By Zeenat Farooq
Hypothyroidism, also called as underactive thyroid describes an endocrine disorder in which the thyroid gland which lies in throat remains underactive, and tends to produce lesser quantity of the hormone: Thyroxine (T4). The main function of the Thyroxine hormone remains that it controls how the body regulates its energy needs by controlling metabolism and production of heat by the body to maintain a constant internal body temperature.
The secretion of Thyroxine by thyroid gland remains under the control of another hormone: TSH which is released by the pituitary gland in the brain. Two of the main types of Hypothyroidism are sub-clinical, Hypothyroidism in which TSH levels are elevated to keep Thyroxine levels normal, and overt Hypothyroidism in which Thyroxine levels actually drop down below normal.
Sub-Types of Hypothyroidism
Hypothyroidism is a multi-faceted disorder which can occur because of many reasons.
Some of the most common types of Hypothyroidism include:
Hypothyroidism can occur right from birth in some individuals, in which case it is called as Congenital Hypothyroidism. It can arise in a person due to deficiency of iodine.
Iodine: a mineral nutrient plays an important role in proper functioning and formation of Thyroxine. Hence a deficiency of iodine leads to Thyroxine deficiency.
It can arise as an auto-immune disorder in which the body destroys its own thyroid gland by producing antibodies against it. This condition is quite similar to Type-I Diabetes.
It can arise as a result of some medications which interfere with thyroid function.
It can arise as a result of radiation treatment in case of cancer patients which need radiation therapy.
It can arise in expectant women in conjunction with gestational Diabetes.
It can also arise in some women after child birth.
Major complications associated with Hypothyroidism
Hypothyroidism is a very complicated medical condition which can alter many processes within the body. Some of the worst manifestations of Hypothyroidism include:
If it occurs in children at a young age, it leads to decrease in mental ability, poor mental development and hoarseness in voice.
It usually occurs in young females, with an incidence rate of around 23% in the age group of 18-50 years.
It can result in unexplained weight loss.
It can lead to the swelling of thyroid gland in case of overt Hypothyroidism. This condition is known as Goiter.
It leads to feeling of chills and hypothermia which can be fatal in extreme cases.
In case of young females, it leads to alterations in menstrual cycle, drying of skin, weight gain and changes in voice, increased chances of infertility.
In case of expectant women, it leads to increased changes of spontaneous abortions, pre mature child birth and poorly developed brain in the infant because the developing infant receives Thyroxine from the mother during the first trimester of pregnancy and if the mother is deficient in Thyroxine, the infant also faces the same deficiency.
In case of older people, it can lead to increased complications as already the body undergoes various changes in processes, like metabolism and insufficiency of Thyroxine further complicates the situation.
It can lead to confusion, slow responsiveness, drowsiness and below normal IQ.
Hypothyroidism in Valley
Sub-clinical Hypothyroidism is a common endocrine problem in Kashmir valley especially in young women. In fact, it is the second most commonly found endocrine disorder in valley after Type-II Diabetes. There are various reasons which have led to increased incidences of this disorder in the valley. One of the most important reasons, in spite of the consumption of iodized salt, is the improper cooking and food preservation methods adopted by our local population which leads to destruction of iodine obtained from iodized salt and other iodine rich foods. As already stated, some medications also increase chances of developing this disorder. Easy availability of medicines and indiscriminate drug abuse is another major reason of a very high incidence of Hypothyroidism in Kashmir valley. A number of population based studies conducted in Kashmir have reported that the incidence of Sub-Clinical Hypothyroidism in the valley can be as high as 22%.
Considering the potential danger to progression to overt disease state, and also sub-clinical Hypothyroidism may itself be associated with serious complications, there needs to be proper guidelines to recommend the screening and treatment of this disorder. Studies have reported psychiatric problems such as: panic disorder, anxiety and depression disorders to be more common in Sub Clinical Hypothyroidism patients. Therefore, community level awareness programs need to be organized wherein people of the valley could be motivated to take salt iodized salt, have diets rich in iodine and adopt proper cooking and preservation techniques to ensure proper thyroid gland functioning. Every individual, especially young females in the reproductive age group should get themselves screened for serum TSH levels, at least once in every six months. Also, drug abuse should be eradicated on a massive scale, both at personal level and also at the state level to prevent some of the incidences of not only Hypothyroidism but also a wide array of other diseases and disorders.
(Author is a Research Scholar at Department of Biotechnology, University of Kashmir.)