THYROID

One out of every hundred women and one tenth of this number in men will be suffering from thyroid hormone deficiency (hypothyroidism) and its implications are therefore considerable. Symptoms of lethargy, weight gain, menstrual irregularity, infertility, impotency in men, depression, loss of productivity in work, skin symptoms, abdominal bloating sensation, facial puffiness, etc either alone or in combination can indicate onset of thyroid hormone deficiency in adults. In children, the sole symptom may be failure to gain height or failure to mature as an adult (failure of breast development, axillary & pubic hair growth, failure to menstruate in girls, & in boys, absence of masculine features developing at expected age) with or without weight gain and they may be underachievers in school.


This can be easily managed but requires attention to adequate replacement as both over and under treatment can cause irreversible damage. Ten times this number of hypothyroid patients have, what we now realize as 'mild thyroid failure' and this entity does not mandate therapy in all individuals. With a number of newer modalities of investigation, we can now safely say which form of thyroid hormone deficiency can be self-reverting and what form will require life long treatment.

Hyperthyroidism also has an alarming prevalence of one in every hundred adult women and one tenth in men.Hyperthyroidism, which has a number of causes, some which revert within a short time, can also be easily managed with modern strategies.

However one common form of hyperthyroidism has associated eye changes, which need not parallel the thyroid disease course, and only a watchful specialist can predict the occurrence of disabling eye disease and hence preserve useful vision.

Here again, it is important to detect disease early, as symptoms of weight loss, frequent stools, feverishness, anxiety, palpitations, breathlessness, weakness, menstrual irregularity, etc if not paid attention to, just because there is no neck swelling can lead to considerable organ complications which less often can threaten survival. It is essential to emphasize that thyroid disease does not mean neck swelling. Nearly half or more of patients with thyroid disorder I will have no swelling.

Similarly, in case of a swelling it is not necessary to operate always, as medical therapy can take care of the size in several instances.