CASE...1

A female patient age 19 ,unmarried ,suffering from right side abdominal pain ,near the novel. gastralgia ,nausea *mind- changeable mood ,weeping and give sympathy then Happy *head- frontal headache and heaviness *Mense- regularly, profuse,painful.and no white discharge *Urine - normal *Stool-Normal ,no constipation * desire- Great desire for chilli,and eggs aversion to sweet **U.S.G

A 18 years girl came with irregular menstruation since puberty . associated with boils like painful eruption over back and chest for last 1 year. past illness- Typhoid family history- Mother- Diabetes Generalities-hot pt Appetite- less Craving- sweets thirst-moderate perspiration- moderate stool-clear urine- clear menses-Irregular sleep- good mind- Talk less Irritable weeps easily ( after weeping she gets relief) want company and consolation intelligent what is the similimum? please respected doctors share your views in that case

WHAT WOULD YOU SUGGEST FOR THIS CASE? THIS IS THE CONVSERSATION. PLEASE TAKE TIME TO CONCLUDE THE CASE. ANY RUBRIC SELECTION? ANY GROUP SELECTION? ANY KINGDOM SPECIFIC? IMPORTANT POINTS? PATIENT AGE 20/F. DATE 12/11/17 MEDICAL DIAGNOSIS. PYTRIASIS ROSEA TELL ME HOW CAN I HELP YOU? I have these red rashes all over the body. These are very itchy. O/E SKIN The rashes are small oval, itchy and papular all over the body except face. ARE YOU TAKING ANY PRECAUTIONS? Yes, I am not going outside not applying any soap and not wearing any other fabrics except the cotton. OK ANY DIETARY CHANGES??? I am not eating any junk food. OH OK WHAT KIND OF JUNK FOOD DO YOU EAT REGULARLY? Pasta, Pizza and much of chicken dishes. WHAT ELSE? Actually, I eat chicken regularly. SO YOU ARE NON VEG? Yes, but I am not eating these days because of skin issue. DO YOU EAT DAILY NON VEG? Yes, I eat daily egg or chicken. OK, ANY DRINKS? I normally like the red bull and if in hard drinks I like to drink beer but occasionally. YOU DO DRINK BEER HEY! Yes DO YOU LIKE BEER? No no it's not like that's drink it occasionally. HOW MUCH DO YOU DRINK? 1-2 bottles. HOW OFTEN DO YOU DRINK? Like once a month. Now, I am thinking of not to drink beer. OK GOOD. Actually I want to loose weight and want to increase my stamina. TO INCREASE STAMINA? IN WHAT WAYS? SO YOU ARE FEELING WEAK? For gymming. OK HOW MUCH IS YOUR WEIGHT RIGHT NOW? Right now I am 60 KG. HOW ABOUT HEIGHT? 5'3". OK DO YOU DRINK HARD DRINKS TOO LIKE VODKA ETC? ( THIS IS TOLD BY HER MOTHER TO ME THATS WHY I HAVE ASKED) No, very less like way too rare. MEANS YOU DO DRINK VODKA TOO? I had it 3 - 4 months ago. I don't like them actually. DO YOU SMOKE TOO? (AGAIN HER MOTHER GAVE ME THIS INFORMATION THAT SHE SMOKE HUKKA) No I don't smoke ( SHE DENIED) ANY OTHER HEALTH ISSUE? Yes, I get cold very often. OK IN WHICH WEATHER?? Especially in summer. HOW DOES IT AFFECT YOU? I sneeze a lot. OK HOW DOES IT AFFECT YOUR DAILY WORK? Sometime but usually at night nose becomes stuffy and obstructed and I can not breath through nose and I have to breath from mouth. However, the rest of the day is fine I do not have any problem. OK SO YOU DO NOT HAVE ANY PROBLEM IN DAY TIME? No it's just at night time. And it started a month ago. And as the winter starts I am totally fine. WHAT ELSE? Nothing all good. OK TELL ME WHAT KIND OF PERSON YOU ARE? NATURE WISE? I am very kind, Helpful, kind of dominating, and cheerful and wanted to be in group to enjoy more. CAN YOU GIVE ANY SITUATION FOR THE ABOVE SAID WORDS? I HAVE ASKED A LONG QUESTION TAKE YOUR TIME TO ANSWER. Kind:- if some one is sad or in a bad situation I support them. Helpful:- If someone needs my help I barely say no to them. Dominating:- it's like if I want anything to be done according to me so I want it in that way only and I likes to control. Cheerful:- I stay happy most of the time. CAN YOU GIVE AN EXAMPLE WHERE YOU FELT TO CONTROL OVER SITUATION? Like if my