Dr.Tanvi's Diabetes Thyroid Obesity Hormones (Endocrine) Clinic

Hello,

 My name is Dr. Tanvi Mayur Patel. I'm practicing endocrinologist. Today we are going to talk about hypothyroid medication. Now, many people who have primary hypothyroidism also known as Hashimoto's disease they must be taking thyroid medications now today I'm going to talk about how to get the complete benefits from this medicine and how to take medications correctly. Now those people who are taking this hypothyroid medication that is a levothyroxine that is a generic content in it they may have been prescribed this medicine by their thyroid treating physician or an endocrinologist doctor, so first questions which you need to ask yourself and your doctor why are you prescribed this medicine and what is the indication of you taking this medicine and how long you have to take the medicine? so once you are clear with these answers then you must start taking the medication. Now you have gone out of the doctor's chamber and a doctor has written a medication and now you go to a chemist store to purchase the medicine, make sure that you buy the same brand that the doctor has prescribed to you and the same dose.

Now the dose is very very important and thyroid medications are very small dose prescribed in micrograms so even if there is a small mistake, let's say instead of 12.5 microgram by mistake if the chemist dispenses you of 125 microgram it can make a huge mistake in your dose, so once you purchase the medication make sure the dose is very very accurate after that check the expiry date of the medication, if medicine is coming near the expiry or it is already expired then the potency and the effectiveness of the medications will be very very limited. Now secondly when you come and bring this medication with you at your home, store this medicine in a cupboard or somewhere which is a little darker area, do not expose this medicine to direct sunlight as it can affect the quality of the drug. If you're buying the medication for a long period of time, let's say you have a thyroid problem since many years and you're buying the drug again and again then my advice will be to stick to the same brand, don't keep jumping from one brand to another brand as it will have a different efficacy in different, different company products.

Now taking the medication is very very important. Consistency is the key for this medicine now since this drug has to be taken early in the morning on an empty stomach many a times patients tend to forget taking medications and same if you keep forgetting this medicine you will not get full benefit out of the drug and when you go to your doctor with your follow-up visit, you will find that your thyroid reports are not completely normal and then your doctor may think that you may have to change the drug; however, the problem was not the dose of the drug but the problem was of you not taking the drug properly so the consistency is very very important. Now how do you remember whether you have to take the medication, so my advice would be to keep the drug next to your bed so that the first thing in the morning when you wake up you have to take the drug either you can put an alarm for that which can help, then the second is a calendar method so the moment you have taken that drug put a cross mark over the calendar and if you have forgotten do not put a cross mark, so at the end of the week or at the end of the month you know how many days you have taken the medicine and how many days you have forgotten, this will help you in understanding your compliance of the medicine and when you go to your doctor you can discuss this with your doctor before he or she changes your dose of the drug.

Now when you wake up in the morning and the first thing you do is to take the medicine after that only you do your daily activities like going to the washroom and brushing your teeth, making the tea and by doing all that process or maybe doing an exercise you will spend at least half an hour to 45 minutes. Now how do I take the medicine? you have to take this medication early in the morning now along with this medicine you cannot eat or drink anything except plain water for at least 30 to 45 minutes, after that only you can have your meal or your tea, coffee or your breakfast. Now, many people are taking calcium supplements, iron supplements or maybe an acidity medications, these medicines should not be taken together with the thyroid medicine, if you have to take this medication make sure you change the timing of this drug because it will have a hampering effect over your absorption of the thyroid medicine, so thyroid medicine in the early morning on an empty stomach nothing for 30 minutes to 45 minutes, then tea, coffee, breakfast and if you are taking calcium and iron tablets some other time of the day. I hope my video has helped you in understanding how to take the thyroid medications correctly. If you have any more questions you can feel free to ask us and contact me through lybrate.

Thank you.

Hello,

I am Dr. Tanvi Mayur Patel, Endocrinologist. Today I will talk about PCOS or PCOD. How common is this problem? Out of 100 women, nearly 30-45% of the women are having PCOS. At what age this disease occurs? This occurs mainly at the reproductive age group. How will you come to know whether you have a PCOS? I am going to share a couple of symptoms and if you have any of these symptoms, it is more likely that you are suffering from PCOD. If you have hair loss or thinning, excess of hair growth over upper lips or over the side of your chin, infertility issue in married ladies or if you have irregular periods where you are getting periods once in a 2-3 months, a lot of difficulty in losing weight or gaining weight, darkening over side of the neck, these all indicates that you are PCOD patient. How do we diagnose this problem? When we diagnose based on your first symptoms, then we also do an ultrasound of your pelvis wherein we see your ovaries have tiny immature follicles which termed as a cyst. If it is diagnosed as PCOD then it has to be treated.

Now is this problem a serious. Does the answer depend on what level you are talking about? If you are talking about immediate complication, the answer is no. But over a long period of time, it may add major complications. You may end up to get obesity. You may get type 2 diabetes, blood pressure, your thyroid level may get disturbed. You can have a high cholesterol level. All this can happen over a long period of time. It may also affect your fertility. Many women may suffer from infertility. Now the next question to whom do I consult? WHich Dr should I go to do? PCOS is an endocrine hormonal problem. So, the ideal Dr is an endocrinologist. Now the PCOS is of 2 types. Primary in which the problem mainly lies in the ovary of your reproductive system. And secondary can happen because of certain other problems.

