June 11, 2020

scalloped tongue thyroid

Hypothyroidism and the Scalloped Tongue: Quick Overview

People with hypothyroidism (an underactive thyroid gland) usually develop enlarged tongues with scalloped edges. In other words, when there is a decrease in the thyroid function, your tongue becomes slightly larger, which then presses onto the teeth, causing indentations.

February 8, 2017

Polycystic (pah-lee-SIS-tik) ovary syndrome (PCOS) is a health problem that can affect a woman’s menstrual cycle, ability to have children, hormones, heart blood vessels and appearance. Women with PCOS typically have high levels of androgens, also known as male hormones which may become the reason for the body to stop ovulating, reason for getting acne, and grow extra facial and body hair. They also have higher levels of insulin production that can result in excess weight gain and increases your chance of getting diabetes. They may have enlarged ovaries that contain small collections of fluid called follicles located in each ovary as seen during an ultrasound exam.

The term “polycystic ovaries” refers to the many tiny cysts, or bumps, in the ovaries. These cysts themselves are not harmful and do not need to be removed. Most women with PCOS grow many small cysts camera.gif on their ovaries. That is why it is called polycystic ovary syndrome. PCOS is also known as ‘Stein-Leventhal syndrome’.

Hormones are chemical messengers that trigger many different processes, including growth and energy production. Often, the job of one hormone is to signal the release of another hormone. For reasons that are not well understood, in PCOS the hormones get out of balance. One hormone change triggers another, which changes another.

Between 1 in 10 and 1 in 20 women of childbearing age has PCOS. As many as 5 million women in the United States may be affected. It can occur in girls as young as 11 years old.


Although the exact cause is unknown, it is known that PCOS is a result of a hormone imbalance in the brain and ovaries. Also, many women with PCOS have too much insulin, a hormone that turns food into energy. Having too much insulin may cause the body to make too much testosterone. This high testosterone level would account for some of the symptoms, like excess body hair or irregular periods.

  • Resistance to insulin – Insulin is a hormone produced by the pancreas to control the amount of sugar in the blood. It helps to move glucose from blood into cells, where it’s broken down to produce energy. Insulin resistance means the body’s tissues are resistant to the effects of insulin. The body therefore has to produce extra insulin to compensate. High levels of insulin cause the ovaries to produce too much testosterone, which interferes with the development of the follicles (the sacs in the ovaries where eggs develop) and prevents normal ovulation. It can also lead to weight gain, hence making the symptoms worse.
  • Hormone Imbalance – This includes:
    • Raised levels of testosterone– a hormone often thought of as a male hormone, although all women usually produce small amounts of it
    • Raised levels of luteinising hormone (LH)– this stimulates ovulation, but may have an abnormal effect on the ovaries if levels are too high
    • Low levels of sex hormone-binding globulin (SHBG) –a protein in the blood, which binds to testosterone and reduces the effect of testosterone
    • Raised levels of prolactin(only in some women with PCOS) –  hormone that stimulates the breast glands to produce milk in pregnancy
  • Genetics – PCOS sometimes runs in families. If any relatives, such as your mother, sister or aunt, have PCOS, then the risk of you developing it is often increased. This suggests there may be a genetic link to PCOS, although specific genes associated with the condition haven’t yet been identified.
  • Low-grade Inflammation – It has also been found that women with PCOS have low-grade inflammation, which may be a cause for insulin resistance. White blood cells produce substances to fight infection, this is known as inflammatory response. In some predisposed people eating certain foods, or exposure to certain environmental factors may trigger an inflammatory response. When inflammatory response is triggered, white blood cells produce substances that may contribute to insulin resistance and atherosclerosis.


The symptoms of PCOS can vary from woman to woman. Some of the symptoms

of PCOS include:

  • Infertility (not able to get pregnant) because of not ovulating. In fact, PCOS is the most common cause of female infertility.
  • Infrequent, absent, and/or irregular menstrual periods.
  • Hirsutis— increased hair growth on the face, chest, stomach, back, thumbs, or toes.
  • Cysts on the ovaries
  • Acne, oily skin, or dandruff.
  • Weight gain or obesity, usually with extra weight around the waist.
  • Male-pattern baldness or thinning hair.
  • Patches of skin on the neck, arms, breasts, or thighs that are thick and dark brown or black.
  • Skin tags —excess flaps of skin in the armpits or neck area.
  • Pelvic pain
  • Anxiety or depression.
  • Sleep apnea – when breathing stops for short periods of time while asleep.

While not symptoms of the disease, many women with PCOS have other concurrent health problems, such as diabetes, hypertension, and high cholesterol. These are linked to the weight gain typical in PCOS patients.

PCOS and Menopause

PCOS affects many systems in the body. So, many symptoms may persist even though ovarian function and hormone levels change as a woman nears menopause. For instance, excessive hair growth continues, and male pattern baldness or thinning hair gets worse after menopause. Also, the risks of complications (health problems) from PCOS, such as heart attack, stroke, and diabetes, increase as a woman gets older.

Women with PCOS appear to have higher rates of:

  • Miscarriage
  • Gestational diabetes
  • Pregnancy-induced high blood pressure (preeclampsia)
  • Premature delivery

Babies born to women with PCOS have a higher risk of spending time in a neonatal intensive care unit or of dying before, during, or shortly after birth. Most of the time, these problems occur in multiple-birth babies (twins, triplets).


Treatment goals are based on the symptoms, whether or not a woman want to become pregnant, and lowering the chances of getting heart disease and diabetes. Many women will need a combination of treatments to meet these goals. Some treatments for PCOS include:

  • Lifestyle modification – Women with PCOS are generally over- weight or obese, that may result in health problems. This modification may include –
    • Limiting processed foods and foods with added sugars
    • Adding more whole-grain products, fruits, vegetables, and lean meats to your diet

This helps to lower blood glucose (sugar) levels, improve the body’s use of insulin, and normalize hormone levels in your body. Even a 10 percent loss in body weight can restore a normal period and make your cycle more regular.

  • Birth Control Pills – For women who don’t want to get pregnant, birth control pills can:
    • Control menstrual cycles
    • Reduce male hormone levels
    • Help to clear acne

Since the menstrual cycle will become abnormal again if the pill is stopped, women may also think about taking a pill that only has progesterone like Provera, to control the menstrual cycle and reduce the risk of endometrial cancer.

  • Diabetes Medication – The medicine metformin (Glucophage) is used to treat type 2 diabetes. It has also been found to help with PCOS symptoms. Metformin affects the way insulin controls blood glucose (sugar) and lowers testosterone production. It slows the growth of abnormal hair and, after a few months of use, may help ovulation to return. Recent research has shown metformin to have other positive effects, such as decreased body mass and improved cholesterol levels. Metformin will not cause a person to become diabetic.
  • Fertility medications – Lack of ovulation is usually the reason for fertility problems in women with PCOS. Several medications that stimulate ovulation can help women with PCOS become pregnant. Even so, other reasons for infertility in both the woman and man should be ruled out before fertility medications are used. Also, some fertility medications increase the risk for multiple births (twins, triplets). Treatment options include:
    • Clomiphene (Clomid, Serophene) — the first choice therapy to stimulate ovulation for most patients.
    • Metformin taken with clomiphene — may be tried if clomiphene alone fails. The combination may help women with PCOS ovulate on lower doses of medication.
    • Gonadotropins — given as shots, but are more expensive and raise the risk of multiple births compared to clomiphene.
    • Another option is IVFe. vitro fertilization.
  • Surgeries – Ovarian drilling is a surgery may increase the chance of ovulation.

Alternative Treatment

Many of the conventional treatments being utilized are not specific for PCOS but have been used because the mechanisms of action indicate a potential benefit. There are a number of natural products which may have potential benefit without the possible side effects of abnormal uterine bleeding, weight gain, and liver failure seen with some of the conventional approaches.

  • Dietary Fiber – The health benefits of dietary fiber in reducing the risk of chronic disease have been well-established. Several characteristics of dietary fiber have been established, including the bulking effect that increases fecal volume, limits caloric intake, slows stomach emptying, and dilutes the content of urine. Dietary fiber also has the capacity to bind and eliminate organic compounds, which could reduce the interaction of potentially carcinogenic compounds within the intestinal mucosa. Several lines of evidence also suggest that dietary fiber may play a key role in the regulation of circulating insulin levels. Fiber reduces insulin secretion by slowing the rate of nutrient absorption following a meal. Studies show that insulin sensitivity increases and body weight decreases in people on high fiber diets.
  • Flaxseed – Flaxseed is one of the most significant sources of plant lignans, one of the main classes of estrogenic compounds called phytoestrogens. Phytoestrogens represent a family of plant compounds that have been shown to have both estrogenic and antiestrogenic properties. Flaxseed and its isolated lignans have been shown to have numerous chemoprotective effects both in vitro and in vivo. Many of the chemoprotective effects may be mediated through their influence on endogenous sex hormone production, metabolism, and biological activity.
  • Fish Oil – Adjusting the quality of food eaten – specifically fats – appears to be an important component of treatment of PCOS. The fatty acid components of dietary lipids not only influence hormonal signaling events by modifying membrane lipid composition, but fatty acids may directly influence molecular events that govern gene expression. It is thought that this regulation of gene expression by dietary fats has the greatest impact on the development of obesity and insulin resistance. Fish oils, which are comprised of the essential fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), fall into a larger category of fats called polyunsaturated fatty acids (PUFAs).
  • D-chiro-inositol – Studies suggest that women with PCOS may have insulin resistance and hyperinsulinemia due to a D-chiroinositol deficiency. D-chiro-inositol is a component of a phosphoglycan that has been shown to mediate the action of insulin.
  • Chromium – Chromium is one of the most widely studied nutritional interventions in the treatment of glucose- and insulin-related irregularities. While research shows a clear link between chromium and glucose metabolism, evidence for its interaction in insulin resistant states is a bit more ambiguous. Chromium picolinate is the form of chromium which has been used in a number of studies on insulin resistance.
  • Amino acid glutamine – Is reputed to improve blood sugar control.
  • Evening Primerose Oil – Evening Primrose Oil helps to increase cervical mucous and metabolic function.
  • Calcium and Vitamin D – Both calcium and vitamin D play significant roles in the health of many parts of the body. Where PCOS is concerned, calcium protects cardiovascular health. Vitamin D plays a role in glucose metabolism. Studies have shown that people with type 2 diabetes are often deficient in vit. D. Calcium can be found in kale, turnips, collards, mustard greens, kelp and wakame seaweed.
  • Herbs – These include –
    • Licorice Root – Helps the body to maintain proper hormone production and release. Licorice also supports healthy insulin levels and liver health which is important for women with PCOS.
    • Maca – Maca works to balance estrogen and progesterone in the body which may help to encourage a healthy menstrual cycle. Maca is an adaptogen and an incredible fertility superfood. It helps to balance the hormones, but does not contain any hormones itself. It is able to do this by nourishing the endocrine system.
    • Vitex – Helps encourage regular ovulation in infertile women when used prior to ovulation. This herb has been found to be wonderful in aiding women with menstrual irregularities, improving the timing of the entire menstrual cycle.
    • White Peony – Helps in relaxing muscles, reducing painful menstruation, as well as lowering serum and free testosterone levels in women with PCOS.

PCOS is a complex female health issue. It consists of many different health concerns and risks. If alternative treatment options are implemented, these risks and health issues may become obsolete.