family wants to organize something for someone then at that time I felt like to control and sometimes when I go out with my friends and I want to go to the place I suggested then I feel control. HOW WOULD YOU FEEL IF YOUR FRIENDS DO NOT GO TO THE PLACE YOU HAVE SUGGESTED? I feel sad and afterwards I don't think about it. I go with the friends where ever they want to go together. CAN YOU EXPLAIN MORE WHAT DOES THIS CONTROL MEANS? They should do few things according to me. WHEN YOU SUGGESTED ANY PALCE YOU WANT TO GO WITH THEM AND YOUR FRIENDS DID NOT AGREE WITH YOU HOW WOULD YOU FEEL? Sad and ignored (RUBRIC DELUSION?) IS THERE ANY THOUGHTS COMES TO MIND THAT MAKES YOU SAD? Actually what I do for my family and for my friends I do it with my heart. So, if I do not get the chance to express my love, my ideas then I feel sad and ignored. I feel sad inside but will not show on face. WHY YOU WILL NOT SHOW ON FACE SADNESS? It's because I do not want any one to pity on me. WHAT WOULD YOU THINK WHEN A PERSON DO WITH HEART FOR OTHER PERSON AND THEN THAT PERSON WILL NOT ACCEPT THE SUGGESTION THEN HOW THAT PERSON WOULD FEEL? ITS NOT ABOUT YOU ITS SOMEONE ELSE. That person will obviously feel low and ignored. (SAME REPLY IGNORED) HOW DO YOU REACT WHEN YOU ARE SAD AND IGNORED AT HOME? I lay on my bed and I don't interact with my family and just listen to music. WHAT KIND OF MUSIC DO YOU LISTEN AT THAT TIME? Dancing, hip hop, romantic, sad all kind. DO YOU WEEP TOO? No if I weep I weep alone. Because I do not want to show that I'm weeping. WHEN YOU ARE WEEPING AND SOMEBODY COME WHAT WOULD YOU DO? ESPECIALLY WHEN THAT PERSON KNOWS YOU ARE WEEPING? Then my tears comes out more and I think it's human nature. WOULD YOU LIKE TO BE ATTENDED IN THAT SITUATION OR WANT SUPPORT? I would like if someone would give me the privacy. I don't want anyone to ask me questions and just give me the space may be I will discuss it with myself. YOU PERHAPS GET ANGRY IF SOMEONE DISTURB YOU WHILE YOU ARE SAD? Irritated. HOPE I AM NOT IRRITATING YOU? No. You are not irritating. DO YOU HAVE ANY DREAMS AT NIGHT? Yes, before I had dreams but now I am perfectly fine no dreams at all. CAN YOU TELL ANY DREAM WHICH WAS RECURRENT? Once I had a dream and I saw a person but I was not able to see the face of that person a black person totally black. WHAT WAS YOUR FEELING? I woke up WHAT WAS YOUR REACTION? I was kind of scared. SCARED? It felt like someone was following me. DOES ANYBODY FOLLOW YOU IN REAL LIFE? No ARE YOU SURE NO ONE FOLLOW YOU? Yes I am sure no one followed. IS THERE ANY INCIDENT IN YOUR LIFE THAT HAS BIG IMPACT ON YOU? No OK WHAT KIND OF EXERCISES DO YOU LIKE AT GYM? Cardio and all. SO YOU LIKE VERY HARD, FAST EXERCISE OR SOFT, SLOW EXERCISE? I like sort of weight trading plus normal exercises. ARE YOU A COLD PERSON OR HOT PERSON? I feel equal but I would like winters because you have more choices to wear clothes. ANY HEADACHE? When I do not have enough sleep I got headaches. I get bad headache with dizziness. WHERE DO YOU HAVE PAIN IN HEAD? Whole head. WHAT MAKES THE PAIN BETTER? Sleep ANY BOWEL ISSUE? No ANY OTHER COMPLAINTS? Facial hairs. The hairs texture on face are very dark and thick. ANY GYANE PROBLEMS? Lot of pain for the first two days and I can't get up from bed for 2 days. I need-heating bottle to get some relief. THE PERIODS PAIN STAYS DURING PERIODS OR GETS BETTER WHEN PERIODS STARTS. After 2 days it gets better CAN YOU DESCRIBE THE SENSATION DURING PERIODS? Lower abdominal pain with trouble passing stool. I have actually cramps in lower abdomen And do not want to eat anything with mood swings. Sometimes I have loose motions. (DIARRHOEA MENSES DURING) DO YOU LIKE TO KEEP ANY PET? ( I USE TO ASK THIS QUESTION ITS HELPFUL SOMETIMES) Yes, I love dogs and cats . I play a lot with dog. WHICH PET YOU LIKE THE MOST? Dogs THANKS TO ALL OF YOU IN ADVANCE!

