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Panel Doctor
Gujarat State Electricity Co. Ltd. (GSECL)
Uttar Gujarat Vij Co. Ltd. (UGVCL)
Clinic -1 Clinic – 2
Plot No. 286, F – 1, ‘Akshar Krupa’,
Akshar Complex, Plot No. 598/2,
Opp. Gopal Dairy, Sector – 5 B,
Sector –20, Near KH – 2,
Gandhinagar - 382020 Gandhinagar 382006

6. T3 and T4 regulation
The production of thyroxine and triiodothyronine is regulated by thyroid-stimulating
hormone (TSH), released by the anterior pitutary. The thyroid and thyrotropes form
a negative feedback loop: TSH production is suppressed when the T 4levels are
high. The TSH production itself is
modulated by thyrotropin –releasing
hormones (TRH), which is produced by
the hypothalamus and secreted at an
increased rate in situations such as cold
exposure (to stimulate thermogenesis).
TSH production is blunted
by somatostatin (SRIH), rising levels of
glucocorticoids and sex
hormones (oestrogen and testesterone),
and excessively high blood iodide
concentration.

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Hypothyroidism is a condition in which body doesn't
have sufficient thyroid hormone levels in the blood
stream. Since the body's metabolism is managed by
the thyroid hormones,
persons suffering with
hypothyroidism will have
a slow metabolism.

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Causes www.phcindia.org, contact@phcindia.org
The most common cause of hypothyroidism is the chronic autoimmune
thyroiditis (Hashimoto's thyroiditis), a form of thyroid inflammation caused
by damage to the thyroid tissue. Damage occurs because immune cells which
usually fight off infection and colds attack the body's own thyroid tissue
instead.
• Autoimmune Diseases - You may be at risk for thyroiditis if you have other
autoimmune diseases. Some examples of these autoimmune diseases include
rheumatoid arthritis (the immune cells attack the joints), vitiligo (patches of
skin lose their color and become white), Addison's disease (a disorder of the
adrenal glands), and diabetes (the immune cells attack the pancreas which
produces insulin).

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• Age - Hypothyroidism becomes increasingly common as we age, particularly
in women. If you are older your thyroid may not provide enough thyroid
hormones, thus resulting in hypothyroidism.
• Surgery - Removal of a portion or all of the thyroid gland is another cause. If
the total mass of thyroid producing cells left within the body are not enough to
meet the needs of the body, the patient will develop hypothyroidism.
• Radioactive iodine - If a patient has undergone radioactive iodine therapy to
kill a portion of the thyroid, either to prevent goiters from growing larger, or to
prevent the production of too much of the hormone (Hyperthyroidism), too
many cells can be damaged and the patient could become hypothyroid in
couple of years following the therapy.

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•Secondary Hypothyroidism - There are some rare causes of hypothyroidism
related to brain diseases, also called secondary hypothyroidism. Disorders of
the pituitary gland or hypothalamus portions of the brain may cause thyroid
hormone deficiency in addition to other hormonal imbalances.

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Symptoms
The symptoms of hypothyroidism mainly depend on the severity of the
hormone deficiency and how long the decrease has been present. For most
patients, the symptoms are mild and can often be confused with other
problems. The symptoms may include the following:
•Weakness •Dry, rough pale skin •Decreased concentration
•Hair loss •Coarse dry hair •Constipation
•Fatigue •Cold intolerance •Irritability
•Weight gain •Depression •Muscle cramps
•Muscle aches •Abnormal menstrual •Slowed heart rate
•Memory loss cycle

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Stress and hypothyroidism
Stress is known to be a significant contributor to thyroid dysfunction; this can be
environmental stress as well as lesser-considered homeostatic stress such as fluctuating
blood sugar levels and immune problems.Stress's effect on thyroid function can be
indirect, through its effects on blood sugar levels (dysglycemia), but it can also have
more direct effects. Stress may cause hypothyroidism or reduced thyroid functioning by
disrupting the HPA axis which down-regulates thyroid function, reducing the
conversion of T4 to T3, weakening the immune system thus promoting
autoimmunity , causing thyroid hormone resistance, and resulting in hormonal
imbalances. Indeed, excess estrogen in the blood caused by chronic cortisol elevations
can result in hypothyroid symptoms by decreasing levels of active T3. Stress also affects
thyroid functioning through the sympathetic nervous system. A 1994 study of refugees
from East Germany who experienced chronic stress found them to have a very high rate
of hypothyroidism or subclinical hypothyroidism, although not all refugees displayed
clinical or behavioral symptoms associated with this reduced thyroid
unctioning. TSH levels correlate positively with physiological stress.