Reference –












February 8, 2017

The metabolic syndrome is a cluster of the most dangerous heart attack risk factors: diabetes and raised fasting plasma glucose, abdominal obesity, high cholesterol and high blood pressure. When a patient presents with these risk factors together, the chances for future cardiovascular problems are greater than any one factor presenting alone.

The term “metabolic” refers to the biochemical processes involved in the body’s normal functioning. Risk factors are traits, conditions, or habits that increase the chance of developing a disease.

Metabolic syndrome is a serious health condition that affects about 34 percent of adults and places them at higher risk of cardiovascular disease, diabetes, stroke and diseases related to fatty buildups in artery walls. The underlying causes of metabolic syndrome include overweight and obesity, physical inactivity and genetic factors.

The condition is also known by other names including Syndrome X, insulin resistance syndrome, and dysmetabolic syndrome. According to a national health survey, more than one in five Americans has metabolic syndrome. The number of people with metabolic syndrome increases with age, affecting more than 40 percent of people in their 60s and 70s.


Metabolic syndrome has several causes that act together. A person can control some of the causes, such as overweight and obesity, an inactive lifestyle, and insulin resistance.

People can’t control other factors that may play a role in causing metabolic syndrome, such as growing older. The risk for metabolic syndrome increases with age.

People also can’t control genetics (ethnicity and family history), which may play a role in causing the condition. For example, genetics can increase the risk for insulin resistance, which can lead to metabolic syndrome.

People who have metabolic syndrome often have two other conditions: excessive blood clotting and constant, low-grade inflammation throughout the body. Researchers don’t know whether these conditions cause metabolic syndrome or worsen it.

Researchers continue to study conditions that may play a role in metabolic syndrome, such as –

  • A fatty liver (excess triglycerides and other fats in the liver)
  • Polycystic ovarian syndrome (a tendency to develop cysts on the ovaries)
  • Gallstones
  • Breathing problems during sleep (such as sleep apnea)

Risk Factors

The following factors increase the chances of having metabolic syndrome –

  • Age – The risk of metabolic syndrome increases with age, affecting 40 percent of people over the age of 60.
  • Race – Hispanics and Asians seem to be at greater risk of metabolic syndrome than are people of other races.
  • Obesity – Carrying too much weight increases the risk of metabolic syndrome
  • Diabetes – People are more likely to have metabolic syndrome if they had diabetes during pregnancy (gestational diabetes) or if they have a family history of type 2 diabetes.
  • Other diseases – The risk of metabolic syndrome is higher if people have ever had cardiovascular disease, nonalcoholic fatty liver disease or polycystic ovary syndrome.


Clinical manifestations of metabolic syndrome include the following –

  • Hypertension
  • Hyperglycemia
  • Hypertriglyceridemia
  • Reduced high-density lipoprotein cholesterol (HDL-C)
  • Abdominal obesity
  • Chest pains or shortness of breath: Suggesting the rise of cardiovascular and other complications
  • Acanthosis nigricans, hirsutism, peripheral neuropathy, and retinopathy: In patients with insulin resistance and hyperglycemia or with diabetes mellitus
  • Xanthomas or xanthelasmas: In patients with severe dyslipidemia


  • Arteriosclerosis – This happens when cholesterol hardens and begins to build up in the walls of arteries, causing blockages that can lead to high blood pressure, heart attack, and stroke.
  • Poor kidney function – The kidneys become less able to filter toxins out of the blood, which can also increase the risk of high blood pressure, heart attack, or stroke.
  • Insulin resistance – This occurs when the body’s cells don’t respond to insulin (the hormone that helps to regulate sugar in the blood) normally, and that can lead to high blood sugar levels and diabetes.
  • Polycystic ovarian syndrome – Thought to be related to insulin resistance, this disorder involves the release of extra male hormones by the ovaries, which can lead to abnormal menstrual bleeding, excessive hair growth, acne, and fertility problems. It is also associated with an increased risk for obesity, hypertension, and — in the long-term — diabetes, heart disease, and cancer.
  • Acanthosis nigricans – A skin disorder that causes thick, dark, velvet-like patches of skin around the neck, armpits, groin, between the fingers and toes, or on the elbows and knees.


Lose weight – Moderate weight loss, in the range of 5 percent to 10 percent of body weight, can help restore your body’s ability to recognize insulin and greatly reduce the chance that the syndrome will evolve into a more serious illness. This can be done via diet, exercise, or even with help from certain weight-loss medications if recommended by your doctor.

Exercise – Increased activity alone can improve your insulin levels. Aerobic exercise such as a brisk 30-minute daily walk can result in a weight loss, improved blood pressure, improved cholesterol levels and a reduced risk of developing diabetes. Most health care providers recommend 150 minutes of aerobic exercise each week. Exercise may reduce the risk for heart disease even without accompanying weight loss.

Consider dietary changes – Maintain a diet that keeps carbohydrates to no more than 50 percent of total calories. Eat foods defined as complex carbohydrates, such as whole grain bread (instead of white), brown rice (instead of white), and sugars that are unrefined (instead of refined; for example cookies, crackers).

Alternative Treatment


Reference –













February 8, 2017

Menopause is an important milestone and may be one of the first times a woman seeks medical advice around issues of long-term health promotion and disease prevention.

Menopause is a normal part of life, just like puberty. It is the time of your last menstrual period. You may notice changes in your body before and after menopause. The transition usually has three parts: perimenopause, menopause, and postmenopause.

Women are born with about a million eggs in each ovary. At puberty approximately 300,000 eggs remain, and by menopause there are no active eggs left.

On average, a woman will have 400-500 periods in her lifetime. From about 35-40 years of age, the number of eggs left in your ovaries decrease quickly and you ovulate (release an egg from the ovary) less regularly until your periods stop.

Natural menopause is the permanent ending of menstruation that is not brought on by any type of medical treatment. For women undergoing natural menopause, the process is gradual and is described in three stages –

Perimenopause or “menopause transition” – Perimenopause can begin 8 to 10 years before menopause, when the ovaries gradually produce less estrogen. It usually starts in a woman’s 40s, but can start in the 30s as well. Perimenopause lasts up until menopause, the point when the ovaries stop releasing eggs. In the last 1-2 years of perimenopause, the drop in estrogen accelerates. At this stage, many women can experience menopause symptoms. Women are still having menstrual cycles during this time, and can get pregnant.

Menopause – Menopause is the point when a woman no longer has menstrual periods. At this stage, the ovaries have stopped releasing eggs and producing most of their estrogen. Menopause is diagnosed when a woman has gone without a period for 12 consecutive months.

Postmenopause – These are the years after menopause. During this stage, menopausal symptoms, such as hot flashes, can ease for most women. But, as a result of a lower level of estrogen, postmenopausal women are at increased risk for a number of health conditions, such as osteoporosis and heart disease. Medication, such as hormone therapy and/or healthy lifestyle changes, may reduce the risk of some of these conditions. Since every woman’s risk is different, talk to your doctor to learn what steps you can take to reduce your individual risk.

Hormones and Menopause

Hormones are chemicals made in your body, which relay messages through the blood stream. They alert the body that it is time to do something. They help control many body functions such as growth, energy, repair of cells, reproduction, sexual function, digestion and the body’s temperature. They alert the body to eat, to stop eating, to sleep, to wake up, to grow, or when hormone levels decrease, to stop growing.

The three hormones of particular relevance at menopause are –

  • Oestrogen – The hormone oestrogen is made up of a group of three hormones: oestradiol, oestrone and oestriol. It is produced from the cells around the eggs in your ovaries. Oestrogen acts in the vagina, uterus, skin, bowel, liver, heart, blood, brain and throughout most of the body. The production of oestrogen fluctuates during the transition to menopause (perimenopause).
  • Progesterone – Progesterone, another natural female hormone, decreases toward menopause. Progesterone is responsible for changes to mucus in the cervix, from thin to thicker. It reduces acidity levels in the vagina, works on milk cells in the breast, and also can make us more moody.
  • Testosterone – Testosterone is produced by the ovaries and in other parts of the body, such as the adrenal glands (which sit above the kidney). Rather than a sudden or dramatic drop at menopause, testosterone decreases gradually with age. In some women, levels fall by half between the ages of 20-40 years.

Menopausal symptoms are created by changes in the levels of these hormones. These changes usually happen over months or years as you approach menopause. If you have menopause induced by surgery or cancer treatment, there can be a sudden drop in some of these hormones, causing symptoms to be more severe.

Menopause, when it occurs between the ages of 45 and 55, is considered “natural” and is a normal part of aging. But, some women can experience menopause early, either as a result of a surgical intervention (such as hysterectomy) or damage to the ovaries (such as from chemotherapy). Menopause that occurs before the age of 45, regardless of the cause, is called early menopause. Menopause that occurs at 40 or younger is considered premature menopause.


Natural Menopause – Natural menopause occurs at the expected age of around 51-52 – it is considered a natural life event due to ovaries running out of eggs.

Induced menopause – Chemotherapy & radiotherapy induced menopause. Menopause may happen as a result of chemotherapy and/or radiotherapy treatment for cancer because the treatments can cause ovaries to stop working.

Primary ovarian insufficiency (POI) – When periods stop spontaneously, either prematurely or early, this is referred to as ‘primary ovarian insufficiency’. This can be the result of several conditions or an unknown cause.

Menopause due to surgery

  • Removal of ovaries – Menopause occurs when a woman who is still having periods has surgery to remove both ovaries (oophorectomy). When the ovaries are removed, the levels of oestrogen and progesterone fall. These are hormones produced from eggs and ovulation (the release of an egg). Because ovaries are the main source of the hormone testosterone, these levels can also drop.
  • Hysterectomy – Sometimes there is confusion about whether having a hysterectomy (the removal of the uterus) will put you into menopause. If your uterus is removed but you still have your ovaries, you will not necessarily go straight into menopause. 10-12% of women who have a hysterectomy and keep their ovaries have menopause approximately one to four years earlier than their expected menopause.

Other Causes

Some women may experience premature menopause – their ovaries fail earlier than they are supposed to (before the age of 45). Ovarian failure can occur at any age – but very rarely – and often the doctor and patient will never find out why. Some who experience ovarian failure may still have periods and some degree of fertility for a while. Premature menopause may be caused by –

  • Enzyme deficiencies
  • Down’s syndrome
  • Turner’s syndrome
  • Addison’s disease
  • Hypothyroidism
  • Some infections – such as mumps or TB (tuberculosis), malaria and varicella. However, in all cases risk of ovarian failure is extremely small.
  • Genetic factors – scientists have been able to identify genetic factors that influence the age at which natural menopause occurs.
  • Being a twin – twins are more likely to have a premature menopause.

Smoking can lead to early menopause.


The hormone changes that happen around menopause affect every woman differently. Also, symptoms sometimes are not caused by menopause but by other aspects of aging instead. Some changes that might start in the years around menopause include –

Irregular periods – This is usually the first symptom; menstrual pattern changes. Some women may experience a period every two to three weeks, while others will not have one for months at a time.

Hot flashes (or flushes) – This is a sudden feeling of heat in the upper body. It may start in the face, neck or chest, and then spreads upwards or downwards (depending on where it started). The skin on the face, neck or chest may redden and become patchy, and the woman typically starts to sweat. The heart rate may suddenly increase (tachycardia), or it may become irregular or stronger than usual (palpitations). Hot flashes generally occur during the first year after a woman’s final period.

