Update of hypothyroidism and its management in Unani medicine

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Md. Anzar Alam ◽  
Mohd Aleemuddin Quamri ◽  
Ghulamuddin Sofi ◽  
Shabnam Ansari
Keyword(s):  
Thyroid Hormone ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Clinical History ◽  
Developed Countries ◽  
Modern Medicine ◽  
Thyroid Stimulating Hormone ◽  
Clinical Syndrome ◽  
Hormone Deficiency ◽  
Unani Medicine

AbstractHypothyroidism is a clinical syndrome caused by thyroid hormone deficiency due to reduced production, deranged distribution, or lack of effects of thyroid hormone. The prevalence of hypothyroidism in developed countries is around 4–5%, whereas it is about 11% in India, only 2% in the UK, and 4·6% in the USA. It is more common in women than in men. Hypothyroidism has multiple etiologies and manifestations. The most common clinical manifestations are weight gain, loss of hair, cold intolerance, lethargy, constipation, dry skin, and change in voice. The signs and symptoms of hypothyroidism differ with age, gender, severity of condition, and some other factors. The diagnosis is based on clinical history, physical examination and serum level of FT3, FT4, and thyroid-stimulating hormone, imaging studies, procedures, and histological findings. The treatment of choice for hypothyroidism is levothyroxine, however; in this review article, we have discussed the epidemiology, etiology, clinical sign and symptoms, diagnosis, complications, and management of hypothyroidism in modern medicine and a comparative treatment by the Unani system of medicine (USM). In the USM, the main emphasis of the principle of treatment (Usool-e-Ilaj) is to correct the abnormal constitution (Su-e-Mizaj) and alter the six prerequisites for existence (Asbab-e-Sitta Zarooriya) to restore normal health. It is a packaged treatment, that is, different components of treatment are given as a package form which includes different drugs, dosages form, and regimens.

scholarly journals Graves Disease in Childhood

2021 ◽  
Author(s):  
Madhukar Mittal ◽  
Vanishri Ganakumar
Keyword(s):  
Thyroid Hormone ◽  
Side Effects ◽  
Age Of Onset ◽  
Severe Disease ◽  
Clinical Manifestations ◽  
Thyroid Stimulating Hormone ◽  
Graves Disease ◽  
Older Children ◽  
Prepubertal Children ◽  
Pediatric Age Group

Graves’ disease (GD) is an autoimmune disease caused by autoantibodies against thyroid stimulating hormone receptor (TSH-R), resulting in stimulation of thyroid gland and overproduction of thyroid hormones resulting in clinical manifestations. It is uncommon in children and is 6 times more prevalent in females. The symptomatology, clinical and biochemical severity are a function of age of onset of disease. Prepubertal children tend to present with weight loss and bowel frequency, associated with accelerated growth and bone maturation. Older children are more likely to present with the classical symptoms of thyrotoxicosis like palpitations, tremors and heat intolerance. Prepubertal children tend to have a more severe disease, longer duration of complaints and higher thyroid hormone levels at presentation than the pubertal and postpubertal children. The non-specificity of some of the symptoms in pediatric age group can lead to children being initially seen by other specialities before being referred to endocrinology. Management issues are decided based on patient’s priorities and shared decision making between patient and treating physician. Radioactive Iodine Ablation is preferred when there is relatively higher value placed on Definitive control of hyperthyroidism, Avoidance of surgery, and potential side effects of ATDs. Similarly Antithyroid drugs are chosen when a relatively higher value is placed on possibility of remission and avoidance of lifelong thyroid hormone treatment, Avoidance of surgery, Avoidance of exposure to radioactivity. Surgery is preferred when access to a high-volume thyroid surgeon is available and a relatively higher value is on prompt and definitive control of hyperthyroidism, avoidance of exposure to radioactivity and avoidance of potential side effects of ATDs. Continental differences with regards to management do exist; radio-iodine ablation being preferred in North America while Anti-thyroid drug treatment remains the initial standard care in Europe.