Acne is an inflammatory skin disorder ofthe skin’s sebaceous glands and hair folliclesthat affects about 80% of people between the ages of 12 and 24. During puberty high levels of hormones are produced in both girls and boys. This leads to the production of large quantities of sebum. Sebum is an irritantthat can clog the pores and form a pimple which may become infected and form a pustule. Hormones don’t go away after adolescence. Many women still get premenstrual acne from of the release of progesterone after ovulation. Acne is a disease that affects the skin’s oil glands. The small holes in your skin (pores) connect to the oil glands under the skin. These glands make an oily substance called sebum. The pores connect to the glands by a canal called a follicle. Inside the follicles, oil carries dead skin cells to the surface of the skin. A thin hair also grows through the follicle and out to the skin. When the follicle of a skin gland clogs up, a pimple grows. Most pimples are found on the face, neck, back, chest, and shoulders. Acne is not a serious health threat but it can cause scars. *Causes of Acne The exact cause of acne is unknown, several related factors are :* Hormonal activity supposed to be responsible, such as menstrual cycles andpuberty. *Increase in hormones called androgens (male sex hormones), which causes sebaceous glands to enlarge and make more sebum. *Hormonal changes related to pregnancy can also cause acne. § Another factor is heredity or genetics. Researchers believe that the tendency to develop acne can be inherited from parents. For example, studies have shownthat many school-age boys with acne have a family history of the disorder .§ Accumulation of dead skin cell. § Bacteria in the pores, to which body becomes allergic. § Skin irritation or scratching of any sortwill active the inflammation. § Starting or stopping birth control pills. § Heredity (if your parents had acne, you might get it too). § Some types of medicine. § Greasy makeup.In some patients, contributing factors may be:Pressure: In some patients, pressure from helmets, chinstraps, collars, and thelike can aggravate acne.Drugs: Some medications may cause or worsen acne, such as those containing iodides, bromides, or oral or injected steroids (either the medically prescribedprednisone or the steroids bodybuilders or athletes take.) Most cases of acne, however, are not drug-related. Occupations: In some jobs, exposure to industrial products like cutting oils may produce acne.. . HOMOEOPATHIC REMEDIES. 1)SulphurIs perhaps the remedy most often indicated in this affection, especially if chronic. The skin is rough and hard and the acne is associated with comedones and constipation; great aggravation from water is the characteristic leading to Sulphur in skin affections. Face is Pale, sickly color. Heat and spotted redness of face. Black pores. Itching intensely in evening and from warmth. The acne punctata is the variety corresponding most nearly to Sulphur. Simple forms yield to Belladonna or Pulsatilla. Acne rosacea yields to Arsenicum iodatum or Sulphur iodide.SanguinariaIt is another useful remedy in acne, especially in women with scanty menses and irregular circulation of blood. Other remedies for acne dependent on sexual disturbances of women are Calcarea carbonica and Aurum muriaticum natronatrum.Kali bromatumAcne on the face, neck and shoulders. Wefrequently find acne in Epileptics who have been maltreated by bromides. This remedy is especially adapted to the acnesimplex and the acne indurata, especiallyin hyperaesthetic, nervous females. Faceflushed. Acne of face, pustules. General failure of mental power, loss of memory, melancholia, anesthesia of the mucous membranes. Suicidal mania with tremulousness. Itching of skin worse on chest, shoulders, and face. Anesthesia ofskin. This remedy may be given if Asterias Rubens fails. Dr. J.H.Clarke says, “I know of no remedy of such universal usefulness in cases of simple acne as Kali bromatum 30,” and the late Dr.A.M. Cushing recommended Arsenicum bromatum 4x as very efficacious.Thuja is one of our best remedies for acne facialis. Calcarea picrata is also a useful remedy for acne; clinically it has been found one of the good remedies. Calcarea sulphurica is indicated where the pimples suppurate. Antimonium crudumSmall red pimples on face, acne in drunkards with gastric derangements, thirst and white-coated tongue. Face with sad expression Fat, fretful, cross and peevish; cries if looked at, touched or washed. Ecstatic, dreamy, sentimental. Pustules. Antimonium tartaricum.Obstinate cases, with tendency to pustulation, are curable with this remedy.Berberis