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Aesthetic Medicine
Aesthetic Medicine


T time


Rizvan Batha is the superintendent pharmacist at Specialist Pharmacy, the first compounding pharmacy of its kind in the UK, producing custom-made medications across a wide range of treatment areas such as bioidentical hormones, pain management, dermatology, haircare, sports medicine and veterinary medications. Specialist Pharmacy is a full-service pharmacy with over 25 years of combined expertise and experience, and is fully-regulated by the General Pharmaceutical Council.

There are many symptoms that could indicate a thyroid problem, but the main one is usually feeling utterly exhausted and like you can never get on top of your fatigue. If this is the case, then maybe it’s time to get your thyroid hormones tested. Signs of thyroid problems include reduction in energy, hair loss, battles with weight and PMS.

Thyroid hormones, thyroxine (T4) and triiodothyronine (T3) are produced by the thyroid gland and have diverse actions, acting on nearly every cell in the body to regulate metabolism, maintain brain function and development and maintain heart and digestive function, to name a few.

Just some of the common symptoms of a thyroid problem can include:

• Susceptibility to colds and infections

• Lethargy or fatigue that does not improve with rest

• Enlarged thyroid gland (goitre)

• Difficulty losing weight

• Depression

• Dry skin, hair & nails

• Hair loss

• Thinning or loss of eyebrows, especially the outer third

• Muscle weakness and joint pain

• Menstrual problems

• Infertility

• Sluggish memory and poor concentration

• Lowered stress resistance

• Recurrent infections

• Deep, hoarse voice

It is common for patients who have symptoms of thyroid dysfunction to have normal or borderline results in their thyroid function blood tests. Therefore it is important for the practitioner to take their symptoms into account too.


The thyroid is a small, butterfly-shaped gland in the neck, just in front of the windpipe (trachea). It produces hormones that affect things such as your heart rate and body temperature. Common signs of an underactive thyroid (hypothyroidism) are tiredness, weight gain and feeling depressed. This can be successfully treated by taking daily medication to replace the hormones your thyroid is not making. Hypothyroidism is five to 10 times more prevalent in women and affects at least 2% of the UK population.

By contrast, an overactive thyroid, also known as hyperthyroidism or thyrotoxicosis, is when the thyroid gland produces too many thyroid hormones, which can cause unpleasant and potentially serious problems that may need treatment. An overactive thyroid can affect anyone, but it’s about 10 times more common in women than men and typically happens between 20 and 40 years of age. An overactive thyroid can cause nervousness, anxiety, hyperactivity where a person can’t sit still, or even unexplained weight loss.


When testing for thyroid dysfunction, most GPs check only TSH (thyroid-stimulating hormone). When levels are within range, no further testing would be carried out, even though the patient may be experiencing symptoms.

To gain a complete picture of thyroid function, it is often important to measure not just TSH but also Total T4, Free T4 and Free T3 and often thyroid antibodies.

The first-line treatment for underactive thyroid problems is Thyroxine (T4), but sometimes T4 alone is ineffective, especially if someone has problems converting T4 to the active form of T3. In this scenario giving more T4 may not be enough to resolve hypothyroidism.

T3 is an active circulating thyroid hormone made from T4. Supplementing thyroxine medication with a small amount of T3 can make all the difference to energy levels and a general feeling of wellbeing.

T3 is generally more readily absorbed and has a more rapid and profound effect. Therefore, it needs to be monitored more closely.

By supplementing with thyroid supportive nutrients or prescribing appropriate doses of thyroid hormones, it is possible to improve a patient’s symptoms and quality of life. Treatment plans should be tailored to an individual’s needs, and progress monitored closely.


Many people with thyroid problems will experience difficulty in maintaining weight and either gain or lose weight, depending on whether their thyroid is underactive or overactive.

For people experiencing weight gain, this could signal low levels of thyroid hormones or hypothyroidism. If the thyroid produces more hormones than the body needs, then the opposite may be seen, and people can lose weight unexpectedly.

Weight gain can be helped via diet and exercise, but if the underlying thyroid problem isn’t fixed, it will be harder to manage weight effectively.


Nails will also be affected by thyroid problems, with many people reporting dry, brittle nails that split easily or peel as being common symptoms of hypothyroidism.

These issues can also be made worse with products such as gel nail varnishes and acrylics that can dry the nails out further. A great way to help is to use a vitamin-infused, strengthening polish that can put the necessary vitamins back into the nails, but ultimately the thyroid problems need to be treated too.

