Thyroid disorders are on the rise as reported by various surveys and research studies. There are various myths and concerns related to thyroid disorders which must be dealt with judiciously. On this World Thyroid Day, Vivid Homeopathy presents its latest article on Thyroid Disorders under PHHA series of articles.
Thyroid Disorders and Role of Homeopathy: Facts and General Considerations
Issued in Public Interest by
World Thyroid Day 2018
Public Health and Homeopathy Awareness ©
www.vividhomeopathy.com | firstname.lastname@example.org | +91 9811425214
Dr Saurav Arora
BHMS (Gold Medalist), Founder: Vivid Homeopathy
Dr Saurav Arora has a rich experience of more than 11 years being a medical homeopath and independent researcher. Dr Arora has served various key positions in Ministry of AYUSH, Govt. of India; Ministry of Defence, India; Govt. of NCT of Delhi etc. Dr Arora’s profile and achievements may be seen at www.sauravarora.com
Dr Bharti Arora
MD (Hom.), BHMS (Silver Medalist), Co-Founder: Vivid Homeopathy
Dr Bharti Arora is a medical homeopath committed to promoting homeopathy for the benefit of individual and health care system. Dr Bharti has been awarded Silver medal for meritorious position in BHMS. For more info visit www.arorasclinic.com/bhartiarora/
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In This Issue
- General Considerations
- Thyroid Disorders
- How Thyroid Disorders Develop or Progress
- Available Tests to Diagnose Hypothyroidism
- How to Diagnose?
- Why Thyroid Disorders are Clinically Relevant
- What is Normal TSH
- Common Symptomatology
- Common Clinical Queries and Misconceptions
- Practical Tips, Good Practices and Dos
- Homeopathic Approach
- Therapeutic Management
- Some of the Commonly Used Medicines
- Ethical Concerns
- Optimal thyroid function is essential for normal growth and development.
- The thyroid regulates the metabolism of our body.
- It influences almost every tissue/part of the body.
- Its dysfunction leads to discomfort, disease(s), decrease quality of life, or even death.
Thyroid disorders can be best understood when we know “thyroid gland” functions. There may be
- Hypo – or less functioning of the thyroid gland – represented by low T3, T4 values and high TSH – this is called Hypothyroidism.
- Hyper – or more functioning of the thyroid gland – represented by high T3, T4 values and low TSH – this is called Hyperthyroidism.
- There may be physio/pathological/structural changes in gland leading to conditions like Goitre, Nodules, Carcinoma thyroid etc.
In addition, the clinical presentation of each condition can be presented in more than one form.
How Thyroid Disorders Develop or Progress
There are several theories and phenomenon which are responsible for the development and progression of the thyroid disorders. In the simpler form we can understand it like this:
Available Tests to Diagnose Hypothyroidism
- Thyroid Stimulating Hormone (TSH)
- T4 (total, free) -Protein-Bound and Free
- T3 (total, free) -Protein-Bound and Free
- Anti Thyroperoxidase Antibody (anti-TPO ab)
- Ultrasound of Thyroid Gland
- Technetium scan/Radio Active Iodine Uptake
How to Diagnose?
The thyroid disorders can be easily diagnosed as follows:
FT3: Free T3; FT4: Free T4; aTPOab: anti-TPO antibodies
Why Thyroid Disorders are Clinically Relevant
- There may be no or minimal symptoms – thus there is a challenge in diagnosis.
- The conditions like subclinical hypothyroidism, autoimmune thyroiditis is not yet fully understood.
- The concept of personalized remedy is emerging in other fields also.
What is Normal TSH
This is usually the most common question encountered in clinical practice. Is it
- 2-4μIU/ml or something else?
Various authorities have proposed “normal” ranges for serum TSH. In an epidemiological study done in an Indian population, it was found that mean TSH value in the reference population was 2.2 ±0.9 mIU/L (n=1916 healthy volunteers).
The symptomatology depends upon the condition with which a patient is suffering. For example, in Hypothyroidism the common symptoms may be:
- Weight gain
- Cold intolerance
- Coarse hair and skin
- Brittle nails
- Puffy face
- Non-pitting edema
- Enlargement of tongue
- Periorbital edema
- Decreased exercise capacity
- Menstrual irregularities
- Dementia etc.
In hyperthyroidism, due to increased metabolism, there may be:
- Weight loss
- Excess sweating and hunger
- Heat intolerance
- Mood swings, nervousness, or panic attack
- Fast heart rate, or palpitations
- Irregular menstruation
- Protrusion of eyes or puffy eyes
- Hair fall
- Muscle weakness
While in cases of goitre or nodule there may be no or minimal symptoms.
Common Clinical Queries and Misconceptions
Q: The report shows normal T3 T4, but TSH is in hundreds.
A: Counsel the patient that TSH is ultrasensitive; therefore, it must be repeated before any conclusion is made!
Q: What if T4 and TSH both are low?
A: The case may be of Central Hypothyroidism.