aquifoliumIt is useful where the skin is rough and the acne persistent. Natrum muriaticumIt acts especially on the sebaceous glands, and is a very helpful remedy in acne. In this affection attention must bedirected especially to the patient’s type,temperament and tendencies and the general symptoms are far mores important than the local ones. Asterias RubensPimples on the face at the age of puberty. A remedy for the sycotic diathesis; flabby, lymphatic constitution,flabby with red face. Nervous disturbances. Pimples on side of nose chin and mouth. Belladonna Acne rosacea. Alternate redness and paleness of the skin. Skin dry, hot and swollen, pustules on face. Face is red, bluish-red, hot, swollen, and shining. Patient is restless and talks fast. Acuteness of all senses. Hepar Sulphur Papules prone to suppurate and extend. Acne in youth. Suppurate with prickly pain. Easily bleed. Unhealthy skin; every little injury suppurates. Cannot bear to be uncovered; wants to be wrapped up warmly. Sticking or pricking in afflicted parts. Great sensitiveness to slightest touch. Constant offensive exhalation from the body Face, Yellowish complexion. Suits especially scrofulous and lymphatic constitutions that are inclined to have eruptions and glandular swellings. Unhealthy skin. Great sensitiveness to all impressions. The lesions spread by the formation of small papules around the side of the old lesion.Chilliness, hypersensitiveness, splinter-like pains, craving for sour and strong things are very characteristic. Calcarea Silicata Pimples, comedones. A deep, long acting medicine for complaints which come on slowly and reach their final development after long periods. Hydrogenoid constitution. Skin Itching, burning, cold and blue, very sensitive. very sensitive tocold. Patient is weak, emaciated, cold andchilly, but worse from being overheated; sensitive generally. Nux vomica Acne; skin red and blotchy. Body burninghot, especially face; yet cannot move or uncover without feeling chilly. The typical Nux patient is rather thin, spare, quick, active, nervous, and irritable. Nux patients are easily chilled, avoid open air.Very irritable: sensitive to all impressions. Ugly, malicious. Does not want to be touched. Face Pale, yellowish, earthy or livid countenance. Yellow aboutnose, mouth or eyes. Red, swollen.Arsenicum IodatumAcne hard, shotty, indurated base with pustule at apex. It will be indicated by a profound prostration, rapid, irritable pulse and severe cases of acne vulgaris. Great emaciation. Skin is Dry, scaly, itching. Debilitating night-sweats. Causticum Acne rosacea. Acne in groups, aggravated by heat. Acne especially on nose Adapted to persons with dark hair and rigid fibre; weakly, psoric, with excessively yellow, sallow complexion; Ailments from suppressed eruptions. Burning pimple with itching. Chelidonium Majus Painful red pimples and pustules; especially on nose and cheeks. Wilted skin. Dry heat of skin with itching. Painful red pimples and pustules. Face red, without heat. Itching over entire face and forehead. Depression and sadness, even to weeping. Restlessness and solicitude concerning the present and future. Graphites Pimples and acne; itching. Skin is Rough, hard, persistent dryness of portions of skin. Unhealthy skin; every little injury suppurates. Patients who are rather stout, of fair complexion, with tendency to skin affections and constipation, fat, chilly, and costive, with delayed menstrual history, take cold easily. Has aparticular tendency to develop the skin phase of internal disorders. Anemia with redness of face. Tendency to obesity. Timid. Unable to decide. Psorinum Acne rosacea. Greasy face. Pale, sickly look. Skin is yellow, dirty, and greasy. Roughness of knuckles. Pimples with black points in center. Small numerous pustules, itching unhealthy. Itching, after scratching vesicles arise, when touched. Acne worse during menses, from fats, sugar, coffee, meat. Sabina Hypochondriacal dejection. Low spirited and joyless, with a feeling of general exhaustion. Acne. Face is pale, with lusterless eyes encircled by blue ring. Black pores on nose and face. Calcarea phosphoricum Acne in anaemic girls at puberty, with vertex headache and flatulent dyspepsia, relieved by eating. Skin is dark – brown, yellowish. Red, with prickling like nettles after a bath.Thuja occidentalisPimples on face. Face glowing redness ofwhole face, with a fine network of blood vessels, as if it were marbled. oily skin. Burning heat and redness of. Flushes of heat in. Sweat on, especially on side on which he does not lie. Pimples on upper lipand chin. Lips, etc. All eruptions burn violently after cold washing. Corrosive itching. Better scratching, but then followed by burning. Painful sensitiveness of affected part. The skin symptoms better by touch.Ledum palustreAngry mood. Love for solitude. Great seriousness. Face, Alternatively pale and red. Dry pimples like millet seed on forehead. Red nodules Boils on forehead.Skin Dry, want of natural perspiration.Nitricum acidumAnxious about his complaints, with fear of death. Sadness and despondency. Face yellow. Sunken eyes encircled by yellow. Dark yellow, almost brownish complexion. Pimples on forehead and temples. Skin with Black pores.

