Hello,

Thanks for writing to us. I am trying to give answer according to your query.

1) Hypothyroidism- It is a condition where the thyroid gland does not make enough thyroid hormone and mainly due to iodine deficiency. It is seen in some percentage among reproductive age group women. They are three types:
a) Sub clinical hypothyroidism - only blood TSH level is elevated and T3/ T4 level is normal.
b) Primary hypothyroidism- there may be underlying autoimmune disorder like hashimoto's thyroiditis (needs to be ruled out) and here, blood TSH level is high enough with low level of both T3/T4.
c) Secondary hypothyroidism- pituitary/ hypothalamus causes are needed to be ruled out. Here, T3/T4 level is decreased whether blood TSH level is normal & decreased.

There are several clinical features of hypothyroidism like cold intolerance, obesity/ weight gain, constipation, fatigue, itchy skin, cramp/joint pain, depression, female infertility and problem with menstrual cycle (heavy period), galactorrhea, mood swing, stress etc.

2) Any type of untreated hypothyroidism can give bad impact or ill health effect on marriage, sex life & future fertility/ pregnancy.

In sex life- women with low level of thyroid hormone may have low sex drive, problem with achieving orgasm and difficulty in conceiving etc.

In pregnancy- there are so many effects like poor neurodevelopment of fetus in early weeks, other complications such as miscarriages, anaemia in pregnancy, pre-eclampsia, abruptio placenta, postpartum haemorrhage etc. Baby may have cretinism with low IQ.

3) Menstrual cycle may be hampered by hypothyroidism state. It is associated with heavy or irregular bleeding. Though other associated pathology are needed to be ruled out by ultrasound lower abdomen & other hormone assay. In such cases, specific treatment may be required.

It is better to consult with endocrinologist for complete evaluation of hypothyroidism state through physical examination & blood test for thyroid profile (T3/T4/TSH level). Monitoring of thyroid profile is essential at periodic interval.

Thyroid hormone supplement (thyronorm) is the treatment of choice to cure hypothyroid disorder completely. Iodized salt with diet is very much helpful.

Some measures for life style modification & improving present condition:

1)) Control body weight by regular physical exercise by jogging/ running/ treadmill or she may join into XXXXXXX for daily work out.
2) Take healthy diet with iron supplements with avoidance of junk/ fatty/fast food.
3) Drink plenty of fluids/water and eat more vegetables & fresh fruits.
4) Avoid stress/tension/ depression by doing yoga/deep breathing regularly (20-30 times at a time)
5) Maintain personal hygiene properly and need adequate sleeping with complete relaxation.
6) One premarital counseling is quite helpful in such condition.

I think that above information is much sufficient & helpful to you. If you have any further questions I will be happy to help.

Wish you for good health & successful marriage life in future.

Regards,
Dr Soumen.

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Hello XXXXXXX,

Thanks for follow up query. I am happy to help you.

1) We can not tell exactly how long she has been suffering from hypothyroidism. But it can be guessed from appearing of certain clinical features (that I describe in earlier reply) besides heavy period. Heavy menstrual bleeding may be due to hypothyroidism or uterine pathology (like fibroid/ endometriosis/ polyp etc). It can be ruled out by one pelvic sonography (ultrasound). She may need specific treatment for the same after consultation with gynecologist.

2) Diet therapy can be given basically to control future obesity & type 2 diabetes. In case of autoimmune hypothyroid, there is full restriction of spinach, radish, cauliflower and cabbage. Total 1600-1700 kcal/day with 50-60 gm protein is required. Diet schedule would be as follows:

In breakfast: Idly/ Dosa/ Chapatti/ Upma /Wheat Bread /Sambar/ Vegetable Curry/ Corn flakes with skimmed milk etc.

In lunch/ dinner time: iodized salt with Rice/ Chapatti/ Vegetables/ Salad/ Fish curry/ Chicken curry /Egg white/ Low fat paneer/ Soya bean / Curd/ Buttermilk etc.

In between major meals: Fruits/ Salad /Veg Soup/Tea/ Coffee/ Milk/ Biscuits/ Bread Toast/ Veg Sandwich etc.

Regular physical exercise by means of jogging/ running/ treadmill along with above diet therapy and regular taking of thyroid medication can only improve above condition.

If you do not have any clarifications, you can close the discussion and rate the answer.

Be well & take care yourself.

Regards,
Dr Soumen

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Hello XXXXXXX.

Thanks again for your query.

There is no permanent cure for hypothyroidism and most of the patients have it for life time. But it can be controlled completely with proper diet therapy & thyroid medication.

If you do not have any clarifications, you can close the discussion and rate the answer.

Regards,
Dr Soumen.

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