Chronic heart failure

2020 ◽  
pp. 217-240
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Mortality Rate ◽  
Adult Population ◽  
Age Groups ◽  
Severe Heart Failure ◽  
Signs And Symptoms ◽  
Developed Countries ◽  
Clinical Syndrome ◽  
The Uk

Heart failure is a complex clinical syndrome of signs and symptoms that suggest the ability of the heart to pump effectively has been impaired. It is distinguished by dyspnoea, effort intolerance, fluid retention, and poor survival. The prevalence of heart failure is around 1–2% in the adult population in developed countries, and 920 000 people in the UK have heart failure. The incidence of heart failure has decreased; however, the number of people newly diagnosed with heart failure has increased. This is thought to be largely due to an ageing population, improvement in the management and survival of people with ischaemic heart disease, and effective treatment of heart failure. The condition can occur in all age groups; however, the incidence and prevalence steeply increase with age. The average age at first diagnosis is typically 77yrs. Chronic heart failure (CHF) has a poor prognosis, the mortality rate for CHF being worse than for many cancers. It is estimated that 70% of those hospitalized for the first time with severe heart failure will die within 5yrs. However, this has been improving, with 6mth mortality rate ↓ from 26% in 1995, 15% in 2009, to 8.9% in 2016. This chapter will outline the aetiology, pathophysiology, and management of CHF, including considerations for palliative care.

scholarly journals SECONDARY HYPOTHYROIDISM: CURRENT APPROACHES TO DIAGNOSIS AND TREATMENT

2017 ◽  
pp. 64-67
Author(s):  
T. A. Gavrilova ◽  
T. B. Morgunova ◽  
V. V. Fadeev
Keyword(s):  
Thyroid Hormone ◽  
Replacement Therapy ◽  
Thyroid Function ◽  
Clinical Manifestations ◽  
Primary Hypothyroidism ◽  
Free Thyroxine ◽  
Diagnosis And Treatment ◽  
Hormone Deficiency ◽  
Secondary Hypothyroidism ◽  
Peripheral Markers

Secondary hypothyroidism is a very rare cause of hypothyroidism in adults. Clinical manifestations of secondary as well as primary hypothyroidism are nonspecific; in addition, thyroid hormone deficiency often clinically simulates other tropic hormone deficiencies, thus complicating timely diagnosis of the disease. Certain difficulties are also caused by replacement therapy in secondary hypothyroidism, since the level of free thyroxine in the blood is used as the criterion for evaluating levothyroxine dosage, and questions about the use of peripheral markers of thyroid function to assess the adequacy of therapy remain understudied.

scholarly journals Hypothyroidism: current state of the problem

2020 ◽  
pp. 96-107
Author(s):  
E. V. Biryukova ◽  
D. V. Kileynikov ◽  
I. V. Solovyeva
Keyword(s):  
Kinase Inhibitors ◽  
Clinical Manifestations ◽  
Final Diagnosis ◽  
Thyroid Stimulating Hormone ◽  
Pathological Process ◽  
Primary Hypothyroidism ◽  
The Body ◽  
Hormone Deficiency ◽  
Side Reactions ◽  
Secondary Hypothyroidism

The article presents the issues of epidemiology, classification, and clinic of hypothyroidism. The frequency of hypothyroidism increases significantly with age. The most common form is primary hypothyroidism, caused by a pathological process in the thyroid gland itself. Secondary hypothyroidism or tertiary hypothyroidism is caused by insufficient secretion of thyroid- stimulating hormone (TSH), or thyrotropin-releasing hormone. The article deals with the main causes of primary and secondary hypothyroidism. The most common cause of primary hypothyroidism is autoimmune thyroiditis, which can develop both separately and simultaneously with other autoimmune diseases, as part of polyglandular syndrome. Special attention should be paid to the change of thyroid status as a result of adverse side reactions when using a range of drugs. The questions about the mechanisms of thyroid insufficiency development as a result of unfavorable side reactions when using a number of drugs (lithium preparations, iodine-containing compounds, tyrosine kinase inhibitors, etc.) have been raised. Undiagnosed hypothyroidism is a risk factor for the progression of already existing cardiovascular diseases. The severity of clinical manifestations is determined by the severity of thyroid hormone deficiency. There are no significant clinical differences between the pronounced forms of primary and secondary hypothyroidism. Depending on the degree of lesion, secondary hypothyroidism may be complicated by other manifestations of hypothalamic-pituitary disorders, as well as the latter may include a decrease in the secretion of antidiuretic hormone at a certain stage of their development. Diagnostic difficulties are discussed, as hypothyroidism disrupts the functioning of most organs and systems of the body (musculoskeletal, cardiovascular, urinary, gastrointestinal, central and peripheral nervous systems) and can be masked by various diseases. The final diagnosis of hypothyroidism is clarified by a number of laboratory and instrumental studies. Substitution therapy with levothyroxine is used to treat hypothyroidism of any etiology.