Friends today I am discussing about a problem known as Thyroid Disease & Pregnancy. Thyroid disease is a group of disorders that affects the thyroid gland. The thyroid is a small, butterfly-shaped gland in the front of your neck that makes thyroid hormones. Thyroid hormones control how your body uses energy, so they affect the way nearly every organ in your body works—even the way your heart beats. The thyroid is a small gland in your neck that makes thyroid hormones. Sometimes the thyroid makes too much or too little of these hormones. Too much thyroid hormone is called hyperthyroidism and can cause many of your body’s functions to speed up. “Hyper” means the thyroid is overactive. Too little thyroid hormone is called hypothyroidism and can cause many of your body’s functions to slow down. “Hypo” means the thyroid is underactive. If you have thyroid problems, you can still have a healthy pregnancy and protect your baby’s health by having regular thyroid function tests and taking any medicines that your doctor prescribes. What role do thyroid hormones play in pregnancy? Thyroid hormones are crucial for normal development of your baby’s brain and nervous system. During the first trimester—the first 3 months of pregnancy—your baby depends on your supply of thyroid hormone, which comes through the placenta . At around 12 weeks, your baby’s thyroid starts to work on its own, but it doesn’t make enough thyroid hormone until 18 to 20 weeks of pregnancy. Two pregnancy-related hormones—human chorionic gonadotropin (hCG) and estrogen—cause higher measured thyroid hormone levels in your blood. The thyroid enlarges slightly in healthy women during pregnancy, but usually not enough for a health care professional to feel during a physical exam. Thyroid problems can be hard to diagnose in pregnancy due to higher levels of thyroid hormones and other symptoms that occur in both pregnancy and thyroid disorders. Some symptoms of hyperthyroidism or hypothyroidism are easier to spot and may prompt your doctor to test you for these thyroid diseases. Another type of thyroid disease, postpartum thyroiditis, can occur after your baby is born. Hyperthyroidism in Pregnancy Some signs and symptoms of hyperthyroidism often occur in normal pregnancies, including faster heart rate, trouble dealing with heat, and tiredness. Other signs and symptoms can suggest hyperthyroidism: fast and irregular heartbeat shaky hands unexplained weight loss or failure to have normal pregnancy weight gain Causes of hyperthyroidism in pregnancy Hyperthyroidism in pregnancy is usually caused by Graves’ disease and occurs in 1 to 4 of every 1,000 pregnancies in the United States.1 Graves’ disease is an autoimmune disorder. With this disease, your immune system makes antibodies that cause the thyroid to make too much thyroid hormone. This antibody is called thyroid stimulating immunoglobulin, or TSI. Graves’ disease may first appear during pregnancy. However, if you already have Graves’ disease, your symptoms could improve in your second and third trimesters. Some parts of your immune system are less active later in pregnancy so your immune system makes less TSI. This may be why symptoms improve. Graves’ disease often gets worse again in the first few months after your baby is born, when TSI levels go up again. If you have Graves’ disease, your doctor will most likely test your thyroid function monthly throughout your pregnancy and may need to treat your hyperthyroidism.1 Thyroid hormone levels that are too high can harm your health and your baby’s. Pregnant woman having her blood drawn If you have Graves’ disease, your doctor will most likely test your thyroid function monthly during your pregnancy. Rarely, hyperthyroidism in pregnancy is linked to hyperemesis gravidarum —severe nausea and vomiting that can lead to weight loss and dehydration. Experts believe this severe nausea and vomiting is caused by high levels of hCG early in pregnancy. High hCG levels can cause the thyroid to make too much thyroid hormone. This type of hyperthyroidism usually goes away during the second