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Hormonal Havocs in 21st Century

Currently, we are facing with several hormonal problems in our day-to-day life. It is difficult to find a family where one of these disorder is lacking. Some of the people may have combination of these disorders. People with all socio-economic status are affect. Hence, no one is protected. These hormonal disorders are often ignored in the early stages till it becomes a major health problem. These menace disorders includes:

  • Obesity
  • Type II Diabetes
  • Hypothyroidism
  • PCOS

  • Obesity
    Some facts:

  • 1 in 5 individual is either overweight or obese in urban area
  • Sedentary lifestyle is main cause for obesity
  • Obesity is seed for several diseases like Diabetes, High Blood pressure, High cholesterol, osteoarthritis etc.
  • Often ignored, people visit doctor when weight has increased tremendously
  • Also seen in low socio-economic population

  • Causes:

  • Lifestyle disorder
  • Hormonal disturbances
  • Hypothyroidism
  • PCOS
  • Cushing’s syndrome
  • Medications
  • Steroids
  • Anti-depressants
  • Genetic syndromes

  • How to diagnose

  • Body Mass index : weight in kg/(Height in meters)2
  • BMI > 25 kg/m2 is considered as obesity amongst Indians
  • Body fat > 25% in women and > 20 in men
  • Waist circumference > 80 cm in women and 90 cm in men

  • Treatment:

  • Life style modification
  • Daily 45-60 min of exercise
  • Reduce caloric intake in diet
  • Avoid high caloric food completely like ice-cream, dry fruits, sweets, deep fried items
  • Medicines as prescribed by doctor
  • Only approved medication available in India is Orlistat
  • Regular check up of weight, blood pressure and blood sugar

  • Type II Diabetes
    Some facts:

  • 1 in 5 individual is diabetic or at risk of diabetes
  • India is capital of Diabetes
  • 80% of diabetic patients are obese
  • Often ignored due to lack of symptoms
  • Chronic complications lead to health and socio-economic burden

  • Symptoms:

  • Increased frequency of urination
  • Increased hunger
  • Weight loss
  • Genital infection
  • Blurring of vision

  • How to diagnose

  • Blood sugar testing at fasting state and then2 hours after glucose ingestion is diagnostic.

  • Treatment:

  • Life style modification
  • Medicines as prescribed by doctor
  • Regular check up of blood sugar
  • Annual check up for diabetic complications

  • Test

    Frequency

    Target

    FBS

    Every fortnightly

    70-110 mg/dl

    PPBS

    Every fortnightly

    < 160 mg/dl

    HbA1c

    Every Quarter

    6.5%

    Lipid Profile

    Every 6 months

    LDL 100 mg/dl, TG 150 mg/dl

    Creatinine

    Annually

    0.6-1.2 mg/dl

    Urine Micro-albumin

    Annually

    <30 mg/l

    Fundus (Eye test)

    Annually

     

    ECG

    Annually  


    Hypothyroidism
    Some facts:

  • Incidence of Hypothyroidism is rising
  • Often ignored due to lack of symptoms

  • Symptoms:

  • Puffiness of face and feet
  • Dryness of skin
  • Hair loss
  • Weight gain
  • Tiredness
  • Constipation
  • Laziness
  • Forgetfulness
  • Menstrual irregularities

  • How to diagnose

  • Blood testing for Thyroid hormone levels: T3, T4, and TSH.
  • Thyroid antibodies if needed.

  • Treatment:

  • Medicines as prescribed by doctor
  • Remember: Thyroxine tablet should be taken empty stomach preferably in morning
  • Regular check up of thyroid levels quarterly
  • Target TSH: 0.5-2.5 uU/ml

  • PCOS – Polycystic Ovarian syndrome
    Some facts:

  • 5-10 % of women in child bearing age are affected by PCOS
  • Often associated with several endocrinopathies
  • Obesity
  • Type II Diabetes
  • Dyslipidemia
  • Insulin resistance

  • Symptoms:

  • Menstrual irregularities
  • Infertility
  • Excess hair growth
  • Acne
  • Scalp hair loss
  • Obesity

  • How to diagnose

  • Atleast 2 of the following 3 criteria are essential for diagnosis:
  • Irregular or absent periods
  • Blood tests or physical signs that show high androgens
  • Polycystic ovaries on sonography
  • Hormone testing like LH, FSH, Free testosterone, 17 Hydroxy-progestrone testing.

  • Treatment:

  • Life style modification
  • Modest weight loss of 5-10% of initial body weight improves metabolic, physiological and psychological aspects of PCOS
  • Medicines as prescribed by doctor
  • Anti-androgens
  • OCP’s
  • Metformin
  • Regular check up for hormones levels and to estimate side effect of medications

  • Early recognition is key to prevent major problems. One should be watchful about any such abnormal features, and should consult doctor immediately. Healthy lifestyle can prevent major complications of these disorders.