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Diagnosis
The only validated test to diagnose primary hypothyroidism, is to measure thyroid-
stimulating hormone (TSH) and free thyroxine (T4). However, these levels can be
affected by non-thyroidal illnesses.
High levels of TSH indicate that the thyroid is not producing sufficient levels of thyroid
hormone (mainly as thyroxin (T4) and smaller amounts of triiodothyronine (T3)).
However, measuring just TSH fails to diagnose secondary and tertiary hypothyroidism,
thus leading to the following suggested blood testing if the TSH is normal and
hypothyroidism is still suspected:
•Free triiodothyronine (fT3)
•Free thyroxine (fT4)
•Total T3
•Total T4

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Treatment
Treatment in conventional medicine advocates artificial supplementation of the
deficient thyroid hormone. This triggers a negative feedback, causing further under
activity of the thyroid gland, making the body dependent on this external source for life.
.
Homeopathic treatment makes more sense because it treats the root cause of the
problem, subtly by stimulating the patient’s thyroid to function optimally.
The thyroid gland, an endocrine gland in the neck, is known to get influenced by
psychological stress. Hypothyroidism could be due to radioactive destruction or surgical
removal of thyroid tissue in order to treat hyperthyroidism, autoimmune diseases, or
certain medications like lithium. Congenital hypothyroidism in newborns is usually seen
in cases where hypothyroidism in the mother during pregnancy went undetected. Such
infants run the risk of developing mental retardation.
There are excellent remedies in Homeopathy for the patients suffering from
hypothyroidism symptoms. The homeopathic remedies are prepared from a wide range
of substances such as the vegetables, herbs, minerals, chemicals and animal products in
extremely minute doses. The homeopathic remedy selected will be based on all the

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symptoms of the patient including physical, mental and emotional states, and family
history of the patient. Homeopathic remedies stimulate the body's own immune system
and offer a long lasting cure rather than giving temporary relief.
Homeopathic Treatment requires strict individualization. Please do not take any
medicine without consulting your physician/homeopath.
The treatment of Hypothyroidism should be strictly based on the totality of
symptoms and constitution. The totality in these cases guides for the miasmatic
consideration which in this case generally is Sycotic and the constitution is Hydro-
genoid. A remedy base on totality may be able to cure this problem on a long term basis.
Some important medicines for the purpose are as follows:
Calcarea Carb, Thuja, Nat. Sulph, Graphites, Ammon Carb, Thyrodinum, Iodium, Nux
Mosc, Lycopodium, Pulsatilla etc.

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Diet and Nutrition in Hypothyroidism (Underactive Thyroid or Impaired
Production of Thyroid Hormone)
Avoid peaches, cabbage, soybeans, spinach, peanuts, and radishes, as these
foods can interfere with the manufacture of thyroid hormones.
Supplements of vitamin c, vitamin E, riboflavin (vitamin B2), zinc and niacin
(vitamin B3), pyridoxine (vitamin B6), and tyrosine might help boost thyroid
production.

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CLINICAL DIFFERENCES BETWEEN HYPOTHYROIDISM AND
HYPERTHYROIDISM
SYMPTOMS HYPOTHYROIDISM HYPERTHYROIDISM
1. Intolerance of cold 1. Intolerance of heat
2. Weight gain 2. Weight loss despite good
3. Sweating scanty appetite
General
4. Somnolence (prolonged 3. Excessive sweating
drowsiness 4. Insomnia
Loss of Memory and Anxiety, nervousness,
Mental concentration irritability
Deafness may be present Not present
Ears
CVS Chest pain on effort Dyspnoea and palpitation

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SYMPTOMS HYPOTHYROIDISM HYPERTHYROIDISM
Female: Menorrhagia and Female: usually
polymenorrhoea oligomenorrhoea
Reproductive System Galactorrhea
Male: Complete loss of libido Male: Impotence
Slowness of thought and Restless and irritable, Fidgety ,
Mind sluggish response to questions can not sit still
Puffy, dull, expressionless, Hollowed cheeks and temporal
Face thickening of facial features fossae
1. Bradycardia 1. Tachycardia
CVS 2. Pulse pressure normal 2. Wide pulse pressure
Neurological Tendon jerks; hung-up reflex Brisk tendon jerk, fine tremors

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SYMPTOMS HYPOTHYROIDISM HYPERTHYROIDISM
Periorbital oedema, sometimes Exophthalmos
with bag like swelling under Lid retraction
the eyes Lid lag
Lagophthalmos
Eyes
Chemosis; conjunctigal
oedema
Ptosis and diplopia
Voice Husky with a changed timber No change
1. Appetite: Anorexia 1. Appetite: Extremely god
G I System 2. Thirst: Not much 2. Thirst: excessive
3. Bowels: Constipated 3. Bowels: Diarrhoea

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SYMPTOMS HYPOTHYROIDISM HYPERTHYROIDISM
Dry and cool, myxoedema Warm and moist with ‘velvety’
Skin feel
Respiratory Obstructive sleep apnea ------
Serum T3, T4 Reduced Raised
Raised in primary Low
Hypothyroidism
Serum TSH Normal or low in Sec.
Hypothyroidism