half of pregnancy. Less often, one or more nodules, or lumps in your thyroid, make too much thyroid hormone. Untreated hyperthyroidism during pregnancy can lead to miscarriage premature birth low birthweight preeclampsia—a dangerous rise in blood pressure in late pregnancy thyroid storm—a sudden, severe worsening of symptoms congestive heart failure Rarely, Graves’ disease may also affect a baby’s thyroid, causing it to make too much thyroid hormone. Even if your hyperthyroidism was cured by radioactive iodine treatment to destroy thyroid cells or surgery to remove your thyroid, your body still makes the TSI antibody. When levels of this antibody are high, TSI may travel to your baby’s bloodstream. Just as TSI caused your own thyroid to make too much thyroid hormone, it can also cause your baby’s thyroid to make too much. Tell your doctor if you’ve had surgery or radioactive iodine treatment for Graves’ disease so he or she can check your TSI levels. If they are very high, your doctor will monitor your baby for thyroid-related problems later in your pregnancy. An overactive thyroid in a newborn can lead to a fast heart rate, which can lead to heart failure early closing of the soft spot in the baby’s skull poor weight gain irritability Sometimes an enlarged thyroid can press against your baby’s windpipe and make it hard for your baby to breathe. If you have Graves’ disease, your health care team should closely monitor you and your newborn. How do doctors diagnose hyperthyroidism in pregnancy? Your doctor will review your symptoms and do some blood tests to measure your thyroid hormone levels. Your doctor may also look for antibodies in your blood to see if Graves’ disease is causing your hyperthyroidism. Learn more about thyroid tests and what the results mean. How do doctors treat hyperthyroidism during pregnancy? If you have mild hyperthyroidism during pregnancy, you probably won’t need treatment. If your hyperthyroidism is linked to hyperemesis gravidarum, you only need treatment for vomiting and dehydration. If your hyperthyroidism is more severe, your doctor may prescribe antithyroid medicines, which cause your thyroid to make less thyroid hormone. This treatment prevents too much of your thyroid hormone from getting into your baby’s bloodstream. You may want to see a specialist, such as an endocrinologist or expert in maternal-fetal medicine, who can carefully monitor your baby to make sure you’re getting the right dose. Doctors most often treat pregnant women with the antithyroid medicine propylthiouracil (PTU) during the first 3 months of pregnancy. Another type of antithyroid medicine, methimazole , is easier to take and has fewer side effects, but is slightly more likely to cause serious birth defects than PTU. Birth defects with either type of medicine are rare. Sometimes doctors switch to methimazole after the first trimester of pregnancy. Some women no longer need antithyroid medicine in the third trimester. Small amounts of antithyroid medicine move into the baby’s bloodstream and lower the amount of thyroid hormone the baby makes. If you take antithyroid medicine, your doctor will prescribe the lowest possible dose to avoid hypothyroidism in your baby but enough to treat the high thyroid hormone levels that can also affect your baby. Antithyroid medicines can cause side effects in some people, including allergic reactions such as rashes and itching rarely, a decrease in the number of white blood cells in the body, which can make it harder for your body to fight infection liver failure, in rare cases Stop your antithyroid medicine and call your doctor right away if you develop any of these symptoms while taking antithyroid medicines: yellowing of your skin or the whites of your eyes, called jaundice dull pain in your abdomen constant sore throat fever If you don’t hear back from your doctor the same day, you should go to the nearest emergency room. You should also contact your doctor if any of these symptoms develop for the first time while you’re taking antithyroid medicines: increased tiredness or weakness loss of appetite skin rash or itching easy bruising If you are allergic to or have severe side effects from antithyroid medicines, your doctor may consider surgery to remove part or most of your thyroid gland. The best time for thyroid surgery during pregnancy is in the second trimester. Radioactive iodine treatment is not an option for pregnant women because it can damage the baby’s thyroid gland. Hypothyroidism in Pregnancy Symptoms of an underactive thyroid are often the same for pregnant women as for other people with hypothyroidism. Symptoms include extreme tiredness