There can be the problem of prolactin hormone which is secreted by the gland and located in your brain. There can be a problem with the thyroid gland or with the adrenal gland which is located in the top of your kidney. So, if you have a problem with these disorders, you can have a secondary PCOS. Now about the treatment plan. It depends on your age and what is your future expectation from the treatment. First and foremost plan of the treatment changes in your lifestyle. Make sure you eat healthy and a balanced diet. You start doing physical activity. Do any kind of exercises for 45-60 minutes in a day.

Try to reduce stress. Stress plays a very important role in developing PCOS. Do meditation, yoga. Avoid smoking and alcohol. Now, these are lifestyle changes. Now about medical treatment. If you have irregular periods, not married and not planning for pregnancy, so the common treatment is oral contraceptive pills. Nowadays various pills are available which will not only normalize your hormonal level but also the menstrual cycle. If you have a lot of hair growth over your chin or have the problem of hirsutism then, in this case, you will be prescribed a anti-male hormone. Since the insulin resistance is the main cause of the PCOS, this medication work for this. If you are planning for the fertility then in that case you need to be treated with the help of the endocrinologist and fertility specialist. PCOS woman can also achieve a pregnancy. If you have any query, you can consult me through Lybrate.

Thank You.

Hello,

My name is Dr Tanvi. I am a consultant endocrinologist practicing in Mumbai. Let me take a towards a couple of myths which are commonly associated when it comes to thyroid problem. I do come across a lot of patients coming to my chamber and on the very first visit they come and say "Madam, I have a thyroid." Now everyone of us has a thyroid. Thyroid is a gland which is located in our neck on the front side of our neck. Everyone one of us whether you are a small baby or you are an old person, whether you are male or female, everyone has a thyroid gland. What you can have are a thyroid problems. Some people have thyroid problems, some people who do not have. Those who have thyroid problem, they can have a hypothyroid or a hyperthyroid or a thyroiditis. A couple of myths which are associated with it, let me try and clarifying them one by one. The first common myth is that an if I have a thyroid problem, I will know immediately.

Yes, it can happen, it cannot even happen because sometimes it takes 6-8 weeks for your thyroid hormones to start showing its effect inside your body. And similarly if you take a medication which is prescribed by your endocrinologist, it's not necessary that all your problems from the day one you take a medicine and the second day you will start feeling better. Thyroid medicines are not like a painkiller which shows its effect immediately. Yes you do feel better after couple of doses but it takes minimum 6 weeks to 3 months for your thyroid to come back to normal and you feel better as you were before. Second myth associated is people feel that if I am taking a thyroid medicine, this dose will remain with me lifelong and that's the reason why most of the time they do not follow up with their doctors and once they come after one year or 2 year, there realise that your thyroid is completely out of normal level.

Yes, it does happen. Thyroid medications keep changing with time to time. As you age, your weight also changes, your age changes, for a woman especially if they are pregnant, the thyroid doses keep changing. So most important advice to all the people is please do not self medicate. Many people feel that my cousin or my mother is taking XYZ dose, I can also start the same dose. That's a very big problem which everyone is doing and because of that they put their thyroid into complete havoc. Realize that thyroid medications are hormonal medications. They should be taken at the right dose only by a prescribed endocrinologist and not self medication. Another myth associated with thyroid is that this medications are a lifelong medication. It depends on what is the cause of your thyroid problem. There are many conditions in which thyroid medicines are just required may be for 3 months or 2 years.

And in some cases yes they do require for a long period of time but as i told you earlier, the doses keep changing. Another common myth associated with the thyroid is problems are that these are only a women problems. How does a man get it? As per the studies yes women are more prone to get the thyroid problem, however, men are not immune to it. There are possibilities that there are a lot of men are developing thyroid problems. It has to do with their immunity. Another common myth associated with the thyroid medications are I am feeling perfectly alright now, I can stop my medications. This is a very common mistake, most of the thyroid patients do, thinking that all my symptoms are fine, I can stop the medicine. Please do not do that because thyroid medications are to be taken and to be stopped only as per your endocrinologist's advise. Do not self medicate.

Do not self stop it because thyroid hormone affects each and every body parts and that is a reason why if you are not having an adequate level of thyroid in your body, you can end up having heart problems, bone problems like in osteoporosis, you can have an even infertility issues when woman is finding it very difficult to concieve. Another common myth is that if I have a thyroid problem, I cannot eat cabbage or broccolis. Yes, in certain studies it is found that eating raw cabbage, raw broccoli or we call it as cruciferous vegetables do hamper your thyroid problems because it has a certain chemical called Goitrogens. However, if you have these foods in a limited quantity and especially in a cooked form which is most common practice in India, you can have these kinds of foods or at some point of time, you did not avoid it completely. If you have more queries, you can connect with me via lybrate and for more information, you can check out on my lybrate page.

Thank you!