Q: What would be the effect of family history on thyroid status of the child?
A: Children who have a positive history of thyroid disorders must be screened regularly, as they have increased chances of developing the disease.
Q: Should anti-TPO antibodies be repeated too often?
A: They are more of prognostic value than diagnostic. It is observed that antibody positive population has more chances to go into hypothyroidism. In such cases, TSH still remains the best screening and follow up test.
Q: What is the role of T3 and T4?
A: T3 is biologically active and T4 is a biological stable hormone. In the body, T4 is converted to T3 and used up by cells.
Q: What is LT4?
A: In the conventional system of medicine the deficiency of T4 is replaced by Levo-Thyroxine (LT4) which commonly comes with many brand names – Eltroxin, Thyrox, Thyroff, Synthyroid etc.
Q: Can I change my LT4 dosage on my own?
A: No, the dosage of LT4 depends upon many factors, and not only body weight or TSH levels. Therefore, to regulate the dosage of LT4 you need to visit your treating physician.
Q: Can I taper off the medicine?
A: Yes in many cases the medicines can be tapered off, but that doesn’t happen in every case. The medicines must be tapered off gradually in consultation with your treating physician. During this process, the health is assessed from the mental, physical and social point of view.
Practical Tips and Good Practices
- Whenever a patient is suspected of a thyroid problem – TSH and FT4 may be done immediately followed by other necessary tests.
- If you are on treatment you need to regularly follow up your treating physician. The follow up depends upon symptoms, history and severity and may vary from every 6 –8 weeks to every 3 – 6 months. The routine tests while at follow up are TSH and FT4 or as advised by your physician.
- The assessment is divided into the symptomatic and biochemical assessment. Both are necessary and important.
- Co-morbid factors ie other diseases and symptoms are not be ignored at any stage
- When there are raised anti-TPO antibodies the case is usually assessed with FT4, TSH and if possible USG neck.
- At no point in time, antiTPOab must be misinterpreted at own level.
- The antiTPOab may be raised in Hashimoto thyroiditis, Graves, and even in acute fever associated with thyroid malfunction.
- Acute illness alone may alter thyroid function tests without thyroid disease, so be aware and repeat the thyroid profile after few weeks of normalcy.
- When a patient comes with Goiter it must be assessed for physiological causes also such as during puberty and pregnancy.
- Goitre must always be assessed with TSH and USG of Thyroid to rule out any nodule.
The management goal for thyroid disorders depends upon the correct diagnosis, however, broadly, they can be summarized as:
Educate: The thyroid education is of vital importance. Many a time people are treated for the diagnosis they never had. Yes, it is true. In the majority of the cases, due to lack of knowledge and misdiagnosis, the treatment modalities tend to fail.
Treat – Manage: Every thyroid disorder can’t be cured but every thyroid disorder can be managed. The treat – manage balance must be understood by the physician as well as patients. Patients must be educated and counselled about the possibility of being treated and managed.
The treatment must aim at holistic normalcy and not only “good” reports.
Screen: The most important aspect always remains alertness. The more alert an individual is, easier things can go. Early detected thyroid disorders tend to manage early then untreated and complex, chronic cases. Screening must be done whenever there is any suspicion or indication. Nowadays thyroid screening tests such as TSH are within reach of any strata of the patient.
Follow up: Follow up under guidance is a must!
Don’t Ignore: A very important point is the alertness for one’s own health. Thyroid disorders are not stand alone diseases in the body. Sometimes there is an association with other diseases or co-morbid symptoms are a matter of concern. Therefore, every deviation from health must be reported to your treated physician.
“Access to a good healthcare is a fundamental right of everyone.”
- Understanding the pathophysiology is the key point. We must be able to differentiate what is “treatable”, “manageable”, or “curable”.
- Assess the thyroid function status, health as well as other risk factors like dyslipidemia, cardiovascular diseases, infertility, pregnancy, old age etc.
- As a thumb rule, believe in Individualized Medicine and regular follow up of the patient.
- The aim of treatment of thyroid disorders is not only the biochemical normalcy, but holistic improvement as a whole. As thyroid hormones affect almost every part of the body, therefore, the improvement should aim at the person as a whole.
Time and again there is a debate between individualized and specific medications in thyroid disorders! Specifics too have a role to play especially when homeopathy is used as add-on or cases where we taper off the conventional medicines.
Some of the Commonly Used Medicines
- Calcarea carb
- Natrum mur
- Baryta carb
- Spongia tosta
Treatment of Thyroid disorders is a matter of special concern in:
- With other co-morbid incurable diseases such as uncontrolled hypertension, heart diseases etc.
This article does not intend to replace the in-person consultation. The facts are for general purpose and public awareness only, and must not be taken as Medical Consultation in any form. For a consultation, treatment and specific queries, you need to contact your healthcare professional.
Not for Medico-legal purposes.
© Vivid Homeopathy & Arora’s Homeopathic Clinic 2018.
For reprint and collaborations please contact Dr Saurav Arora at email@example.com