trouble dealing with cold muscle cramps severe constipation problems with memory or concentration Woman with a coat shivering outdoors You may have symptoms of hypothyroidism, such as trouble dealing with cold. Most cases of hypothyroidism in pregnancy are mild and may not have symptoms. What causes hypothyroidism in pregnancy? Hypothyroidism in pregnancy is usually caused by Hashimoto’s disease and occurs in 2 to 3 out of every 100 pregnancies.1 Hashimoto’s disease is an autoimmune disorder. In Hashimoto’s disease, the immune system makes antibodies that attack the thyroid, causing inflammation and damage that make it less able to make thyroid hormones. How can hypothyroidism affect me and my baby? Untreated hypothyroidism during pregnancy can lead to preeclampsia—a dangerous rise in blood pressure in late pregnancy anemia miscarriage low birthweight stillbirth congestive heart failure, rarely These problems occur most often with severe hypothyroidism. Because thyroid hormones are so important to your baby’s brain and nervous system development, untreated hypothyroidism—especially during the first trimester—can cause low IQ and problems with normal development. How do doctors diagnose hypothyroidism in pregnancy? Your doctor will review your symptoms and do some blood tests to measure your thyroid hormone levels. Your doctor may also look for certain antibodies in your blood to see if Hashimoto’s disease is causing your hypothyroidism. Learn more about thyroid tests and what the results mean. How do doctors treat hypothyroidism during pregnancy? Treatment for hypothyroidism involves replacing the hormone that your own thyroid can no longer make. Your doctor will most likely prescribe levothyroxine , a thyroid hormone medicine that is the same as T4, one of the hormones the thyroid normally makes. Levothyroxine is safe for your baby and especially important until your baby can make his or her own thyroid hormone. Your thyroid makes a second type of hormone, T3. Early in pregnancy, T3 can’t enter your baby’s brain like T4 can. Instead, any T3 that your baby’s brain needs is made from T4. T3 is included in a lot of thyroid medicines made with animal thyroid, such as Armour Thyroid, but is not useful for your baby’s brain development. These medicines contain too much T3 and not enough T4, and should not be used during pregnancy. Experts recommend only using levothyroxine (T4) while you’re pregnant. Some women with subclinical hypothyroidism—a mild form of the disease with no clear symptoms—may not need treatment. Pregnant woman with a pill in one hand and a glass of water in the other Your doctor may prescribe levothyroxine to treat your hypothyroidism. If you had hypothyroidism before you became pregnant and are taking levothyroxine, you will probably need to increase your dose. Most thyroid specialists recommend taking two extra doses of thyroid medicine per week, starting right away. Contact your doctor as soon as you know you’re pregnant. Your doctor will most likely test your thyroid hormone levels every 4 to 6 weeks for the first half of your pregnancy, and at least once after 30 weeks.1 You may need to adjust your dose a few times. Postpartum Thyroiditis What is postpartum thyroiditis? Postpartum thyroiditis is an inflammation of the thyroid that affects about 1 in 20 women during the first year after giving birth1 and is more common in women with type 1 diabetes. The inflammation causes stored thyroid hormone to leak out of your thyroid gland. At first, the leakage raises the hormone levels in your blood, leading to hyperthyroidism. The hyperthyroidism may last up to 3 months. After that, some damage to your thyroid may cause it to become underactive. Your hypothyroidism may last up to a year after your baby is born. However, in some women, hypothyroidism doesn’t go away. Not all women who have postpartum thyroiditis go through both phases. Some only go through the hyperthyroid phase, and some only the hypothyroid phase. What are the symptoms of postpartum thyroiditis? The hyperthyroid phase often has no symptoms—or only mild ones. Symptoms may include irritability, trouble dealing with heat, tiredness, trouble sleeping, and fast heartbeat. Symptoms of the hypothyroid phase may be mistaken for the “baby blues”—the tiredness and moodiness that sometimes occur after the baby is born. Symptoms of hypothyroidism may also include trouble dealing with cold; dry skin; trouble concentrating; and tingling in your hands, arms, feet, or legs. If these symptoms occur in the first few months after your baby is born or you develop postpartum depression , talk with your doctor as soon as possible. What