Monday , 23 July 2018

Teen Thyroid: Hidden problem

Dr Kedar Padte

Anzer Zenner was 14-years-old when he reached a height of 5 feet 8 inches. He had 6 packs, great looks and complexion and was a scholar in the class. He won a few medals in academics and sports.

At 16 Anzer was 6 feet 2 and was the envy of his class. However in the next six months he began gaining weight. His marks were not up to expectations and the decline in the sports was obvious. The principal had a special meeting to counsel Anzer, who he thought was distracted.

‘He is eating too much’, ‘he has lost interest’, ‘it must be the crush’ were some of the comments that came his way or rather behind his back.

Little did anyone suspect that Anzer had developed an endocrine disorder called hypothyroidism.

For various reasons hypothyroidism has become an endemic with around 11 per cent of the Indian population afflicted by it.

In the general Indian population almost 7 per cent girls and 4 to 5 per cent of boys suffer from hypothyroidism. The disorder starts insidiously and causes little clinical changes for years. In many cases hypothyroidism is subclinical and is noted only when the TSH (thyroid stimulating hormone) levels are noted to be high in the blood test.

The thyroid gland is a butterfly-shaped endocrine gland situated in the neck, just anterior to the laryngotracheal area above the sternal notch.

The hypothalamus is situated just below the human brain and is also the master of the endocrine orchestra. It releases a tropic hormone called thyrotropin releasing hormone. This in turn acts on the anterior pituitary gland to release TSH which travels through blood to the thyroid gland to produce thyroxine.

Thyroxine is like the fire of the body that is needed for all its activities. It’s the human body’s fuel.

Causes of hypothyroidism

 Iodine deficiency in the diet is the common cause of endemic hypothyroidism.

Autoimmune condition called Hashimoto thyroiditis causes hypothyroidism as well other condition such as hypopituitarism, radioactive iodine and thyroidectomy. Surgery on anterior pituitary may also cause hypothyroidism.

Signs and symtoms

 Fatigue, coarse dry skin, feeling cold, cool extremities constipation, hairloss and poor concentration and memory.

 A peculiar swelling sets into the body (myxedema due to mucopolysaccharide deposit). This can result in swelling of limbs and hoarse voice. There can also be a swelling of the thyroid gland (goiter) as the gland is trying to produce more thyroxine.

Reduced sexual function

 In males hypothyroidism can result in loss of libido oligozoospermia (low sperm count) and male infertility.

 In females there can be oligomenorrhea, amenorrhea, polymenorrhea or a variety of menstrual dysfunctions. Hypothyroidism can also cause lack of libido and frigidity. It also causes anovulation resulting in female infertility.

 Tests for hypothyroidism such as free levels of T3, T4 hormone and TSH are diagnostic.

 A proper evaluation by an expert endocrinologist and appropriate treatment is essential.

 Treatment: Proper diet and replacement of iodine in the diet results in marked improvement.

 Oral levothyroxine is available in the strength of 12.5 micrograms to 150 micrograms. If administered in appropriate doses it will control the condition rapidly.

 The thyroxine dose is always given on an empty stomach – before breakfast and in the morning to mimic the circadian rhythm.

 Six months into the treatment Anzer Zenner was back to normal. His marks were on the board and he was athletic again.

 Ensure that this subtle hypo is not the cause of your hypo function in life. Rise and shine friends.

(Columnist is a well-known gynaecologist practising in Panaji. Send in your queries to


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