Ridges in nails and lifting of the nail from the nailbed, otherwise known as onycholysis, are often signs of hyperthyroidism.


Another common problem with hypothyroidism is dry skin, which people may experience on their faces but also on their bodies. As the skin contains cells which are rapidly regenerating, it is susceptible to losing growth signals from the thyroid hormone. When this cycle is broken, it takes longer for the skin to renew, which then causes dryness.

Severely advanced hypothyroidism can result in Myexdema, where the skin can take on a waxy, doughy, swollen and dry appearance. The skin condition needs to be addressed at its root cause, but some ingredients that should be looked for in a skin cream include:

• Zinc liposome serum to support regeneration, boost enzymes and stop dryness.

• Boswellia nanoparticles are antiinflammatory and have anti-ageing properties for barrier-disordered skin.

• Butcher’s broom to help stabilise blood vessels and smooth skin.

• Evening primrose oil to prevent moisture loss and increase hydration.

It also reinforces the skin’s barrier for dehydrated skin and those with barrier-disordered and atopic skin.


Hypothyroidism and hyperthyroidism can cause thinning hair and even hair loss. If you have hyperthyroidism, your hair might feel overly fine and brittle, whereas, with hypothyroidism, your hair might feel dry, harsh and more coarse than normal. For those who experience hair loss or thinning, regrowth can be achieved with the right thyroid medication, but sometimes it won’t regrow completely. Topical hair tonics containing ingredients such as caffeine may be indicated to help with regrowth.


Diet is an important factor for anyone with thyroid problems. A well-balanced diet filled with fruit and vegetables, whole grains, fresh fish, and a moderate amount of meat is advised. However, not all vegetables are good to eat when you are suffering from thyroid problems. Keep away from foods that have a thyroid-suppressing effect. They are known as ‘goitrogens’, as their suppressing nature can induce a goitre in the base of the throat area, which is a sure symptom of thyroid disease. While considered healthy for most, these foods should be restricted for anyone with an underactive thyroid. They include broccoli, cabbage, Bok choy, cauliflower and Brussels sprouts – all members of the Brassicaceae family of plants.

Sushi wrapped in nori seaweed is good to include in the diet. Nori (along with other seaweeds) is a rich source of iodine, an essential mineral for the support of the thyroid. Iodine is often lacking in modern food because most of it has been farmed out of the soil in the Western world. Iodine and zinc, which are found in shellfish, whole grains, nuts and seeds, are vital for healthy thyroid function.

Many people with thyroid problems will prop themselves up with caffeinated drinks, which is actually the worst thing they can do, as it will actually exacerbate the issue. Tea, coffee and fizzy drinks all place a burden on the adrenal glands, which then rely on the thyroid gland for support. This is known in medical terms as the hypothalamic pituitary adrenal axis and is a fine example of how the endocrine system’s glands work together to maintain homeostasis.

Not only will symptoms affect skin, hair, nails and weight, but they will also affect energy levels, quality of life and ultimately how the body functions


Borderline (subclinical hypothyroidism) may respond well to appropriate dietary and lifestyle advice, as well as a personalised supplement regime, whereas hypothyroidism will need to be treated with thyroid hormones too. There are various types of thyroid medication available, depending on the patient’s individual needs. Natural Desiccated Thyroid (NDT) naturally contains both T4 and T3. This is an alternative medication to conventional levothyroxine (T4), which isn’t effective for all patients, especially if they are having difficulty converting T4 to T3.

Although there have been no randomised controlled trials using NDT, it was the most commonly used thyroid replacement treatment before levothyroxine came to the market. There is long-standing evidence that NDT is equivalent in efficacy to levothyroxine and some studies have suggested that some patients respond better to NDT for their hypothyroidism. An alternative to NDT would be synthetic T4 and T3. These can be given in their licensed form or, for those who are not able to tolerate the licensed form (either due to allergies or intolerances to the excipients), there is the option to compound these to a dose personalised to the patient. They can be prescribed in varying doses in both standard and slowrelease formulations, either alone or as a combined capsule.


Overall, anyone with a thyroid problem will experience symptoms that affect their aesthetics and should seek medical help to treat the underlying problem. Not only will symptoms affect skin, hair, nails and weight, but they will also affect energy levels, quality of life and, ultimately, how the body functions, so obtaining treatment is of paramount importance.


This article appears in the July-August 2022 Issue of Aesthetic Medicine

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This article appears in the July-August 2022 Issue of Aesthetic Medicine