causes postpartum thyroiditis? Postpartum thyroiditis is an autoimmune condition similar to Hashimoto’s disease. If you have postpartum thyroiditis, you may have already had a mild form of autoimmune thyroiditis that flares up after you give birth. Woman holding her baby. Postpartum thyroiditis may last up to a year after your baby is born. How do doctors diagnose postpartum thyroiditis? If you have symptoms of postpartum thyroiditis, your doctor will order blood tests to check your thyroid hormone levels. How do doctors treat postpartum thyroiditis? The hyperthyroid stage of postpartum thyroiditis rarely needs treatment. If your symptoms are bothering you, your doctor may prescribe a beta-blocker, a medicine that slows your heart rate. Antithyroid medicines are not useful in postpartum thyroiditis, but if you have Grave’s disease, it may worsen after your baby is born and you may need antithyroid medicines. You’re more likely to have symptoms during the hypothyroid stage. Your doctor may prescribe thyroid hormone medicine to help with your symptoms. If your hypothyroidism doesn’t go away, you will need to take thyroid hormone medicine for the rest of your life. Is it safe to breastfeed while I’m taking beta-blockers, thyroid hormone, or antithyroid medicines? Certain beta-blockers are safe to use while you’re breastfeeding because only a small amount shows up in breast milk. The lowest possible dose to relieve your symptoms is best. Only a small amount of thyroid hormone medicine reaches your baby through breast milk, so it’s safe to take while you’re breastfeeding. However, in the case of antithyroid drugs, your doctor will most likely limit your dose to no more than 20 milligrams (mg) of methimazole or, less commonly, 400 mg of PTU. Thyroid Disease and Eating During Pregnancy What should I eat during pregnancy to help keep my thyroid and my baby’s thyroid working well? Because the thyroid uses iodine to make thyroid hormone, iodine is an important mineral for you while you’re pregnant. During pregnancy, your baby gets iodine from your diet. You’ll need more iodine when you’re pregnant—about 250 micrograms a day.1 Good sources of iodine are dairy foods, seafood, eggs, meat, poultry, and iodized salt—salt with added iodine. Experts recommend taking a prenatal vitamin with 150 micrograms of iodine to make sure you’re getting enough, especially if you don’t use iodized salt.1 You also need more iodine while you’re breastfeeding since your baby gets iodine from breast milk. However, too much iodine from supplements such as seaweed can cause thyroid problems. Talk with your doctor about an eating plan that’s right for you and what supplements you should take. Learn more about a healthy diet and nutrition during pregnancy . Homeopathy provides remedies which treat not just the above symptoms but the person as a whole. Sepia Officinalis: Used when the patient presents with the following symptoms. Weak, slightly yellow appearance Tendency to faint, especially when in cold temperatures Extreme intolerance to cold, even in warm surroundings Increased irritability Hair loss Increased menstrual flow that occurs ahead of schedule Constipation Increased desire for pickles and acidic foodstuff Calcarea Carbonica: This popular medicine is useful when patients present with the following symptoms. Fat, flabby, fair person Increased intolerance to cold Excessive sweating, especially in the head Aversion to fatty foods Peculiar food habits including craving for eggs, chalk, pencils, lime, Increased menstruation that is also prolonged and is associated with feet turning cold Lycopodium Clavatum: Useful in patients who present with these symptoms: Physically weakened Increased irritability Excessive hair fall Face is pale yellow with blue circles around the eyes Craving for foods that are hot and sweet Acidity that is worse in the evenings Gastric issues including excessive flatulence Constipation with painful, hard, incomplete stooling Graphites: Presenting symptoms where Graphites are mainly used include: Obesity Intolerance to cold Depressed emotionally, timid, indecisive, weeping, listening to music Bloated, gassy abdomen Chronic constipation with hard, painful stooling process Lodium: Good appetite but lose weight quickly Tendency to eat at regular intervals Excessive warmth and need to stay in a cool environment Anxiety about present Excessive palpitations Lachesis Mutus: These patient present with the following symptoms: Feeling extremely hot, so inability to wear tight clothes Generally sad with no inclination to do any work Tendency to stay aloof and alone Excessive talkativeness Women around menopausal age