Trouble sleeping – Sleeping problems are generally caused by night sweats, but not always. Sleep disturbance may be caused by insomnia or anxiety. Difficulty falling asleep and staying asleep increase as women go through menopause.

Night sweats – If the hot flashes happen in bed they are called night sweats. Most women say their hot flashes do not last more than a few minutes.

Vaginal Dryness – This may be accompanied by itching and/or discomfort. It tends to happen during the peri-menopause. Some women may experience dyspareunia (pain during sex). The term vaginal atrophy refers to an inflammation of the vagina as a result of the thinning and shrinking of the tissues, as well as decreased lubrication, caused by a lack of estrogen.

Low Fertility – During the peri-menopausal stage of a woman’s life, her estrogen levels will drop significantly, lowering her chances of becoming pregnant.

Mood changes – Moodiness often goes hand-in-hand with sleep disturbance. Experts say that most mood disturbances are triggered by poor sleep.

Urinary Problems – Women tend to be more susceptible to urinary tract infections, such as cystitis. Having to urinate may also occur more frequently.

Changing feelings about sex – Lack of interest in sex.

Problems focusing and learning – Some women may also have short-term memory problems, as well as finding it hard to concentrate on something for long. Some women may not be able to learn as well shortly before menopause compared to other stages in life.

Women who are still in the menopause transition (perimenopause) may experience the above as well as –

  • Breast tenderness
  • Worsening of premenstrual syndrome (PMS)
  • Irregular periods or skipping periods
  • Periods that are heavier or lighter than usual

Some women might also experience –

  • Racing heart
  • Headaches
  • Joint and muscle aches and pains
  • Changes in libido (sex drive)
  • Difficulty concentrating, memory lapses (often temporary)
  • Weight gain
  • Hair loss or thinning

These symptoms can be a sign that the ovaries are producing less estrogen. Not all women get all of these symptoms. However, women affected with new symptoms of racing heart, urinary changes, headaches, or other new medical problems should see a doctor to make sure there is no other cause for these symptoms.


Osteoporosis – Day in and day out, your body is busy breaking down old bone and replacing it with new healthy bone. Estrogen helps control bone loss, and losing estrogen around the time of menopause causes women to lose more bone than is replaced. In time, bones can become weak and break easily. This condition is called osteoporosis.

Heart disease – After menopause, women are more likely to have heart disease. Changes in estrogen levels may be part of the cause. But, so is getting older. As you age, you may gain weight and develop other problems, like high blood pressure. These could put you at greater risk for heart disease.

Urinary incontinence – The menopause causes the tissues of the vagina and urethra to lose their elasticity, which can result in frequent, sudden, strong urges to urinate, followed by urge incontinence (involuntary loss of urine). Stress incontinence may also become a problem – urinating involuntarily after coughing, sneezing, laughing, lifting something, or suddenly jerking the body as may happen when we temporarily lose our balance.

Low libido – This is probably linked to disturbed sleep, depression symptoms, and night sweats, a study found.

Overweight/obesity – During the menopausal transition women are much more susceptible to weight gain. Experts say women may need to consume about 200 to 400 fewer calories each day just to prevent weight gain – or burn of that number of calories each day with extra exercise. The chances of becoming obese rises significantly after the menopause.

Breast cancer – women are at a higher risk of breast cancer after the menopause. Regular exercise after menopause significantly reduces breast cancer risk.


Paroxetine for the treatment of hot flashes caused by menopause, the first non-hormonal treatment to be FDA-approved for hot flashes linked to menopause.

HRT (hormone replacement therapy) – Also known as HT (hormone therapy), this is very effective for many of the symptoms that occur during the menopause, including vaginal dryness, vaginal itching, vaginal discomfort, urinary problems, bone-density loss, hot flashes and night sweats.

Low-dose antidepressants – SSRIs (selective serotonin reuptake inhibitors) have been shown to decrease menopausal hot flashes. Drugs include venlafaxine (Effexor), fluoxetine (Prozac, Sarafem), paroxetine (Paxil, others), citalopram (Celexa) and sertraline (Zoloft).

Omega 3s – Omega-3s may ease psychological distress and depressive symptoms often suffered by menopausal and peri-menopausal women.

Gabapentin (Neurontin) – This medication is effective in treating hot flashes. It is commonly used for treating seizures (epilepsy).

Clonidine (Catapres) – This can be taken either orally as a pill or placed on the skin as a patch. It is effective in treating hot flashes. The drug is commonly used for treating high blood pressure (hypertension). However, unpleasant side-effects are common.

Osteoporosis treatments – Depending on individual needs, doctors may recommend medication to prevent or treat osteoporosis. Several medications are available that help reduce bone loss and risk of fractures.

Vaginal estrogen – Vaginal estrogen may be applied locally using a tablet, ring or cream. This medication effectively treats vaginal dryness, discomfort during intercourse, as well as some urinary problems. A small amount of estrogen is released and absorbed by the vaginal tissue.

Alternative Treatment

Black cohosh may work for hot flushes and night sweats but more studies are needed to see whether there is a real benefit. It can have minor side effects such as stomach upsets or rashes. Serious side effects affecting the liver are rare. You should stop taking black cohosh immediately if you have jaundice (yellowing of your skin and eyes), if you have severe stomach pains with nausea and vomiting or if you go off your food.

Chasteberry (agnus castus), selenium, vitamin C and herbs such as ginkgo biloba, hops, sage leaf, liquorice and valerian root are taken by some women but there are very few studies on whether any of these work for menopausal symptoms.

Dehydroepiandrosterone (DHEA) may have a positive effect on your sense of wellbeing, improving your memory, sexual libido and potentially reducing vaginal dryness. However, the longterm effects are unknown. Further studies are needed to see whether DHEA helps hot flushes.

Calcium, as estrogen levels decline with menopause, women are at risk for osteoporosis. Calcium citrate seems to be more easily absorbed by the body, but it has less elemental calcium than calcium carbonate. Calcium carbonate, however, needs an acid environment to be absorbed, so is best taken with a glass of orange juice.

Omega-3 fatty acids help reduce LDL (“bad”) cholesterol and lower the risk of heart disease. Women who are at greater risk of heart disease after menopause may want to ask their doctor whether they should take a fish oil supplement, or simply increase the amount of fish they eat.

Phytoestrogens are plant substances that have similar effects to estrogen.

Acupuncture – Several studies show acupuncture may help many women with symptoms of menopause, particularly with hot flashes and mood changes.

Reflexology: there have been very few studies of reflexology and whether it helps menopausal symptoms and more studies are needed to see whether it helps.


Reference –











February 8, 2017

During a woman’s reproductive years, a normal menstrual cycle usually lasts anywhere from 21 to 35 days, with approximately seven to eight days of bleeding, and usually expelling approximately two to three ounces of blood. For the majority of women, the color of the blood or the amount of bleeding is not as important as how regular her menstrual periods are and whether there is any bleeding between periods. Menstruation is the time of month when the womb (uterus) sheds its lining and vaginal bleeding occurs. Periods vary widely from woman to woman. Some periods are punctual, some are unpredictable. On average, a woman gets her period every 21 to 35 days. A period usually lasts about three to five days. Irregular periods may require treatment.

Irregular Periods

To have an irregular cycle means that the interval between periods varies each month. That is, sometimes they come every 28 days, sometimes every 20, sometimes every 30.

Having irregular periods is very common. The causes can range from something insignificant to something that requires treatment. For example, if a girl is in her teen, her body’s hormones can fluctuate and take some time until they find a balance. Therefore, it’s normal to have an irregular period during adolescence or, sometimes, for the period not to arrive in a given month.

Women may have irregular periods if –

  • Periods that occur less than 21 days or more than 35 days apart.
  • Missing three or more periods in a row.
  • Menstrual flow that is much heavier or lighter than usual.
  • Periods that last longer than seven days.
  • Periods that is accompanied by pain, cramping, nausea, or vomiting.
  • Bleeding or spotting that happens between periods, after menopause, or following sex.

Types of irregular Periods

  • Amenorrhea is a condition in which a woman’s periods have stopped completely. The absence of a period for 90 days or more is considered abnormal unless a woman is pregnant, breastfeeding, or going through menopause (which generally occurs for women between ages 45 and 55). Young women who haven’t started menstruating by age 15 or 16 or within three years after their breasts begin to develop are also considered to have amenorrhea.
  • Oligomenorrhea refers to periods that occur infrequently.
  • Dysmenorrhea refers to painful periods and severe menstrual cramps. Some discomfort during the cycle is normal for most women.
  • Abnormal uterine bleeding may apply to a variety of menstrual irregularities, including: a heavier menstrual flow; a period that lasts longer than seven days; or bleeding or spotting between periods, after sex, or after menopause.


Age – During the first few years after menstruation starts, periods are often irregular while the hormones that control menstruation reach a balance. They may also be irregular at the end of menstrual years when women reach perimenopause and menopause – menopause starts when it’s been 12 months since a menstrual period.

Those irregularities are normal and common. But there are other times in women’s lives and other conditions that can lead to irregular menstrual cycles.

Pregnancy – The most common cause of a missed period is pregnancy. Until the woman knows for sure if she is pregnant or not, she should treat herself as though she is. This is one instance when she should be called OB/GYN or midwife. she can use an at-home pregnancy test, but the healthcare provider can use other tests to determine whether she is pregnant.

Medical Conditions – Two common causes of irregular menstrual periods are polycystic ovary syndrome (PCOS) and hypothyroidism.

PCOS is a hormone imbalance that can affect ovulation, cause issues with a woman’s period and make it more difficult to get pregnant. If the doctor determines this is the cause of the irregular periods, treatment may include birth control pills or other hormones to restore hormonal balance.

Hypothyroidism, a.k.a. underactive thyroid disease, is caused by the thyroid gland not producing enough of its hormone. Similar to PCOS, treating hypothyroidism involves supplementation of thyroid hormones.

Other medical conditions include-

  • Uterine polyps or fibroids – Uterine polyps are small benign (noncancerous) growths in the lining of the uterus. Uterine fibroids are tumors that attach to the wall of the uterus. There may be one or several fibroids that range from as small as an apple seed to the size of a grapefruit. These tumors are usually benign, but they may cause heavy bleeding and pain during periods. If the fibroids are large, they might put pressure on the bladder or rectum, causing discomfort.
  • Endometriosis – The endometrial tissue that lines the uterus breaks down every month and is discharged with the menstrual flow. Endometriosis occurs when the endometrial tissue starts to grow outside the uterus. Often, the endometrial tissue attaches itself to the ovaries or fallopian tubes; it sometimes grows on the intestines or other organs in the lower digestive tract and in the area between your rectum and uterus. Endometriosis may cause abnormal bleeding, cramps or pain before and during periods, and painful intercourse.
  • Pelvic inflammatory disease. Pelvic inflammatory disease (PID) is a bacterial infection that affects the female reproductive system. Bacteria may enter the vagina via sexual contact and then spread to the uterus and upper genital tract. Bacteria might also enter the reproductive tract via gynecologic procedures or through childbirth, miscarriage, or abortion. Symptoms of PID include a heavy vaginal discharge with an unpleasant odor, irregular periods, pain in the pelvic and lower abdominal areas, fever, nausea, vomiting, or diarrhea.
  • Premature ovarian insufficiency – This condition occurs in women under age 40 whose ovaries do not function normally. The menstrual cycle stops, similar to menopause. This can occur in patients who are being treated for cancer with chemotherapy and radiation, or if you have a family history of premature ovarian insufficiency or certain chromosomal abnormalities.
  • Uterine cancer or cervical cancer.
  • Medications, such as steroids or anticoagulant drugs (blood thinners).
  • Medical conditions, such as bleeding disorders, an under- or pituitary disorders that affect hormonal balance.
  • Complications associated with pregnancy, including miscarriage or an ectopic pregnancy (the fertilized egg is implanted outside the uterus; for example, within the fallopian tube).