scholarly journals Severe primary hypothyroidism in an apparently asymptomatic 19-year-old woman: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Rania Dannan ◽  
Sulaiman Hajji ◽  
Khaled Aljenaee
Keyword(s):  
Incidental Finding ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Thyroid Stimulating Hormone ◽  
Primary Hypothyroidism ◽  
Conflicting Evidence ◽  
Thyroid Function Testing ◽  
History Of ◽  
Asymptomatic Individuals ◽  
High Index Of Suspicion

Abstract Background Hypothyroidism is diagnosed on the basis of laboratory tests because of the lack of specificity of the typical clinical manifestations. There is conflicting evidence on screening for hypothyroidism. Case presentation We report a case of an apparently healthy 19-year-old Kuwaiti woman referred to our clinic with an incidental finding of extremely high thyroid-stimulating hormone (TSH), tested at the patient’s insistence as she had a strong family history of hypothyroidism. Despite no stated complaints, the patient presented typical symptoms and signs of hypothyroidism on evaluation. Thyroid function testing was repeated by using different assays, with similar results; ultrasound imaging of the thyroid showed a typical picture of thyroiditis. Treatment with levothyroxine alleviated symptoms and the patient later became biochemically euthyroid on treatment. Conclusion There is controversy regarding screening asymptomatic individuals for hypothyroidism; therefore, it is important to maintain a high index of suspicion when presented with mild signs and symptoms of hypothyroidism especially with certain ethnic groups, as they may be free of the classical symptoms of disease.

scholarly journals Thyroid Hormone Resistant Syndrome

2020 ◽  
pp. 6-10
Author(s):  
Karo Gyurjian ◽  
Vishwanath Venketaraman
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Hormone Receptor ◽  
Receptor Gene ◽  
Signs And Symptoms ◽  
Thyroid Stimulating Hormone ◽  
Hormone Resistance ◽  
Thyroid Receptor ◽  
Thyroid Hormone Levels ◽  
Beta Gene ◽  
Receptor Beta

Thyroid hormone resistance (THR), also known as resistance to thyroid hormone (RTH), is an inherited condition characterized by reduced end-organ responsiveness to thyroid hormone, caused by mutations in the thyroid hormone receptor gene. Patients typically present with elevated thyroid hormone levels (T3 and T4) with normal, or slightly elevated thyroid-stimulating hormone (TSH) levels.1 In a majority of cases, the disease is caused by a mutation in the thyroid receptor beta (TR-beta) gene. Patients can present with signs and symptoms of hypothyroidism or hyperthyroidism or can be asymptomatic. We present a case of a 16-year-old male who was referred for endocrinologic evaluation after abnormal findings in the thyroid function panel.

scholarly journals Thyroid hormone resistance syndrom: difficulties in differential diagnosis

2018 ◽  
Vol 14 (1) ◽  
pp. 39-46
Author(s):  
Lyudmila A. Ruyatkina ◽  
Aguniya A. Molchanova ◽  
Alina S. Ruyatkina ◽  
Lyudmila Y. Rozhinskaya
Keyword(s):  
Differential Diagnosis ◽  
Thyroid Hormone ◽  
Thyroid Hormones ◽  
Thyroid Hormone Receptor ◽  
Signs And Symptoms ◽  
Thyroid Stimulating Hormone ◽  
Heterozygous Mutation ◽  
Hormone Resistance ◽  
Thyroid Hormone Resistance ◽  
Free Thyroid Hormones

Thyroid hormone resistance syndrome (RTH) is a rare disorder characterized by reduced peripheral tissue responses to thyroid hormones (TH) and elevated levels of circulating free thyroid hormones. Resistance to thyroid hormone is caused by mutations of the thyroid hormone receptor beta (THRB) gene. In this article, we present case of 26-years-old women who presented with unclear signs and symptoms. Thyroid morphology and function were evaluated with standard ultrasound of the thyroid, scintigraphy and cytological specimen obtained by FNAB. The features of the basic assessment of thyroid status with an emphasis on the concept of “±feedback” of thyroid-stimulating hormone (TSH) and TH. A differential diagnosis of TSH-secreting pituitary adenoma and RTH was discussed. Heterozygous mutation p.P453T in the THRB gene was detected. Thus, the given clinical case demonstrates the necessity of the thorough examination of patients in identifying disorders of the principle of “±feedback”. The observation in dynamics is recommended.

