Thyroid Specialist in Nepal
Thyroid disorders affect millions of women in Nepal, causing weight gain, fatigue, irregular periods, and infertility. Dr Sanjay Kumar Thakur — Hormone & Thyroid Specialist — provides accurate diagnosis and effective treatment.
Conditions We Treat
Diagnosis
Treatment Options
Levothyroxine
Gold standard for hypothyroidism — restores normal thyroid levels
Antithyroid Drugs
Methimazole or PTU for hyperthyroidism
Radioactive Iodine
Definitive treatment for Graves disease
Thyroid Surgery
For large goiters, nodules, or cancer
Lifestyle Optimization
Diet, selenium, iodine, and stress management
Dr Sanjay Kumar Thakur
MBBS, MD Internal Medicine | Hormone & Thyroid Specialist
Dr Sanjay Kumar Thakur specializes in thyroid disorders, hormonal imbalances, and their impact on women's reproductive health. He provides comprehensive thyroid management with a focus on fertility, menstrual health, and metabolic wellbeing.
View Full Profile →Frequently Asked Questions
How does thyroid affect menstrual periods?
Both hypothyroidism and hyperthyroidism can disrupt the menstrual cycle. Hypothyroidism often causes heavy, irregular, or absent periods due to disrupted ovulation. Hyperthyroidism can cause light, infrequent periods or even amenorrhea. Thyroid hormones directly affect reproductive hormones. Treating the thyroid condition usually restores normal cycles within a few months. If periods remain irregular after thyroid normalization, other causes should be investigated.
Can thyroid problems cause infertility and miscarriage?
Yes. Thyroid disorders are a common and often overlooked cause of infertility. Thyroid hormones are essential for ovulation, egg quality, and implantation. TSH levels above 2.5 mIU/L can impair fertility and increase miscarriage risk. Even subclinical hypothyroidism (elevated TSH with normal T4) affects fertility. Treatment with levothyroxine often restores fertility and reduces miscarriage risk. Women planning pregnancy should have TSH below 2.5 mIU/L.
What are the symptoms of hypothyroidism?
Hypothyroidism symptoms include: fatigue and weakness, weight gain or difficulty losing weight, cold intolerance, dry skin and hair, hair loss, constipation, depression, memory problems, heavy or irregular periods, muscle aches and stiffness, slowed heart rate, and facial puffiness. Symptoms develop gradually and may be mistaken for aging or stress. Blood tests confirm the diagnosis.
What are the symptoms of hyperthyroidism?
Hyperthyroidism symptoms include: unintended weight loss, rapid heartbeat (tachycardia), anxiety and irritability, tremor in hands, increased sweating, heat intolerance, changes in menstrual patterns, more frequent bowel movements, fatigue, difficulty sleeping, thinning skin, and brittle hair. Graves' disease may also cause eye symptoms (bulging, irritation). Blood tests and sometimes thyroid scan confirm diagnosis.
What causes weight gain with thyroid problems?
Hypothyroidism slows metabolism, leading to weight gain, fatigue, and difficulty losing weight even with diet and exercise. The weight gain is typically 5–10 kg. Proper thyroid hormone replacement with levothyroxine, combined with diet and exercise, helps manage weight. However, thyroid treatment alone may not cause significant weight loss — lifestyle modifications remain important. Weight should stabilize once thyroid levels normalize.
How is thyroid disease diagnosed?
Diagnosis involves blood tests measuring: TSH (thyroid stimulating hormone) — the most sensitive screening test, free T4 (thyroxine), free T3 in some cases, and thyroid antibodies (TPO, TgAb) to detect autoimmune thyroiditis. Normal TSH is typically 0.4–4.0 mIU/L, though optimal is 1–2.5 mIU/L. Thyroid ultrasound may be done to evaluate nodules or gland structure. Fine needle aspiration may be needed for suspicious nodules.
What is the treatment for hypothyroidism?
