I think by now we have all had to admit that the summer is over and that winter is most definitely on its way. I have certainly seen the usual seasonal coughs and colds beginning to grip the community.

The darker nights and colder weather often affects people's energy levels, and it seems much harder to go out on a dark night and much easier to stay in.

In the last couple of columns we have discussed conditions with fatigue as a common symptom and we are continuing this theme with the subject of the thyroid this week.

The thyroid gland is situated at the junction of the larynx and the trachea and is easily palpated at the front of the throat when enlarged.

Many readers will have seen an enlarged thyroid but perhaps not realised that was what it was.

The thyroid secretes two main hormones namely calcitonin and thyroxin. These two hormones are responsible for controlling bone deposition, the plasma concentration of calcium and also the individual's growth and development and their response to stress and cold. The gland sets the rate at which you produce energy from your body's stores. All very important stuff.

At the back of the thyroid there are also some specialised cells called the parathyroid that control calcium and phosphate balance.

As with most glands, problems with its function can result in either over (hyper) or under (hypo) production of the hormones they secrete. Hypothyroidism, or under active thyroid, can affect both men and women but more women suffer, with one in ten women in the UK having problems.

When compared to the men affected this is lower at one in 100 men suffering. Interestingly, approximately one in ten women over 60 years of age have an under active thyroid but have no symptoms at all.

What are the symptoms of an under active thyroid?

Many patients don't realise they have a problem as it is easy to put some symptoms down to working too hard, not eating properly or not getting a good night's sleep.

Most patients suspect there is something amiss when several symptoms manifest themselves.

The common symptoms are feeling tired all the time, or possibly a bit low. Feeling the cold, weight gain, dry skin and constipation.

If these symptoms are left untreated they can progress over months or years to very dry and flaky skin, a hoarse voice, depression, weight gain, coarse hair and difficulty in thinking clearly.

Rarely, if left untreated at this stage a condition called myxodema can result, which is characterised by a puffy face, an enlarged tongue, weak muscles, painful joints and painful tingling in the hands.

How does the doctor diagnose hypothyroidism?

Following a series of questions relating to how the patient has been feeling, for how long the symptoms have been present, the doctor will perform an examination.

This is likely to include observations on the skin and hair, muscle tests to detect any weakness, as well as pulse and blood pressure being recorded.

Occasionally, the heart can be affected by chronic uncontrolled hypothyroidism. If the doctor wishes to confirm their suspicions, then blood tests will be taken.

The blood tests look at the levels of Thyroid Stimulating Hormone (TSH) and thyroxin (T4). If there are high levels of TSH or low levels of thyroxin the patient may have hypothyroidism.

The level of thyroid antibodies will also be checked as these can indicate an autoimmune thyroid disease.

Hypothyroidism is usually treated by taking tablets that contain thyroxin. Sometimes patients are referred to specialists called Endocrinologists who monitor and control patients' treatment with hormonal problems.

Most patients are treated with levothyroxine and the levels are carefully monitored to ensure that correct dose is given.

Once the correct dose is established people often report that they feel so much better regarding their day-to-day activities as they had not realised how tired they had been before it was diagnosed. They can then get back to enjoying an active and fulfiling life.

As already mentioned, the thyroid can produce too much thyroxin, therefore hyperthyroidism will the next topic for the Spinal Column.

lIf you would like to contact me please email ilkleychiro@tiscali.co.uk or call Ilkley Chiropractic Clinic on 605060.