To detect thyroid problems, healthcare providers typically use a combination of tests. The most common and often first-line tests are blood tests that measure the levels of certain hormones related to thyroid function.
Here’s a breakdown of the key tests:
1. Blood Tests:
* Thyroid-Stimulating Hormone (TSH): This is usually the first test ordered. TSH is produced by the pituitary gland and tells the thyroid how much thyroid hormone (T3 and T4) to make.
* High TSH: Often indicates an underactive thyroid (hypothyroidism), meaning your thyroid isn’t producing enough hormone. The pituitary gland is working harder to stimulate it.
* Low TSH: Usually indicates an overactive thyroid (hyperthyroidism), meaning your thyroid is making too much hormone, so the pituitary slows down TSH production.
* T4 (Thyroxine) and Free T4 (FT4): T4 is one of the main hormones produced by the thyroid.
* High T4/FT4: Can indicate hyperthyroidism.
* Low T4/FT4: Can indicate hypothyroidism.
* “Free T4” is often preferred because it measures the active form of the hormone that is not bound to proteins in the blood, giving a more accurate picture.
* T3 (Triiodothyronine) and Free T3 (FT3): T3 is another main thyroid hormone.
* High T3/FT3: Often used to diagnose hyperthyroidism, especially in cases where T4 levels might be normal.
* T3 is generally less helpful for diagnosing hypothyroidism as it’s one of the last hormones to become abnormal in that condition.
* Thyroid Antibody Tests: These tests look for specific antibodies in your blood that can indicate an autoimmune thyroid disorder, such as:
* Thyroid Peroxidase Antibodies (TPOAb): Common in Hashimoto’s thyroiditis (a common cause of hypothyroidism).
* Thyroglobulin Antibodies (TgAb): Also seen in Hashimoto’s.
* Thyroid-Stimulating Immunoglobulin (TSI): Often present in Graves’ disease (a common cause of hyperthyroidism).
* Thyroglobulin (Tg) Test: While not a primary diagnostic test for general thyroid function, it’s used to monitor patients with thyroid cancer after treatment.
* Calcitonin Test: This measures calcitonin, a hormone produced by C-cells in the thyroid. It’s primarily used to screen for or monitor medullary thyroid cancer.
2. Imaging Tests:
* Thyroid Ultrasound: Uses sound waves to create images of the thyroid gland. It can help detect nodules (lumps) or goiter (enlargement of the thyroid) and assess their size, shape, and characteristics. It’s often used when nodules are felt during a physical exam.
* Thyroid Scan (Nuclear Medicine Scan): Involves taking a small amount of radioactive material (usually iodine), which is absorbed by the thyroid. A special camera then takes pictures to show how much is absorbed and where. It can help:
* Determine the cause of hyperthyroidism.
* Evaluate thyroid nodules (e.g., whether they are “hot” or “cold” – indicating how active they are).
* Radioactive Iodine Uptake (RAIU) Test: Often done in conjunction with a thyroid scan. It measures how much radioactive iodine the thyroid gland takes up over a specific period. This helps differentiate between different causes of hyperthyroidism.
* CT Scans: Less commonly used for initial thyroid detection, but may be used to get a more detailed view of the thyroid and surrounding structures, especially if there are concerns about compression or extension of a mass.
Initial Approach:
Typically, a doctor will start with a TSH test. If the TSH level is abnormal, further blood tests (like T4, Free T4, T3, Free T3, and/or antibody tests) will likely be ordered to pinpoint the specific thyroid condition. Imaging tests are usually reserved for specific situations, such as when nodules are suspected or to determine the cause of hyperthyroidism.
It’s important to consult with a healthcare professional for proper diagnosis and management of any suspected thyroid issues. They will consider your symptoms, medical history, and test results to determine the best course of action.

While there is only one thyroid gland, there are several types of thyroid conditions or diseases that can affect its function. These can be broadly categorized into two main types based on hormone production:
* Hypothyroidism (Underactive Thyroid): This occurs when the thyroid gland doesn’t produce enough thyroid hormones.
* Common causes include:
* Hashimoto’s thyroiditis: An autoimmune disorder where the body’s immune system attacks and damages the thyroid gland.
* Iodine deficiency
* Certain medications
* Post-surgical or radiation treatment of the thyroid
* Congenital hypothyroidism (present at birth)
* Hyperthyroidism (Overactive Thyroid): This occurs when the thyroid gland produces too much thyroid hormone.
* Common causes include:
* Graves’ disease: An autoimmune disorder where the immune system stimulates the thyroid to produce excess hormones.