Causes and laboratory investigations of thyrotoxicosis

2011 ◽  
pp. 466-476 ◽  
Author(s):  
Francesco Latrofa ◽  
Paolo Vitti ◽  
Aldo Pinchera
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Gland ◽  
Thyroid Hormones ◽  
Laboratory Testing ◽  
Thyroid Stimulating Hormone ◽  
Clinical Syndrome ◽  
Laboratory Confirmation ◽  
Common Causes ◽  
Laboratory Investigations ◽  
Destructive Processes

The term thyrotoxicosis identifies the clinical syndrome caused by elevated circulating thyroid hormones of all sources, while the term hyperthyroidism includes only the disorders due to an increased secretion of hormones by the thyroid gland. Hyperthyroidism is the most frequent cause of thyrotoxicosis. Destructive processes involving the thyroid gland that induce unregulated discharge of preformed thyroid hormones (destructive thyrotoxicosis) and circulating thyroid hormone of extrathyroidal origin (exogenous or extrathyroidal thyrotoxicosis) are less common causes of thyrotoxicosis. Although careful history taking and physical examination often allows a diagnosis of thyrotoxicosis to be made, laboratory confirmation by measurement of thyroid-stimulating hormone (TSH) and thyroid hormone is always needed. Once thyrotoxicosis is confirmed, laboratory testing and thyroid imaging are required to identify the cause of thyrotoxicosis.

Herbal preparations in the management of hypothyroidism in Unani medicine

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Md Anzar Alam ◽  
Mohd Aleemuddin Quamri
Keyword(s):  
Conventional Medicine ◽  
Clinical History ◽  
Developed Countries ◽  
The Body ◽  
Thyroid Disorder ◽  
Cold Intolerance ◽  
Unani Medicine ◽  
Comprehensive Information ◽  
Laboratory Investigations ◽  
The Common

AbstractHypothyroidism is the most common thyroid disorder, affects women more frequently, and incidence increases with age. The prevalence of hypothyroidism in developed countries is around 4–5%, whereas, in India, it is about 11%. The common symptoms of hypothyroidism in adults are weight gain, fatigue, lethargy, cold intolerance, constipation, change in voice, and dry skin. It can affect all systems of the body. Diagnosis is mainly based on clinical history and laboratory investigations. Untreated hypothyroidism increases morbidity and mortality. In conventional medicine, the treatment of choice is Levothyroxine, whereas in Unani System of Medicine, pharmacotherapy consists of single and compound drugs. Single drugs are selected as per the constitution (Mizaj) of drugs as opposed to the abnormal constitution (Su-e-Mizaj) of disease and its pathology. Some drugs increase the basal metabolic rate whereas some evacuate the morbid material from the body by the action of purgation. The drugs are used either in a single form or as a prescription of more than one drug in the form of decoction (Joshandah), infusion (Kheshandah), or powder (Safoof). This review aims at providing comprehensive information regarding various drugs used in Unani system of medicine that is used in the management of thyroid dysfunction.

scholarly journals RelapsingCampylobacter jejuniSystemic Infections in a Child with X-Linked Agammaglobulinemia

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Paola Ariganello ◽  
Giulia Angelino ◽  
Alessia Scarselli ◽  
Irene Salfa ◽  
Martina Della Corte ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Systemic Infection ◽  
Signs And Symptoms ◽  
Clinical History ◽  
Duration Of Treatment ◽  
Increased Risk ◽  
Bruton Tyrosine Kinase ◽  
Encapsulated Bacteria ◽  
Specific Association ◽  
Systemic Infections

X-linked agammaglobulinemia (XLA) is a primary immunodeficiency of the humoral compartment, due to a mutation in theBruton tyrosine kinase (BTK)gene, characterized by a severe defect of circulating B cells and serum immunoglobulins. Recurrent infections are the main clinical manifestations; although they are especially due to encapsulated bacteria, a specific association withCampylobacterspecies has been reported. Here, we report the case of a boy with XLA who presented with relapsingCampylobacter jejunisystemic infections. His clinical history supports the hypothesis of the persistence ofC. jejuniin his intestinal tract. Indeed, as previously reported, XLA patients may become chronic intestinal carriers ofCampylobacter, even in absence of symptoms, with an increased risk of relapsing bacteraemia. The humoral defect is considered to be crucial for this phenomenon, as well as the difficulties to eradicate the pathogen with an appropriate antibiotic therapy; drug resistance is raising inCampylobacterspecies, and the appropriate duration of treatment has not been established.C. jejunishould always be suspected in XLA patients with signs and symptoms of systemic infection, and treatment should be based on antibiogram to assure the eradication of the pathogen.

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