Hypothyroidism and Nutrition

Hypothyroidism and Nutrition Therapy

Introduction

Hypothyroidism is a medical condition where the thyroid glands do not produce enough thyroid hormones. The thyroid gland, a small butterfly-shaped gland located in the base of the neck is responsible for producing hormones that regulate metabolism and other bodily functions in heart, brain, muscles and skin. Hormonal changes in the body are natural, but those induced by hypothyroidism are detrimental to the human body as bodily functions are slowed down. About 11% of the Indian population is reported to have been affected by hypothyroidism. Owing to the changing lifestyle hypothyroidism is a fast growing issue.

Causes and Types

Hypothyroidism is generally attributed to unhealthy lifestyles of the modern human being that leads to a nutrient deficient diet, particularly iodine. Other causes include – radiation therapy in neck; radioactive iodine treatments; use of drugs such as amiodarone (Cordarone, Pacerone), lithium, interferon alpha, and interleukin-2; thyroid surgery; deficiencies or problems at birth, during pregnancy; pituitary gland damage or disorder; and hypothalamus disorder.

There are certain other factors that puts one at a risk of hypothyroidism, such as race (particularly white or Asian); gender (women are mostly affected); ageing; premature greying of hair; autoimmune disorders such as type 1 diabetes, multiple sclerosis, rheumatoid arthritis, celiac disease, Addison’s disease, pernicious anaemia, or vitiligo; bipolar disorder; down syndrome; and turner syndrome.

Hypothyroidism can be of three types – primary, where the gland is affected directly; secondary, where the gland is affected due to other disorders such as pituitary gland problem or hypothalamus problem; and tertiary, where sometimes hypothalamus problems result in hypothyroidism.

Symptoms

Hypothyroidism can affect different age groups and symptoms in each of these groups vary a little.

  • Women, Teens – Basic symptoms in women and teens include changes in the menstrual cycle; delayed puberty (in teens); muscle cramps; constipation; depression; dry hair and skin; hair loss; fatigue; increased sensitivity to cold; slowed heart rate; swelling of the thyroid gland; unexplained weight gain; high cholesterol, difficulty in concentrating; pain and swelling of joints; sleeping problems; and carpal tunnel syndrome.
  • Infants, Children – The symptoms in infants often include no symptoms at all but sometimes may show cold limbs; constipation; extreme sleepiness; hoarse cry; little or no growth; low muscle tone; persistent jaundice; poor feeding habits; puffy face; stomach bloating; and swollen tongue. Children may be affected by delayed mental development and slow reaction time.

Diagnosis

Hypothyroidism is to be diagnosed through a comprehensive physical test to check for thyroid inflammation, imaging scan such as thyroid scans and thyroid ultrasounds to check for nodules, and blood tests to check for TSH levels like T4, and total or free T3.

Treatment: Nutrition Therapy

While hypothyroidism is generally treated through supplements and medications, nutrition therapy plays a big part in its treatment since hypothyroidism is caused by nutrient deficiencies in most of the cases. Proper nutrition is responsible for the maintenance of the thyroid gland. Nutrients responsible for this include iodine, selenium, zinc, iron, copper, Vitamins A, E, D and B12, and DHEA and Pregnenolo-sulphate. All of these are to be effectively complemented through a proper diet. Additionally, a common problem in hypothyroidism is an unexpected weight gain and difficulty in losing weight. Nutrition therapy along with an exercise therapy helps in losing and controlling weight. Additionally, physiotherapy and physical therapy help ease symptoms of pain in joints and other body parts. We at Eva Physiocare have an integrated wellness programme comprising of nutrition therapy, exercise therapy and physiotherapy to manage hypothyroidism in patients holistically and therapeutically.

Treating Diabetic Neuropathy with Physiotherapy and Nutrition Therapy

Treating Diabetic Neuropathy with Physiotherapy and Nutrition Therapy

Introduction

Diabetes, a metabolism disorder, is mostly attributed to unhealthy eating habits and a generally unhealthy lifestyle. Various complications can arise in the human body due to its overbearing and elongated presence. Diabetic neuropathy is one such complication where diabetes for a long period results in nerve damage, usually affecting the patient’s leg and feet. Patients with type 1 or type 2 diabetes often run the risk of developing diabetic neuropathy.

Causes

There may be several causes that lead to diabetic neuropathy. However, all of those causes circle back to diabetes being the core issue. As a direct result of diabetes, high levels of blood sugar in the blood for long periods injure nerves in every portion of the body, and kidneys damaged by diabetes send toxins into the blood that in turn cause nerve damage. Additionally, usage of Metformin drugs to manage diabetes can lead to a Vitamin B12 deficiency and this in turn can cause nerve damage. Apart from this, a diabetic patient may develop diabetic neuropathy if his blood vessels are damaged by high levels of cholesterol, mechanical injuries (such as carpal tunnel syndrome), and unhealthy lifestyle factors including overweight, alcohol consumption and smoking.

Symptoms and Types

The common symptoms for diabetic neuropathy include sensitivity to or loss of feeling of touch, trouble with coordination when walking, numbness or pain in the extremities, muscle weakness, nausea and indigestion, diarrhoea or constipation, unsteadiness upon standing, intemperate sweating, vaginal dryness in women and erectile dysfunction in men, to name a few. These symptoms may, however, vary depending on the type of diabetic neuropathy.