Hypothyroidism is treated with levothyroxine (synthetic thyroid hormone), taken as a daily pill on an empty stomach. The dose is adjusted based on TSH levels, checked every 6–8 weeks initially, then annually once stable. Most patients need lifelong treatment. Proper dosing resolves symptoms within weeks. Take levothyroxine 30–60 minutes before breakfast, and separate from calcium, iron, and certain medications by 4 hours.
What are the treatment options for hyperthyroidism?
Hyperthyroidism treatment depends on cause and severity. Options include: antithyroid medications (methimazole, PTU) — first-line for Graves' disease, taken for 12–18 months with possible remission; radioactive iodine therapy — destroys overactive thyroid tissue, often leading to hypothyroidism requiring levothyroxine; and thyroid surgery — removal of part or all thyroid gland. Beta-blockers help control symptoms like rapid heart rate during treatment.
Is thyroid treatment lifelong?
Hypothyroidism usually requires lifelong levothyroxine therapy. The dose may need adjustment during pregnancy, with age, or with other medications. Hyperthyroidism treatment varies: antithyroid drugs may achieve remission after 12–18 months; radioactive iodine typically causes permanent hypothyroidism requiring lifelong levothyroxine; surgery may also result in hypothyroidism. Regular monitoring ensures optimal thyroid levels.
What is Hashimoto's thyroiditis?
Hashimoto's thyroiditis is an autoimmune condition where the immune system attacks the thyroid gland, causing hypothyroidism. It's the most common cause of hypothyroidism in iodine-sufficient areas. Symptoms are those of hypothyroidism. Diagnosis is confirmed by elevated TSH with positive TPO antibodies. Treatment is levothyroxine replacement. Family history, other autoimmune conditions, and female gender increase risk. Regular monitoring is essential as thyroid function can continue declining.
What are thyroid nodules and are they cancerous?
Thyroid nodules are lumps in the thyroid gland, very common and usually benign (95%). Most are found incidentally on imaging. Evaluation includes: thyroid function tests, ultrasound to assess characteristics, and fine needle aspiration (FNA) for suspicious nodules. Features suggesting malignancy include: solid composition, irregular margins, microcalcifications, and rapid growth. Most nodules require only monitoring. Suspicious or cancerous nodules are treated with surgery.
How does thyroid affect pregnancy?
Thyroid hormones are crucial for baby's brain development, especially in the first trimester. Untreated hypothyroidism in pregnancy increases risks of: miscarriage, preterm birth, preeclampsia, placental abruption, low birth weight, and impaired baby's brain development. Target TSH in pregnancy is below 2.5 mIU/L (first trimester) and below 3.0 mIU/L (second/third trimesters). Levothyroxine dose typically increases during pregnancy. Close monitoring is essential.
What is postpartum thyroiditis?
Postpartum thyroiditis is inflammation of the thyroid occurring within 1 year after delivery, affecting 5–10% of women. It typically has three phases: hyperthyroidism (weeks 4–12 postpartum), hypothyroidism (weeks 12–24), then recovery or permanent hypothyroidism. Symptoms may be mild or mistaken for postpartum stress. Treatment depends on phase and severity. Women with TPO antibodies are at higher risk. Annual thyroid testing is recommended as many develop permanent hypothyroidism later.
Can thyroid problems affect mood and mental health?
Yes. Hypothyroidism commonly causes: depression, fatigue, brain fog, memory problems, and slowed thinking. Hyperthyroidism can cause: anxiety, panic attacks, irritability, mood swings, and difficulty concentrating. These symptoms often improve with proper thyroid treatment. However, if mood symptoms persist after thyroid normalization, separate mental health treatment may be needed. Always discuss mood changes with your doctor.
How do I book an appointment?
Call +977 9700682797, WhatsApp us, or use the Book Appointment button on our website to book a consultation with Dr Sanjay Kumar Thakur. Bring any previous thyroid test results. We recommend fasting before blood tests for accurate results. Same-day appointments may be available for urgent concerns. Regular follow-up visits are important for thyroid monitoring.
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Expert thyroid care in Kathmandu. Same-day appointments available.