Lifestyle Conditions

  • Excessive weight loss or gain – Although low body weight is a common cause of missed or irregular periods, obesity also can cause menstrual problems
  • Eating disorders, such as anorexia or bulimia
  • Increased exercise – Missed periods are common in endurance athletes.
  • Emotional stress
  • Medicines such as birth control methods, which may cause lighter, less frequent, more frequent, or skipped periods or no periods at all
  • Hormone problems – this may cause a change in the levels of the hormones that the body needs to support menstruation
  • Illegal drug use
  • Problems with the pelvic organs , such as imperforate hymen, polycystic ovary syndrome, or Asherman’s syndrome
  • Breastfeeding – Many women do not resume regular periods until they have completed breastfeeding.
  • Complications
  • Anemia – Menorrhagia (heavy menstrual bleeding) is the most common cause of anemia (reduction in red blood cells) in premenopausal women. A blood loss of more than 80mL (around 3 tablespoons) per menstrual cycle can eventually lead to anemia. Most cases of anemia are mild. Nevertheless, even mild-to-moderate anemia can reduce oxygen transport in the blood, causing symptoms such as fatigue, lightheadedness, and pale skin. Severe anemia that is not treated can lead to heart problems.
  • Osteoporosis – Amenorrhea (absent or irregular menstrual periods) caused by reduced estrogen levels is linked to osteopenia (loss of bone density) and osteoporosis (more severe bone loss that increases fracture risk). Because bone growth is at its peak in adolescence and young adulthood, losing bone density at that time is very dangerous and early diagnosis and treatment is essential for long-term health. Osteoporosis is a condition characterized by progressive loss of bone density, thinning of bone tissue, and increased vulnerability to fractures.
  • Infertility – Some conditions associated with heavy bleeding, such as ovulation abnormalities, fibroids, or endometriosis, can contribute to infertility. Many conditions that cause amenorrhea, such as ovulation abnormalities and polycystic ovary syndrome, can also cause infertility. Irregular periods from any cause may make it more difficult to conceive. Sometimes treating the underlying condition can restore fertility. In other cases, specific fertility treatments that use assisted reproductive technologies may be needed.
  • Quality of Life – Menstrual disorders, particularly pain and heavy bleeding, can affect school and work productivity and social activities.


The treatment of abnormal menstruation depends on the underlying cause:

  • Regulation of the menstrual cycle – Hormones such as estrogen or progestin might be prescribed to help control heavy bleeding.
  • Pain control – Mild to moderate pain or cramps might be lessened by taking an over-the-counter pain reliever, such as ibuprofen or acetaminophen. Aspirin is not recommended because it might cause heavier bleeding. Taking a warm bath or shower or using a heating pad might help to relieve cramps.
  • Uterine fibroids – These can be treated medically and/or surgically. Initially, most fibroids that are causing mild symptoms can be treated with over-the-counter pain relievers. If a woman experience heavy bleeding, an iron supplement might be helpful in preventing or treating anemia. Low-dose birth control pills or progestin injections (Depo-Provera) may help to control heavy bleeding caused by fibroids. Drugs called gonadotropin-releasing hormone agonists may be used to shrink the size of the fibroids and control heavy bleeding. These drugs reduce the body’s production of estrogen and stop menstruation for a while. If fibroids do not respond to medication, there are a variety of surgical options that can remove them or lessen their size and symptoms. The type of procedure will depend on the size, type, and location of the fibroids. A myomectomy is the simple removal of a fibroid. In severe cases where the fibroids are large or cause heavy bleeding or pain, a hysterectomy might be necessary. During a hysterectomy, the fibroids are removed along with the uterus. Other options include uterine artery embolization, which cuts off the blood supply to the active fibroid tissue.
  • Endometriosis – Although there is no cure for endometriosis, over-the-counter or prescription pain relievers may help to lessen the discomfort. Hormone treatments such as birth control pills may help prevent overgrowth of uterine tissue and reduce the amount of blood loss during periods. In more severe cases, a gonadotropin-releasing hormone agonist or progestin may be used to temporarily stop menstrual periods. In severe cases, surgery may be necessary to remove excess endometrial tissue growing in the pelvis or abdomen. A hysterectomy might be required as a last resort if the uterus has been severely damaged.

Alternative treatment

Multivitamin and Mineral – A good quality multivitamin and mineral would form the foundation of the supplement programme to make sure that the body is getting a ‘little bit of everything’.

Vitamin B – These are often called the ‘stress’ vitamins because they can help to cope with the pressures of everyday life. As stress can be such an important factor in causing irregular periods it is important that you have some help in dealing with it. Vitamins B2, B3 and B6 are also necessary for thyroid hormone production and B5 (pantothenic acid) is essential for optimum adrenal function. Both imbalances in thyroid function and stress can affect the cycle.

The easiest way to make sure that the body is getting a good supply of these vitamins is to take them in the form of a good B-complex tablet. B vitamins are synergistic, which means that they work together.

Antioxidants – Antioxidants are particularly relevant with irregular periods. It is believed that antioxidants have the ability to prevent cells from mutating. In other words, they prevent cells from becoming ‘abnormal’. This is extremely important if a woman has been diagnosed with thickening of the womb lining (endometrial hyperplasia) because she does not want the cells to mutate. Antioxidants include vitamins A, C and E and the mineral selenium. Their effects have been proven – women with womb tumours have been shown to have less of both selenium and vitamin E than women without them so make sure that the body is getting enough of these valuable nutrients.

Magnesium – This mineral has been classed as ‘nature’s tranquilliser’, so it is an essential inclusion in the diet of anyone suffering from irregular periods. In fact, anyone in today’s hectic society will benefit from a magnesium supplement. Stress is often a factor in period irregularity, and this mineral will help to redress the balance of a stressful lifestyle.

Omega 3 Fatty Acids – Flaxseeds (linseeds), which are an excellent source Omega-3 fatty acids, have been shown to encourage regularity of the cycle. Even if hormonal imbalance is not at the root of the problem, it is worth adding these fatty acids to the diet. There are many factors that are now known to affect the way fatty acids are used by the bodies, including high adrenaline levels (in the case of stress), high alcohol consumption, and high levels of cholesterol.

Herbs and Supplements – Generally, manufacturers of herbal remedies and dietary supplements do not need approval from the Food and Drug Administration to sell their products. Just like with drugs, herbs and supplements can affect the body’s chemistry, and therefore have the potential to produce side effects that may be harmful.

  • Black cohosh (also known as Cimicifuga racemosa or squawroot) contains a plant estrogen and is the most studied herbal remedy for treating menopausal symptoms, including dysmenorrhea, although most studies have indicated it is ineffective. Headaches and gastrointestinal problems are common side effects. It should not be taken for more than 6 months.
  • Ginger tea or capsules may help to relieve nausea and bloating.
  • Magnesium supplements may be helpful for relieving dysmenorrhea. Some women also report benefit with vitamin B1 (thiamine) supplements.
  • Aromatherapy with topically-applied lavender, sage, and rose oils may help ease menstrual cramps, according to some small studies.
  • Pycnogenol, an extract from the bark of the French maritime pine tree, may help reduce menstrual pain and discomfort, according to some small studies.

Acupuncture and Acupressure: Some studies have reported relief from pelvic pain after acupuncture or acupressure, a technique that applies small pins or pressure to specific points on the body. More research is needed.

Yoga and Meditation: Yoga and meditative techniques that promote relaxation may help relieve menstrual cramps.


Reference –
















February 8, 2017

Infertility is defined as the inability to conceive a pregnancy after 12 months of unprotected sexual intercourse. Infertility is a disease that results in the abnormal functioning of the male or female reproductive system. Infertility affects approximately 10% of the population. Since infertility strikes diverse groups-affecting people from all socioeconomic levels and cutting across all racial, ethnic and religious lines- chances are great that a friend, relative, neighbor or perhaps you are attempting to cope with the medical and emotional aspects of infertility.

Causes of infertility are many and varied and involve male, female or a combination of factors. This includes problems with the production of sperm or eggs, the structure or function of male or female reproductive systems; and/or hormonal and immune conditions.

In 40% of couples the cause of infertility is attributed to a sperm factor, in another 40% the cause is found within the female reproductive system, and a third will have a combination of male and female factors.

Pregnancy is the result of a process that has many steps. To get pregnant –

  • A woman’s body must release an egg from one of her ovaries (ovulation).
  • The egg must go through a fallopian tube toward the uterus (womb).
  • A man’s sperm must join with (fertilize) the egg along the way.
  • The fertilized egg must attach to the inside of the uterus (implantation).
  • Sufficient embryo quality

Finally, for the pregnancy to progress to full term the embryo must be healthy and the woman’s hormonal environment adequate for its development.  If just one of these factors is impaired, infertility can be the result. The diagnosis of infertility is usually given to couples who have been attempting to conceive for at least 1 year without success.

About 6% of married women 15–44 years of age in the United States are unable to get pregnant after one year of unprotected sex (infertility). Also, about 12% of women 15–44 years of age in the United States have difficulty getting pregnant or carrying a pregnancy to term, regardless of marital status (impaired fecundity). Studies found that 7.5% of all sexually experienced men younger than age 45 reported seeing a fertility doctor during their lifetime—this equals 3.3–4.7 million men. Of men who sought help, 18% were diagnosed with a male-related infertility problem, including sperm or semen problems (14%) and varicocele (6%).

Risk Factors

  • Age – A woman’s fertility starts to drop after she is about 32 years old, and continues doing so. A 50-year-old man is usually less fertile than a man in his 20s (male fertility progressively drops after the age of 40).
  • Smoking – Smoking significantly increases the risk of infertility in both men and women. Smoking may also undermine the effects of fertility treatment. Even when a woman gets pregnant, if she smokes she has a greater risk of miscarriage.
  • Alcohol consumption – A woman’s pregnancy can be seriously affected by any amount of alcohol consumption. Alcohol abuse may lower male fertility. Moderate alcohol consumption has not been shown to lower fertility in most men, but is thought to lower fertility in men who already have a low sperm count.
  • Being obese or overweight – In industrialized countries overweight/obesity and a sedentary lifestyle are often found to be the principal causes of female infertility. An overweight man has a higher risk of having abnormal sperm.
  • Eating disorders – Women who become seriously underweight as a result of an eating disorder may have fertility problems.
  • Being vegan – If a person is a strict vegan you must make sure your intake of iron, folic acid, zinc and vitamin B-12 are adequate, otherwise your fertility may become affected.
  • Over-exercising – A woman who exercises for more than seven hours each week may have ovulation problems.
  • Not exercising – Leading a sedentary lifestyle is sometimes linked to lower fertility in both men and women.
  • Sexually transmitted infections (STIs) – Chlamydia can damage the fallopian tubes, as well as making the man’s scrotum become inflamed. Some other STIs may also cause infertility.
  • Exposure to some chemicals – Some pesticides, herbicides, metals (lead) and solvents have been linked to fertility problems in both men and women.
  • Mental stress – Studies indicate that female ovulation and sperm production may be affected by mental stress. If at least one partner is stressed it is possible that the frequency of sexual intercourse is less, resulting in a lower chance of conception.