Diabetic neuropathy is of four kinds – peripheral, autonomic, proximal, and focal.

  • Peripheral neuropathy is the most common of all that affects the legs, hands and arms, necessarily in that order.
  • Autonomic neuropathy occurs when diabetes affects the autonomic nervous system that controls the heart, bladder, stomach, intestines, sex organs and eyes.
  • Proximal / radiculoplexus / femoral neuropathy, also known as diabetic amyotrophy, affects the nerves in the thighs, hips, buttocks or legs, commonly observed in type 2 diabetes and older patients.
  • Focal neuropathy / mononeuropathy is when a specific nerve in the face or torso or leg is damaged, usually in older patients.

Diagnosis and Treatment: Physiotherapy and Nutrition Therapy

Diabetic neuropathy can be effectively managed through the holistic and therapeutic non-intrusive alternative treatment of physiotherapy. The physiotherapist uses methods such as gross light touch and pinprick sensation to conduct a comprehensive physical test to check the core and muscles strength, sensitivity, reflexes, etc., in order to diagnose and assess the diabetic neuropathy condition. Other tests include filament test, quantitative sensory testing, nerve conduction studies, electromyography (EMG) and autonomic testing.

Techniques such as transcutaneous nerve stimulation (TENS), static magnetic field therapy, low-intensive laser therapy, and monochromatic infrared light therapy, have been shown to have positive effects in the management of diabetic neuropathy, by slowing down the condition, relieving the patient of pain, manage further or associated complications and restore the functionality of the affected regions. There is also an exercise regimen particularly for patients with peripheral and proximal neuropathy, such as aerobic exercise, flexibility exercise, strength training exercise and balance exercise, and generally to manage weight. In addition, nutrition therapy becomes pertinent in order to manage diabetic neuropathy because diabetic conditions call for a massive alteration in food intake. There might be certain nutritional deficiencies that are best managed through food intake. In addition, it also aids in weight loss and maintaining a generally healthy lifestyle.

We at Eva Physiocare have developed an integrated wellness programme comprising of physiotherapy and nutrition therapy in order to effectively manage diabetic neuropathy in our patients.

Anterior Cruciate Ligament (ACL) Injuries & Effective Treatment Through Physiotherapy

Anterior Cruciate Ligament (ACL) Injuries & Effective Treatment Through Physiotherapy

Introduction

The anterior cruciate ligament is a diagonal ligament running through the knee’s middle, preventing the tibia (shinbone) from sliding out before the femur (thighbone) whilst providing the knee with complete rotational stability. ACL injury occurs when there is a tear or a sprain in the anterior cruciate ligament of the knee. There may be a Grade 1 (mildly damaged ligament but stable joint) or Grade 2 (partial tear, which is rare) or Grade 3 sprain (complete or near complete tear).

Causes

ACL injuries mostly occur during sports activities that require sudden slowdowns and direction changes, pivoting on a firmly planted foot, incorrect jump landings, sudden stop while running, and knee collision. They are the most common knee injuries among athletes in very high demanding sports such as football, basket-ball, etc., and even in sports such as cricket, badminton, etc.

As per various studies, female athletes are more prone to ACL injuries. This is due to contrasts in physical conditioning, muscular strength, and neuromuscular control, between male and female athletes. Further reasons may include contrasts in pelvis and leg alignment, increasingly loosened in ligaments, and the consequences of oestrogen on the ligament region.

Symptoms

Symptoms include hearing or feeling a “popping” noise in the knee, severe pain and swelling, loss of motion, tenderness, instability and inability to continue any activity.

Diagnosis

Diagnosis is mostly done through a physical exam, which is usually enough. The most common physical test is the Laxman Test. Other physical tests include pivot shift test, jerk test and anterior drawer test. If it’s unable to be diagnosed through physical tests, there may be a need to diagnose through X-rays, MRIs and ultrasounds.

Effective Treatment Through Physiotherapy

Physiotherapy, with its therapeutic nature, provides effective treatment in case of ACL Injuries, be it mildly damaged, partial tear, or a near complete tear. In most cases where a few weeks of rehabilitation therapy through physiotherapy is adopted, it is possible to avoid intrusive treatment procedures. This is because physiotherapy is capable of reducing these ACL injuries, provided there is stability in the knee. At the same time, physiotherapy also reduces risks of ACL injuries developing into knee osteoarthritis. Treatment of ACL injuries through physiotherapy are more effective in elderly patients, those with less levels of activity, and those who play sports with less stress on knees.

Normally, the physiotherapist provides an assessment of the injury with instructions and feedbacks. The rehabilitation therapy consists of machine based treatment followed  by an exercise protocol for biomechanical correction procedures to bring back motion and flexibility in the knee, and reduce the pain and inflammation. The exercise protocol is made by the physiotherapist based on the medical presentation of the condition. The exercises include – hamstring strengthening exercises to ensure general balance in the knee; exercise that strengthen the hips, pelvis and lower abdomen; training exercises to ensure proper jumping and landing; and training to improve sudden direction changes and pivoting. We at Eva Physiocare are developing rehabilitation therapy programme including diet therapy and an integrated wellness programme for ACL injury patients.