregular menstrual periods. They can
even lead to amenorrhea (absence of menstrual periods). An over- or
under-active thyroid can prevent a woman from ovulating. Also, the
ovaries are at a heightened risk for cyst development if the woman has
an under-active thyroid." Thyroid disorders can also cause premature
menopause; while during pregnancy they can harm the fetus and lead to
postpartum thyroiditis.
A major problem with thyroid disorders is that they can't be easily
diagnosed, as they are often missed in tests. In case of mild
hypothyroidism, the patient may not see the symptoms coming - simply
because the condition exhibits no symptoms at all - before the ailment
advances. According to Dr Prakash, hyperthyroidism can cause
restlessness, irritability, increased perspiration, fatigue, insomnia,
irregular menstrual periods and muscle weakness. Sometimes, the tissues
around the eyes swell up and appear to bulge out, leading to `toad
eyes'.
Very often, symptoms of hyperthyroidism - such as lack of menstruation,
hot flashes, insomnia and mood swings - are confused with the onset of
menopause.
Graves' disease, an autoimmune thyroid disorder, is the most common
cause of hyperthyroidism. Under this condition, the immune system
produces abnormal antibodies, which prompt the thyroid gland to
manufacture extra thyroid hormones. Eventually, the gland enlarges,
triggering goiter. (Goiter generally refers to the enlargement of the
thyroid gland. It is usually marked by uniform swelling in the neck in
front of windpipe. Women are more prone to this disease.) Graves'
disease is common among women, teens and middle-aged adults.
While thyroid disorders are tricky to diagnose, the good news is that if
detected in time, they are usually easy to treat and cure. Says Dr Jha,
"Treatment of hyperthyroidism involves anti-thyroid drugs, radioactive
iodine and in rare cases, surgery. Hypothyroidism, on the contrary,
usually requires replacement of the thyroid hormone by oral pills
customized to produce the required optimal thyroid hormone levels."
With the exception of eating a balanced diet, there's not much that can
be done to prevent thyroid disorders. That's why it is important to get
an annual check-up that includes a thyroid-stimulating hormone test, and
maintain an appropriate programme of nutrition and exercise.
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Over 40 million Indians - 60 per cent of them women - suffer from
thyroid-related disorders, according to the Cochin-based Indian Thyroid
Society (ITS). Last month, ITS observed the Think Thyroid month and
launched a pan-India mass awareness campaign to sensitize people about
the largely under-diagnosed thyroid disorders.