In Men –

Infertility in men can be caused by different factors and is typically evaluated by a semen analysis. A specialist will evaluate the number of sperm (concentration), motility (movement), and morphology (shape). A slightly abnormal semen analysis does not mean that a man is necessarily infertile. Instead, a semen analysis helps determine if and how male factors are contributing to infertility.

Conditions that can contribute to abnormal semen analyses include—

  • Varicoceles, a condition in which the veins on a man’s testicles are large and cause them to overheat. The heat may affect the number or shape of the sperm.
  • Medical conditions or exposures such as diabetes, cystic fibrosis, trauma, infection, testicular failure, or treatment with chemotherapy or radiation.
  • Ejaculation disorders – for some men it may be difficult to ejaculate properly. Men with retrograde ejaculation ejaculate semen into the bladder. If the ejaculatory ducts are blocked or obstructed the man may have a problem ejaculating appropriately.
  • Unhealthy habits such as heavy alcohol use, testosterone supplementation, smoking, anabolic steroid use, and illicit drug use.
  • Environmental toxins including exposure to pesticides and lead.

In Women

Ovulation – Regular predictable periods that occur every 24–32 days likely reflect ovulation. Ovulation can be predicted by using an ovulation predictor kit and can be confirmed by a blood test to see the woman’s progesterone level. A woman’s menstrual cycle is, on average, 28 days long. Day 1 is defined as the first day of “full flow.”

A woman with irregular periods is likely not ovulating – This may be because of several conditions and warrants an evaluation by a doctor. Potential causes of anovulation include the following –

  • Polycystic ovary syndrome (PCOS)
  • Functional hypothalamic amenorrhea (FHA)
  • Diminished ovarian reserve
  • Premature ovarian insufficiency
  • Menopause
  • Salpingitis (Pelvic inflammatory disease) caused by sexually transmitted disease.


Frequency of intercourse – The couple may be advised to have sexual intercourse more often. Sex two to three times per week may improve fertility if the frequency was less than this. Some fertility experts warn that too-frequent sex can lower the quality and concentration of sperm. Male sperm can survive inside the female for up to 72 hours, while an egg can be fertilized for up to 24 hours after ovulation.

For Men

Erectile dysfunction or premature ejaculation – Medication and/or behavioral approaches can help men with general sexual problems, resulting in possibly improved fertility.

Varicocele – If there is a varicose vein in the scrotum, it can be surgically removed.

Blockage of the ejaculatory duct – Sperm can be extracted directly from the testicles and injected into an egg in the laboratory.

Retrograde ejaculation – Sperm can be taken directly from the bladder and injected into an egg in the laboratory.

Surgery for epididymal blockage – If the epididymis is blocked it can be surgically repaired. The epididymis is a coil-like structure in the testicles which helps store and transport sperm. If the epididymis is blocked sperm may not be ejaculated properly.

For Women

Ovulation disorders – If the woman has an ovulation disorder she will probably be prescribed fertility drugs which regulate or induce ovulation. These include –

Clomifene (Clomid, Serophene) – This medication helps encourage ovulation in females who do not ovulate regularly, or who do not ovulate at all, because of polycystic ovary syndrome (PCOS) or some other disorder. It makes the pituitary gland release more FSH (follicle-stimulating hormone) and LH (luteinizing hormone).

Metformin (Glucophage) – Women who have not responded to Clomifene may have to take this medication. It is especially effective for women with PCOS, especially when linked to insulin resistance.

Human menopausal gonadotropin, or hMG, (Repronex) – This medication contains both FSH and LH. It is an injection and is used for patients who don’t ovulate on their own because of a fault in their pituitary gland.

Follicle-stimulating hormone (Gonal-F, Bravelle) – This is a hormone produced by the pituitary gland that controls estrogen production by the ovaries. It stimulates the ovaries to mature egg follicles.

Human chorionic gonadotropin (Ovidrel, Pregnyl) – This medication is used together with clomiphene, hMG and FSH. It stimulates the follicle to ovulate.

Gn-RH (gonadotropin-releasing hormone) analogs – For women who ovulate prematurely, before the lead follicle is mature enough during hmG treatment. This medication delivers a constant supply of Gn-RH to the pituitary gland, which alters the production of hormone, allowing the doctor to induce follicle growth with FSH.

Bromocriptine (Parlodel) – This drug inhibits prolactin production. Prolactin stimulates milk production in breast feeding mothers. If non-pregnant, non-breast feeding women have high levels of prolactin they may have irregular ovulation cycles and have fertility problems.

Fallopian tube surgery – If the fallopian tubes are blocked or scarred surgery may repair them, making it easier for eggs to pass through them.

Laparoscopic surgery – A small incision is made in the woman’s abdomen. A thin, flexible microscope with a light at the end (laparoscope) is inserted through the incision. The doctor can then look at internal organs, take samples and perform small operations. For women with endometriosis, laparoscopy removes implants and scar tissue, reducing pain and often aiding fertility.

Intrauterine insemination (IUI) is an infertility treatment that is often called artificial insemination. In this procedure, specially prepared sperm are inserted into the woman’s uterus. Sometimes the woman is also treated with medicines that stimulate ovulation before IUI. IUI is often used to treat—

  • Mild male factor infertility.
  • Couples with unexplained infertility.

Assisted Reproductive Technology (ART) includes all fertility treatments in which both eggs and sperm are handled outside of the body. In general, ART procedures involve surgically removing eggs from a woman’s ovaries, combining them with sperm in the laboratory, and returning them to the woman’s body or donating them to another woman. The main type of ART is in vitro fertilization (IVF).

Alternative Treatment


Vitamin D- Vitamin D deficiency is very common in America, especially during the winter, and can be very detrimental to overall health. Recent studies link inadequate vitamin D with infertility and miscarriage.

Vitamin C– A potent antioxidant, vitamin C is good for both male and female infertility.

Folic Acid– Folic acid is well known as a necessary vitamin in early pregnancy to prevent complications, but it is most beneficial when taken for several month before the pregnancy as well as during. It helps cell division and promotes ovulation.

Zinc– It is very important for cell division including sperm production and ovulation.

Selenium– Helps protect the body from free radicals and protects sperm and egg.

B-Vitamins– Deficiency of b-vitamins is common in anyone who consumes large amounts of processed foods, grains or sugars. Optimizing b vitamin levels can increase lutenizing hormone and follicle stimulating hormone to improve fertility.

Bioflavonoids – Helps strengthen the uterus by promoting healthy blood vessels.

Flaxseed oil – A healthy fat that can help normalize hormones and is essential to health.


Black cohosh (Cimicifuga racemosa)—Balances hormones.

Chaste tree (Vitex castus)—Raises progesterone levels, lowers estrogen levels, and helps correct ovarian dysfunction.

Dong quai (Angelica sinensis)—Nourishes and balances the female reproductive system.

False unicorn (Helonias dioica)—Has a reputation for promoting fertility, is recommended for ovarian dysfunction and as a uterine tonic.

Licorice (Glycyrrhiza glabra)—Balances hormones and is anti-inflammatory and sweet tasting (good flavoring for teas).

Red raspberry (Rubus strigosus)—Nourishes and strengthens the female reproductive system.

Squaw vine (Mitchella repens)—Also known as partridge berry. Recommended for fertility as a uterine tonic.

Wild yam (Dioscorea villosa)—Has a reputation for promoting fertility.

To Avoid –

Avoid Estrogen – Estrogen can have a negative effect on the development of the male reproductive tract, semen volume, and sperm count. Therefore, it is important to reduce or eliminate excess estrogen or estrogen-like chemicals in your body. Avoid all dairy products where cows have been fed hormones. The drop in sperm counts since the 1940s parallels a rise in the consumption of dairy products.

Chemicals, such as PCBs, dioxin, etc. are weakly estrogenic and degenerate very slowly, they hang around for years in our environment. Avoid the use of toxic substances such as fertilizers, cleaners. Also avoid all fatty animal products where chemicals may be stored up without being degraded.

Avoid Heavy Metals – Sperm are affected by lead, cadmium, arsenic, and mercury. There are many sources of exposure to these heavy metals such as deep-sea fish, cigarette smoke, and water from old pipes. Just as with men, lead, cadmium, or mercury can impair fertility by affecting sex hormones.

Avoid free radicals – We have all heard that free radicals (the hungry and unstable oxygen in our bodies) can cause cancer, heart disease, and increase the aging process. Like –

  • Cigarette smoke
  • Sunlight
  • Unsaturated oils (corn oil may be the worst)
  • Heating oils to too high a temperature when cooking
  • Foods left out of the refrigerator (oxidation causes butter to turn a slight yellow and cut apples to turn brown)

Caffeine and Alcohol – Both can impair female fertility. Excessive alcohol causes prolactin to rise and too much or too little prolactin is associated with infertility. Caffeine causes a decrease in serum prolactin. Caffeinated soft drinks may also reduce the chance of conception.


  • Flower Essences – The flowers of plants may be prepared in a similar way to homeopathic remedies so that the “essence” of the plant is harnessed in a medicinal way. An example is Pomegranate. Its use is described as a treatment for imbalance, i.e., women who are ambivalent or confused about the focus of feminine creativity, home or career, creative or procreative, those who attempt to balance both possibilities may feel drained and the psychological tension may be profound resulting in physical illness especially in the female organs.
  • Stress Reduction/Relaxation Therapies
  • Diaphragmatic Breathing Exercise


Reference –












February 8, 2017

Idiopathic Hypersomnia

Hypersomnia means “excessive sleep.” Patients with idiopathic hypersomnia sleep a reasonable amount at night (at least six hours) but have difficulty waking up and always feel tired and sleepy. In addition to excessive daytime sleepiness, people with idiopathic hypersomnia may:

  • Sleep enormous amounts every day (10 hours or more)
  • Display “sleep drunkenness,” such as extreme sleep inertia, difficulties waking up with alarm clocks and feeling groggy for long period of times.

Idiopathic hypersomnia (IH) belongs to a class of sleep disorders known as Central Disorders of Hypersomnolence. This group of sleep disorders includes narcolepsy types I and II, idiopathic hypersomnia, Kleine-Levin syndrome, insufficient sleep syndrome, and hypersomnia due to medical, hypersomnia due to medication or substance, and hypersomnia associated with a psychiatric disorder.

IH is a chronic disorder that remits in less than 1 in 6 cases, and that responds poorly to traditional treatments. It often negatively impacts upon the patient’s life to such an extent that working, socializing and even driving eventually become impossible due to an inability to sustain vigilant wakefulness.


The exact cause of idiopathic hypersomnia is unknown.  Researchers suspect that a genetic link may be possible because it appears to run in families, but there is no proof of this.  It seems to be a rather uncommon type of sleep disorder.  The condition usually develops slowly before the age of 30.  In the vast majority of cases, idiopathic hypersomnia is a lifelong condition.

Idiopathic hypersomnia causes people to sleep a long time during the night.  People may sleep more than 10 hours a night.  Despite such long periods of sleep, people with idiopathic hypersomnia feel very sleepy during the day.  No matter how much they nap during the day, they still feel very sleepy.  This condition can be very disabling, limiting a person’s ability to maintain employment, relationships, and quality of life.


The most common symptoms shared by sufferers of IH are –

  • Greater than 10 hours sleep per 24 hour period – often as much as 16+ hours per 24 hour period
  • Long, unrefreshing naps that typically last several hours
  • Awakening from sleep feeling unrefreshed, often with significant sleep inertia (commonly known as ‘sleep drunkenness’)
  • An inability to be woken from sleep – even multiple alarm clocks or physical attempts made by family/friends are largely unsuccessful.
  • Cognitive problems caused by the overwhelming desire to sleep (commonly referred to as ‘brain fog’)

As the condition progresses less common symptoms can include –

  • Anxiety and depression – often as a result of the limits this disorder imposes upon what the patient is able to do with their limited time awake
  • Raynaud’s type phenomena – freezing cold hands and feet
  • Loss of impulse control – especially in regard to food
  • Impotence

Those with IH often describe themselves as experiencing two types of sleepiness –

  • A physical exhaustion that ‘normal’ people might experience after missing several nights sleep in a row.
  • A cognitive exhaustion similar to Executive Dysfunction that can make even simple tasks like reading, conversation with friends, or watching a movie beyond their reach.



There are no medicines specifically designed to treat idiopathic hypersomnia, but medications used for narcolepsy can often help. The main medications used are stimulants, such as modafinil, dexamphetamine and methylphenidate, which help to keep people awake during the day. See treating narcolepsy for more information on these medicines. Antidepressants may be prescribed if emotional problems are interfering with the sleep.

The most common treatments prescribed are:

  • Amphetamines (such as Dextroamphetamine® or Adderall®)
  • Methylphenidate (such as Ritalin® or Concerta®)
  • Modafinil (such as Provigil® or Modavigil®)
  • Armodafinil (such as Nuvigil® or Waklert®) (Currently unavailable in Australia)
  • Sodium Oxybate (such as Xyrem®) (Currently unavailable in Australia)
  • Antidepressants

Lifestyle Changes

  • Keep a consistent sleep schedule
  • Avoid caffeine and alcoholic beverages
  • Talk to others about the condition.
  • Don’t over extend oneself.
  • Avoid operating motor vehicles or using dangerous equipment
  • Avoid working at night or social activities that delay the bedtime

Alternative Treatment

Exercise – Regular exercise not only helps people to lose weight and gain strength, it can also help treat sleep disorders naturally. Regular exercise increases feel-good chemicals such as serotonin in the brain, which can help ease feelings of anxiety and encourage restful sleep.

Nutrients that can help manage IH include calcium and magnesium, choline, chromium picolinate, coenzyme Q10, omega-3 fatty acids, B vitamins, vitamin C complex (including bioflavonoids) and vitamins D and E.

St John’s wort is an herbal remedy recommended for IH because of its action as a nervous system treatment. The herb might improve sleep quality and calm the nerves, which can be affected by the disorder as well as the emotional effects of living with the disease.

Ginkgo biloba nourishes the nervous system in two ways: It protects cells with its antioxidant effects and it improves circulation to the brain. Both of these functions might improve the condition of IH. The active constituents in ginkgo leaves are flavonoids and terpenoids. Balch recommends not taking the herb if you have a bleeding disorder or upcoming surgical procedure.

Gotu kola is an ayurvedic herb native to subtropical climates and has long been used in India as a treatment for the support of veins. It works by strengthening connective tissues. When veins are strong, blood flow is improved and the brain receives more oxygen and nutrients, which might be an effective treatment for narcolepsy, according to Balch.

Country mallow is an ayurvedic herb that stimulates the body and might help those suffering from IH stay awake. Be careful using this herb if you have a cardiovascular disorder, as it causes a rise in blood pressure.

Reference –












February 8, 2017

Hypothyroidism is an endocrine disorder condition identified by abnormally low thyroid production. It’s a condition wherein the thyroid gland is unable to make enough thyroid hormones to keep the body running normally. As the thyroid hormone play an important role in growth, development and many other cellular processes, inadequate thyroid hormone create across the board consequences on the body. People are called to be hypothyroid, when they have too little thyroid hormone in the blood.

To understand hypothyroidism, we first need to understand the thyroid gland. The thyroid gland is a butterfly shaped endocrine gland (system that secretes its hormones using ducts), which is normally located in the lower front of the neck just below the Adam’s apple. These glands produce the hormones, namely, tetraiodothyronine (T4) and triiodothyronine (T3), which are secreted into the blood and then carried to each and every tissue in the body.  Together these hormones regulate how the cells of our body use the energy to stay warm and keep the brain, heart, muscles and other organs working the way they should. This process is called metabolism. The hypothalamus and the pituitary in the brain control the normal secretion of thyroid hormones, which in turn control metabolism. In case the body does not have enough thyroid hormone, the system processes slows down, this means, the body makes less energy and the metabolism becomes sluggish.

The process is as follows:

  • The T4 and T3 hormones regulate the body’s metabolic functions like heat generation and utilization of carbohydrates, fats and proteins. I n children, these hormones are responsible for growth and development.
  • In the pituitary gland, thyrotropinstimulating hormone (TSH) is released when more thyroid hormone is needed and travels via the bloodstream to the thyroid gland. The TSH then stimulates the thyroid to produce T4 and T3.
  • The pituitary gland acts like a thermostat i.e. when there is too much or less thyroid hormones in the bloodstream, it releases TSH accordingly to signal the thyroid hormone production.

About 20 million people suffer from thyroid disorder in the U.S. It’s more common in women than in men and increase with age.

Causes of Hypothyroidism

There may be numerous reasons why the cells in the thyroid gland can’t make enough thyroid hormone. Following are some of the major causes:

  • Autoimmune Diseases – In some cases, the immune system that protects the body from invading infections can mistake thyroid glands and their enzymes for invaders and attack them, in turn there aren’t enough thyroid cells and enzymes left to produce enough thyroid hormones. This is more common in women than in men. Autoimmune thyroiditis can begin suddenly or may develop slowly over years. The most common forms are :
  • Hashimoto’s thyroiditis – An autoimmune disease causing chronic inflammation and consequential failure of thyroid gland. It is also called as chronic lymphocytic thyroiditis. It often leads to hypothyroiditism.
  • Grave’s Disease – It is an autoimmune disease in which the over activity of the thyroid gland causes over production of thyroid hormones. Grave’s disease is the most common cause of hypothyroidism. It has major negative impact on an individual’s mental and physical health.
  • Atrophic Thyroiditis – This condition is considered to be the opposite of Grave’s disease. In atrophic thyroiditis, TSH is blocked from activating thyroid cells. Tissue changes in atrophic thyroiditis are characterized by fibrosis and stunted cell growth, and hypothyroidism generally progresses to complete thyroid failure.
  • Radiation Treatment – Some patients with Grave’s disease, thyroid nodules or thyroid cancer, Hodgkin’s disease and lymphoma or cancer of neck or head are treated with radioactive iodine (I-131) in order to destroy or reduce the thyroid gland. All these patients can lose part or whole of their thyroid function.
  • Damage to the pituitary gland. The pituitary tells the thyroid how much hormone to make. When the pituitary is damaged by a tumor, radiation, or surgery, it may no longer be able to give the thyroid instructions and the thyroid may stop making enough hormones. 
  • Surgery – Some patients with thyroid nodules, thyroid cancer or Grave’s disease need to go under the thyroid removal surgery. If the whole thyroid is removed, there are 100 percent chances of hypothyroid, but if the part of gland is left, it may still produce enough thyroid hormone for the body. 
  • Medications – Certain medicines such as amiadarone, lithium, interferone alpha and interleukin-2 can affect the production of thyroid hormone. These medicines are most likely to trigger hypothyroidism in patients who have genetic tendency to autoimmune thyroid diseases. 
  • Congenital Hypothyroidism – A few babies are born without or with only a partly formed thyroid. In some cases babies have a part or their entire thyroid in wrong places. 
  • Too much or too little iodine in the diet – The thyroid glands need iodine to produce thyroid hormones. To maintain the thyroid hormone production in the body, right amount of iodine is needed. Taking in too much of iodine can cause or worsen hypothyroidism. 
  • Rare Disorders that infiltrate the thyroid – In some people, different diseases deposit abnormal substances in the thyroid and disturb its ability to function. For example, sarcoidosis can deposit granuloas, amydoilosis deposits amyloid protein etc. 


Hypothyroidism generally manifests as a slowing in the mental and physical activity of the affected person. As the symptoms are too variable and nonspecific, the only way to know for sure whether you have hypothyroidism is with a simple blood test for TSH.

The following are the symptoms for Hypothyroidism:

  • Fatigue, loss of energy, lethargy
  • Weakness
  • Sensitivity to cold
  • Dry skin
  • Hair loss
  • Sleepiness
  • Muscle pain, joint pain
  • Depression
  • Menstrual Disturbances and impaired fertility
  • Blurred vision
  • Brittle hair and nails
  • Constipation

If it is left untreated, the following symptoms can occur:

  • Puffiness of the face, hands and feet
  • Hoarseness
  • Decreased taste and smell
  • Thin eyebrows
  • Thickened skin
  • Slowed speech
  • Myxedema Coma
  • Altered Mental Status
  • Hypercarbia – abnormally elevated carbon dioxide (CO2) levels in the blood
  • Hypothermia – unusual and dangerous low body temperature
  • Bradycardia – abnormally slow heart action
  • Hyponatremia – low sodium concentration in the blood
  • Cardiomegaly, pericardial effusion, cardiogenic shock, and ascites may be present. 


Hypothyroidism can lead to following complications it left untreated:

  • Birth Defects – If the patient is pregnant and has an untreated thyroid disorder, the child may be at a higher risk of having birth defects than the ones born to healthy mothers. They may also have a significant mental  or physical development issues
  • Goiter – In situations when the thyroid in the body exerts itself in an effort to produce an adequate amount of hormones, the excessive stimulation results in an enlarged thyroid gland i.e. a bulge in the neck.
  • Heart Problems – Hypothyroidism even in its mildest form, can affect the heart conditions as it increases the levels of the bad cholesterol which leads to atherosclerosis, hardening of the arteries, therefore increasing the chances of heart attacks and strokes.
  • Infertility – If the thyroid hormone levels are too low, it affects ovulation and decreases women’s chances of conceiving.
  • Mental Health Issues


  • Thyroid Hormone Replacement Therapy – The goal of this replacement therapy is to compensate for the lack of hormones secreted by the thyroid gland. It is a very individualized treatment process. Its aim is to normalize the thyroid stimulating hormone (TSH) levels. In most cases, a daily dose of T4 pill is prescribed. The therapy is of variety of forms, including animal thyroid supplements.
  • Synthetic T4 Supplements – The standard form of treatment of hypothyroidism is synthetic forms of thyroid hormone T4 supplement, generally called as levothyroxine. There are 6 types of supplements available – Levo-T, Levothyroxine Sodium, Levoxyl,Novothyrox, Synthroid, UNITHROID.
  • Animal Thyroid Supplement – This type of treatment was once considered to be the standard treatment for hypothyroidism where in pig thyroid extract is used to make the supplement.

Side Effects of Drugs

The only dangers of thyroxin and other such drugs are caused by taking too little or too much. If it is taken too little, hypothyroidism will continue. If it is taken too much, development symptoms of hyperthyroidism—an overactive thyroid gland, is possible . The most common symptoms of too much thyroid hormone are fatigue but inability to sleep, greater appetite, nervousness, shakiness, feeling hot when other people are cold, and trouble exercising because of weak muscles, shortness of breath , and a racing, skipping heart. Patients who have hyperthyroid symptoms at any time during thyroxin replacement therapy should have their TSH tested. If it is low, indicating too much thyroid hormone, their dose needs to be lowered. 

Alternative Treatment

At our center we believe in treating the patients in every natural way possible. Our Comprehensive Treatment Approach helps us to study the patient’s health history and treat him accordingly.

  • Eating foods with high levels of B-vitamins and iron, such as whole grains, fresh vegetables and sea vegetables
  • Avoiding foods that interfere thyroid functions, such as, broccoli, cabbage, Brussels, sprouts, cauliflower, kale, spinach turnips, soybeans, peanuts, linseeds, pine nuts, cassava, millet and mustard greens.
  • Eating food that is rich in antioxidants, including fruits like blueberries, cherries and tomatoes and vegetables like squash and bell pepper.
  • Avoiding alcohol and tobacco.
  • Omega3 fatty acids such as fish oil to help reduce inflammation and enhance immunity.
  • Herbs like –
    • Coleus – for low thyroid function
    • Guggul – for low thyroid support
  • 100% Gluten free – The molecular composition of thyroid tissue is almost similar to that gluten. Hence, eating gluten can increase the autoimmune attack on the thyroid.
  • Acupuncture – It may be helpful in correcting hormonal imbalances including thyroid disorders.
  • Natural Desiccated Thyroid (NDT)

A natural alternative to Synthroid and all other synthetic thyroid medication is natural desiccated thyroid. It is made from pork thyroid glands. This natural source of thyroid has been used to treat hypothyroidism since a long time. It is natural, safe and well tolerated. NDT is commonly standardized by iodine content and not thyroid hormone content. As this contains other sources of iodine besides T4 and T3, it helps the patient, stimulate the thyroid hormone production. Therefore, desiccated thyroid can immediately relieve the symptoms of hypothyroidism by replenishing T3 and T4. It can as well as supply the active ingredient (iodine) required by the thyroid to natively produce its own thyroid hormones. In addition, iodine is another natural alternative to Synthroid. Some cases of hypothyroidism can be treated with natural sources of iodine such as iodized salt and sea vegetables such as kelp (as mentioned earlier). 


The patients need TSH to be checked about every 6 to 10 weeks after a thyroxine dose change.  The patients may need tests more often if they are pregnant or in case they are taking a medicine that interferes with your body’s ability to use thyroxine. The goal of treatment is to get and keep the TSH in the normal range. Babies with hypothyroidism must get all their daily treatments and have their TSH levels checked as they grow, to prevent mental retardation and stunted growth. Once gained a settled thyroxine dose, the patient can return for TSH tests about once a year.

Keeping other people informed

The patients are advised to inform their family members. Because thyroid disease runs in families, people should explain their hypothyroidism to their relatives and encourage them to get regular TSH tests. Informing  other doctors and  pharmacist about their hypothyroidism and the drug and dose with which it is being treated. If at all the patient starts seeing a new doctor, the doctor should be informed about hypothyroidism condition and the need of TSH test every year.

All you need is our support and your willingness to get cured….











February 8, 2017

Hyperthyroidism, or overactive thyroid disease, means your thyroid gland makes and releases too much thyroid hormone. The thyroid gland is located in the front of your neck, just below your Adam’s apple. It makes hormones that control your metabolism. Metabolism is the pace of your body’s processes and includes things like your heart rate and how quickly you burn calories.

Hyperthyroidism can affect your metabolism. It can also cause nervousness, increased perspiration (sweatiness), rapid heartbeat, hand tremors, difficulty sleeping and weight loss.

Hyperthyroidism is sometimes called thyrotoxicosis, the technical term for too much thyroid hormone in the blood. Thyroid hormones circulate throughout the body in the bloodstream and act on virtually every tissue and cell in the body. Hyperthyroidism causes many of the body’s functions to speed up. About 1 percent of the U.S. population has hyperthyroidism.

The thyroid gland is an organ located in the front of your neck and releases hormones that control your metabolism (the way your body uses energy), breathing, heart rate, nervous system, weight, body temperature, and many other functions in the body. When the thyroid gland is overactive (hyperthyroidism) the body’s processes speed up and you may experience nervousness, anxiety, rapid heartbeat, hand tremor, excessive sweating, weight loss, and sleep problems, among other symptoms.


Hyperthyroidism has several causes, including –

Graves’ disease is an autoimmune disorder that frequently results in thyroid enlargement and hyperthyroidism. In some patients, swelling of the muscles and other tissues around the eyes may develop, causing eye prominence, discomfort or double vision

Silent Thyroiditis can cause Transient (temporary) hyperthyroidism, a condition which appears to be the same as postpartum thyroiditis but not related to pregnancy. It is not accompanied by a painful thyroid gland.

Toxic Nodule – A single nodule or lump in the thyroid can also produce more thyroid hormone than the body requires and lead to hyperthyroidism.

Toxic Multi-nodular Goiter – Multiple nodules in the thyroid can produce excessive thyroid hormone, causing hyperthyroidism. Often diagnosed in patients over the age of 50, this disorder is more likely to affect heart rhythm. In many cases, the person has had the goiter for many years before it becomes overactive.

Excessive Iodine Ingestion – Various sources of high iodine concentrations, such as kelp tablets, some expectorants, amiodarone (Cordarone, Pacerone – a medication used to treat certain problems with heart rhythms) and x-ray dyes, may occasionally cause hyperthyroidism in certain patients.

Sub-acute Thyroiditis – This condition may follow a viral infection and is characterized by painful thyroid gland enlargement and inflammation, which results in the release of large amounts of thyroid hormones into the blood. Fortunately, this condition usually resolves spontaneously.

Postpartum Thyroiditis – 5% to 10% of women develop mild to moderate hyperthyroidism within several months of giving birth. Hyperthyroidism in this condition usually lasts for approximately 1 to 2 months. It is often followed by several months of hypothyroidism, but most women will eventually recover normal thyroid function.

Over Medication with Thyroid Hormone – Patients who receive excessive thyroxine replacement treatment can develop hyperthyroidism. They should have their thyroid hormone dosage evaluated by a physician at least once each year and should NEVER give themselves “extra” doses.

Rarely, hyperthyroidism is caused by a pituitary adenoma, which is a noncancerous tumor of the pituitary gland. In this case, hyperthyroidism is due to too much thyroid-stimulating hormone (TSH).

Who is at Risk?

Women are two to 10 times more likely than men to develop hyperthyroidism. Certain factors can increase the chances of developing thyroid disorders. People may need more regular testing if they –

  • have had a thyroid problem before, such
  • as goiter or thyroid surgery
  • have a family history of thyroid disease
  • have pernicious anemia, a B12 deficiency; type 1 diabetes; or primary adrenal insufficiency, a hormonal disorder
  • eat large amounts of food containing iodine, such as kelp, or use iodinecontaining medications such as amiodarone, a heart medication
  • are older than age 60
  • were pregnant or delivered a baby within the past 6 months


  • Rapid heart rate and palpitations
  • Shortness of breath
  • Goiter (swelling of the thyroid gland)
  • Moist skin and increased perspiration
  • Shakiness and tremors
  • Anxiety
  • Heat intolerance and sweating
  • Increased appetite accompanied by weight loss
  • Insomnia
  • Irritability
  • Swollen, reddened, and bulging eyes (in Graves disease)
  • Occasionally, raised, thickened skin over the shins, back of feet, back, hands, or even face
  • In crisis: fever, very rapid pulse, agitation, and possibly delirium
  • Changes in menstrual periods


  • Heart problems – A rapid heart rate, a heart rhythm disorder (called atrial fibrillation) or congestive heart failure can result.
  • Brittle bones (osteoporosis) – Too much thyroid hormone can interfere with your body’s ability to incorporate calcium into your bones.
  • Eye problems due to Graves’ opthalmopathy
  • Red, swollen skin on the shins and feet due to Graves’ disease
  • Thyrotoxic crisis 


Betablockers – Betablockers are a group of drugs that tend to improve some of the symptoms and manifestations of hyperthyroidism. In particular, they can improve palpitations, slow the heart down and improve tremor. They have no effect on curing the thyroid overactivity, but do make many people feel better.

Antithyroid drugs – Carbimazole (Neomercazole) and propylthiouracil are antithyroid drugs that are effective in reducing the production of thyroid hormones in the majority of people with hyperthyroidism. In people with Graves’ disease, treatment with one of these drugs for between 6 months and 2 years results in a long-term remission in around half of patients, once the drug is stopped. Both drugs have the common side effects of rash and joint pains, and more rarely (less than 1 in 500 cases) a serious reduction in the circulating white blood cells (agranulocytosis) may occur during treatment.

Radioiodine – Radioiodine is a radioactive isotope of iodine that is taken up and concentrated selectively by the thyroid gland. In most people, this small dose of radioactivity is sufficient to gradually destroy the thyroid tissue.

Thyroid surgery – Surgery to remove most or all of the thyroid gland (subtotal or total thyroidectomy) is another way of definitively treating thyroid overactivity. This is a straightforward operation when carried out by an experienced thyroid surgeon, with a low risk of complications. Hypothyroidism is a recognized side effect of surgery for which levothyroxine replacement will be needed, lifelong. Thyroidectomy is a good treatment option for people with a large goitre and for those with thyroid eye disease.

Alternative Treatment

A daily multivitamin, containing the antioxidant vitamins A, C, E, the B-complex vitamins, and trace minerals, such as magnesium, calcium, zinc, and selenium.

Omega-3 fatty acids such as fish oil, helps to reduce inflammation and boost immunity. Omega-3 fatty acids can have a blood-thinning effect.

Vitamin C act as an antioxidant and for immune support.

Alpha-lipoic acid for antioxidant support. It can potentially interfere with certain chemotherapy agents.

L-carnitine for decreasing thyroid activity. It may have blood-thinning effects and therefore increase anticlotting effects of certain medicines, such as warfarin (Coumadin).

Probiotic supplement (containing Lactobacillus acidophilus) for maintenance of gastrointestinal and immune health. Some acidophilus products may need refrigeration. Read labels carefully.


Reference –









February 8, 2017

Hyperparathyroidism is a condition in which the parathyroid glands, located in the neck, secrete too much parathyroid hormone (PTH). Parathyroid hormone regulates the amount of calcium and phosphorus (minerals necessary for strong bones and teeth) in the body, by controlling how much calcium is taken from bones, absorbed in the intestines, and lost in urine. When too much parathyroid hormone is secreted, levels of calcium in the blood and urine rise, and bones may lose calcium, leading to osteoporosis.

In the United States, about 100,000 people develop hyperparathyroidism each year. Women outnumber men two to one, and risk increases with age. In women 60 years and older, two out of 1,000 will develop hyperparathyroidism each year.

This excess PTH triggers the release of too much calcium into the bloodstream. The bones may lose calcium, and too much calcium may be absorbed from food. The levels of calcium may increase in the urine, causing kidney stones. PTH also lowers blood phosphorus levels by increasing excretion of phosphorus in the urine.

Calcium is essential for good health. It plays an important role in bone and tooth development and in maintaining bone strength.

Calcium is also important in nerve transmission and muscle contraction. Phosphorus is found in all bodily tissue. It is a main part of every cell with many roles in each. Combined with calcium, phosphorus gives strength and rigidity to the bones and teeth.


  • Primary Hyperparathyroidism, which is usually tied to an enlargement (hyperplasia) of a parathyroid gland, a benign (non-cancerous) growth (adenoma) or (in rare cases) a malignant (cancerous) tumor. The reasons for enlargement are usually undetermined but can be hereditary.
  • Secondary Hyperparathyroidism, when certain medical conditions skew the levels of calcium and a related mineral, phosphate. That prompts the parathyroid glands to compensate and is caused by such problems as a vitamin D or calcium deficiency, or by kidney failure.


In most cases nobody knows. Something happens within the parathyroid gland to cause the cells to replicate over and over until the gland grows into a tumor.

Some rare causes of tumor development are –

  • Lithium – People who take Lithium on a daily basis for 10 or more years may develop parathyroid problems.
  • Radioactive iodine therapy – Radioactive iodine therapy for previous thyroid problems causes approximately 3 percent of all parathyroid problems.
  • Radiation therapy – Radiation treatments to the head, neck and face as a child or teenager account for 1 percent to 2 percent of all parathyroid patients.
  • Family history – Hereditary forms of hyperparathyroidism account for about 2 percent of all parathyroid patients.
  • Kidney failure – Secondary hyperparathyroidism occurs in patients who have renal failure, and almost always in patients who have been on kidney dialysis for several years.

A small number of patients will have two parathyroid adenomas while having two normal parathyroid glands. An even smaller number of patients will have an enlargement of all four parathyroid glands, a term called parathyroid hyperplasia. This is much less common but the end results on the body are identical.

Risk Factors

People are at risk if they –

  • Are a woman who has gone through menopause
  • Have had prolonged, severe calcium or vitamin D deficiency
  • Have a rare, inherited disorder, such as multiple endocrine neoplasia, type I, which usually affects multiple glands
  • Have had radiation treatment for cancer that has exposed the neck to radiation
  • Have taken lithium, a drug most often used to treat bipolar disorder


Most people who have hyperparathyroidism do not experience any symptoms. Some people may have one or more of the following symptoms –

  • Feeling weak or tired most of the time
  • General aches and pains throughout your body
  • Abdominal pain
  • Frequent heartburn (because the high calcium level in your blood causes the stomach to make too much acid)
  • Nausea
  • Vomiting
  • Loss of appetite
  • Bone and joint pain
  • An increase in bone fractures or breaks
  • Confusion and memory loss
  • Kidney stones
  • Excessive urination
  • High blood pressure


  • Osteoporosis – a weakening of the bones that can make them more susceptible to fractures
  • Osteopenia – a condition that often precedes osteoporosis
  • Kidney Stones – hard deposits that result from excess calcium getting in the urine and getting filtered by the kidneys
  • Cardiovascular Disease – research suggests that high-calcium levels are associated with high blood pressure (hypertension) and some types of heart disease


Surgery –

  • Standard parathyroid surgery – The standard parathyroid operation begins with an anesthesiologist putting people to sleep under general anesthesia.
  • Minimal parathyroid surgery – Minimal parathyroid surgery (radio-guided parathyroid surgery) is dramatically changing the way surgeons treat parathyroid disease.

Medications –

Calcimimetics – A calcimimetic is a drug that mimics calcium circulating in the blood. The drug may trick the parathyroid glands into releasing less parathyroid hormone. This drug is sold as cinacalcet (Sensipar)

Hormone replacement therapy – For women who have gone through menopause and have signs of osteoporosis, hormone replacement therapy may help bones retain calcium. This treatment doesn’t address the underlying problems with the parathyroid glands.

Bisphosphonates – Bisphosphonates also prevent the loss of calcium from bones and may lessen osteoporosis caused by hyperparathyroidism. Some side effects associated with bisphosphonates include low blood pressure, fever and vomiting.

Alternative Treatment

Multivitamin – A daily multivitamin, containing the antioxidant vitamins A, C, E, the B-complex vitamins and trace minerals, such as magnesium, calcium, zinc, and selenium.

Calcium citrate is used for bone support.

Vitamin D is for immunity.

Ipriflavone (soy isoflavones) is helpful in for bone loss. Because hyperparathyroidism may lead to osteoporosis, taking ipriflavone may help treat this cause of bone loss. Ipriflavone can lower white blood cell counts and has the potential to interact with a variety of medications.

Chaste tree (Vitex agnus castus) for support of the parathyroid gland. Chaste tree extract has many possible drug interactions and can have hormone-like effects in the body.

Dandelion is used for its high mineral content.


Reference –


















February 8, 2017

Hypercalcemia is an elevated calcium level in the blood. Hypercalcemia can be asymptomatic in laboratory results, but high calcium levels are often an indicator of multiple myeloma. Hypercalcemia related to multiple myeloma is caused by the breakdown of bone which leads to the release of calcium into the blood. This can be a serious problem if appropriate treatment is not given immediately. Severe hypercalcemia can result in coma or cardiac arrest.

Hypercalcemia develops in 10%–20% of adults with cancer, but it rarely develops in children. When it develops in people with cancer, it may be called hypercalcemia of malignancy (HCM)

Calcium enters the blood in different ways. The level of calcium in the blood is controlled by hormones and the kidneys.

Calcitriol is a hormone form of vitamin D. It helps the intestines take up calcium from foods and drinks. The intestines then release calcium into the blood. Parathyroid hormone (PTH) helps control the level of calcium in the blood. When blood calcium levels are low, the parathyroid gland releases PTH. PTH stimulates cells in the bones to break bone down and release calcium into the blood. It also tells the kidneys and intestines to absorb more calcium. The kidneys help control the amount of calcium in the body. They can remove large amounts of calcium from the blood and pass it into the urine.

Severe hypercalcemia can have serious consequences, including kidney damage, dementia, and coma. Treating the underlying disorder is often sufficient to restore blood levels of calcium to normal. However, some of the problems associated with severe hypercalcemia are irreversible.


Calcium is important to many body functions, including –

  • Bone formation
  • Hormone release
  • Muscle contraction
  • Nerve and brain function

Parathyroid hormone (PTH) and Vitamin D help manage calcium balance in the body. PTH is made by the parathyroid glands, which are four small glands located in the neck behind the thyroid gland. Vitamin D is obtained when the skin is exposed to sunlight, and from dietary sources such as –

  • Egg yolks
  • Fish
  • Fortified cereals
  • Fortified dairy products

Primary hyperparathyroidism is the most common cause of hypercalcemia. It is due to excess PTH release by the parathyroid glands. This excess occurs due to an enlargement of one or more of the parathyroid glands, or a growth on one of the glands. (Most of the time, these growths are not cancerous).

Other conditions can also cause hypercalcemia –

  • An inherited condition that affects the body’s ability to regulate calcium (familial hypocalciuric hypercalcemia)
  • Being bed-bound (or not being able to move) for a long period of time (this occurs most often in young people)
  • Calcium excess in the diet. This is called milk-alkali syndrome. It is most often due to at least 2,000 milligrams of calcium per day. Taking too much vitamin D may add to the problem.
  • Hyperthyroidism
  • Kidney failure
  • Medications such as lithium and thiazide diuretics (water pills)
  • Some cancerous tumors (for example, lung cancers, breast cancer)
  • Some infectious and inflammatory diseases such as tuberculosis, Paget’s disease and sarcoidosis

Women in their 50s are the population at highest risk of overactive parathyroid glands.


The symptoms of hypercalcemia often develop slowly and may be similar to the symptoms of cancer or cancer treatment. How serious a person’s symptoms are is not related to the calcium level in the blood. Many patients have no symptoms. And, older patients usually experience more symptoms than younger patients.

People with hypercalcemia may experience the following symptoms –

  • Loss of appetite
  • Nausea and vomiting
  • Constipation and abdominal pain
  • Increased thirst and frequent urination
  • Fatigue, weakness, and muscle pain
  • Confusion, disorientation, and difficulty thinking
  • Headaches
  • Depression

Symptoms of severe hypercalcemia may include –

  • Kidney stones, a painful condition in which salt and minerals form solid masses called stones in the kidneys or urinary tract
  • Irregular heartbeat
  • Heart attack
  • Loss of consciousness
  • Coma

Patients and their families should be familiar with the symptoms on this list. Relieving side effects is an important part of cancer care and treatment. This is called palliative care. Talk with your health care team about any symptoms or side effects you may experience. This includes any new symptoms or a change in symptoms.


  • Pancreatitis
  • Peptic ulcer disease
  • Calcium deposits in the kidney (nephrocalcinosis)
  • Dehydration
  • High blood pressure
  • Kidney failure
  • Kidney stones
  • Depression
  • Difficulty concentrating or thinking
  • Bone cysts
  • Fractures
  • Osteoporosis

These complications of long-term hypercalcemia are uncommon today.


Removal of the abnormal and hyperfunctioning parathyroid tissue results in a long-term cure of HPT in 96% of patients and significant improvement in associated symptoms. The following criteria were proposed as indications for parathyroidectomy based on a National Institutes of Health–sponsored panel and endocrine specialty societies –

  • Serum Ca level more than 1 mg/dL above the upper limit of normal
  • Marked hypercalciuria higher than 400 mg/day
  • Creatinine clearance reduced more than 30% compared with age-matched controls
  • Reduction in bone mineral density of the femoral neck, lumbar spine, or distal radius of more than 2.5 standard deviations below peak bone mass (T score lower than -2.5)
  • Age younger than 50 years
  • Patients for whom medical surveillance is not desirable or possible
  • Presence of any complications (e.g., nephrolithiasis, overt bone disease)
  • An episode of hypercalcemic crisis

Medications – In some cases, the doctor may recommend:

Calcimimetics – This type of drug mimics calcium circulating in the blood, so it can help control overactive parathyroid glands.

Bisphosphonates – Intravenous osteoporosis drugs can help rebuild bone weakened by hypercalcemia. Risks associated with this treatment include osteonecrosis of the jaw and certain types of thigh fractures.

Prednisone – If the hypercalcemia is caused by high levels of vitamin D, short-term use of steroid pills such as prednisone might be helpful.

IV fluids and diuretics – Extremely high calcium levels can be a medical emergency. Hospitalization for treatment with IV fluids and diuretics to promptly lower the calcium level may be needed to prevent heart rhythm problems or damage to the nervous system.

Dialysis – If the kidneys fail due to cancer or its treatment, you may need dialysis. Dialysis removes wastes from the blood when the kidneys don’t work properly.

Alternative Treatment

  • Probiotics – Vitamin K2 (menaquinone) is one of many vitamins that probiotic microbes make in the digestive tract. If the bacteria in the gut are out of balance, people may be deficient in K2 and several other B vitamins. A deficiency of vitamin K2 causes deposition of calcium on the artery walls and atherosclerosis.
  • Drink plenty of fluids, especially water – Drinking fluids can help keep the person from dehydration and help prevent kidney stones from forming.
  • Exercise – Once the calcium levels return to normal, and if the person is otherwise healthy, it’s important to remain active to help maintain bone density. Try to combine strength training with weight-bearing exercises.
  • Don’t smoke – Smoking has been shown to increase bone loss as well as dramatically increase the risk of a number of serious health problems.


Reference –