* Toxic adenomas (nodules that overproduce hormones)
* Thyroiditis (inflammation of the thyroid that can temporarily cause excess hormone release)
Besides these two main categories, other common thyroid conditions include:
* Goiter: An enlargement of the thyroid gland, which can be caused by both hyper- or hypothyroidism, or iodine deficiency.
* Thyroid Nodules: Lumps or growths in the thyroid gland, which are usually benign (non-cancerous) but can sometimes be cancerous or cause hormone imbalances.
* Thyroiditis: Inflammation of the thyroid gland, which can cause temporary hyperthyroidism followed by hypothyroidism. Examples include postpartum thyroiditis, subacute thyroiditis, and silent thyroiditis.
* Thyroid Cancer: Malignant growth of cells in the thyroid gland. There are different types, such as papillary, follicular, medullary, and anaplastic.
So, while there are two primary classifications (hypo- and hyperthyroidism), there are various underlying conditions and diseases that fall under the umbrella of “thyroid problems.”

Thyroid disorders are significantly more common in women than in men and can have a profound impact on various aspects of a woman’s health throughout her life. Here are important questions related to the thyroid that women need to know the answers to:
1. What does the thyroid gland do and why is it important for women?
The thyroid is a butterfly-shaped gland located at the base of your neck. It produces hormones (thyroxine or T4, and triiodothyronine or T3) that regulate your metabolism, energy levels, body temperature, heart rate, and almost every organ in your body. For women, these hormones also play a critical role in:
* Reproductive health: Affecting menstrual cycles, ovulation, and fertility.
* Pregnancy: Essential for healthy fetal development and maternal well-being.
* Bone health: Too much thyroid hormone can lead to bone loss (osteoporosis).
* Emotional and mental health: Imbalances can cause mood swings, depression, and cognitive issues.
2. What are the common types of thyroid disorders in women?
The two main types are:
* Hypothyroidism (underactive thyroid): The thyroid gland doesn’t produce enough hormones. This is the most common thyroid disorder in women.
* Hyperthyroidism (overactive thyroid): The thyroid gland produces too much hormone.
3. What are the symptoms of an underactive thyroid (hypothyroidism) in women?
Symptoms often develop slowly and can be non-specific, making them easy to confuse with other conditions. They include:
* Fatigue and low energy
* Weight gain (even with diet and exercise)
* Feeling cold (cold intolerance)
* Depressed mood, irritability, or mood swings
* Menstrual irregularities (heavy, prolonged, or irregular periods)
* Hair thinning or loss, dry skin, brittle nails
* Constipation
* Muscle aches, tenderness, stiffness, and joint pain
* “Brain fog” or difficulty concentrating
* Slowed heart rate
4. What are the symptoms of an overactive thyroid (hyperthyroidism) in women?
Symptoms of hyperthyroidism can include:
* Unexplained weight loss
* Anxiety, nervousness, and irritability
* Rapid or irregular heartbeat (palpitations)
* Increased sweating and heat intolerance
* Tremors (shaking hands)
* Frequent bowel movements or diarrhea
* Menstrual irregularities (lighter or infrequent periods)
* Muscle weakness
* Sleep problems (insomnia)
* Goiter (enlargement of the thyroid gland in the neck)
* Eye changes (bulging eyes in Graves’ disease)
5. How does thyroid health affect fertility and pregnancy?
Thyroid hormone levels are crucial for healthy reproductive function.
* Infertility: Both hypothyroidism and hyperthyroidism can disrupt ovulation, making it difficult to conceive.
* Pregnancy risks: Untreated thyroid conditions during pregnancy can lead to:
* Increased risk of miscarriage
* Preeclampsia
* Preterm birth
* Low birth weight
* Developmental issues in the baby (including cognitive impairments)
* Placental abruption
* Postpartum thyroiditis: Some women may experience thyroid problems after giving birth.
It’s vital for women who are trying to conceive or are pregnant to have their thyroid function monitored closely.
6. When should a woman get her thyroid checked?
* If you experience persistent symptoms associated with thyroid dysfunction (as listed above).
* If you have a family history of thyroid disorders.
* During pregnancy or if you are planning to become pregnant.
* As part of routine health check-ups, especially as you age, as thyroid dysfunction becomes more common after menopause.
7. How are thyroid conditions diagnosed?
Diagnosis typically involves:
* Blood tests: Measuring Thyroid Stimulating Hormone (TSH), and sometimes T4 and T3 levels. TSH is often the first test to indicate a problem.
* Physical examination: Checking for goiter or other signs.
* Antibody tests: To identify autoimmune thyroid conditions like Hashimoto’s thyroiditis (common cause of hypothyroidism) or Graves’ disease (common cause of hyperthyroidism).
8. What are the treatment options for thyroid disorders in women?
Treatment depends on the type and severity of the condition:
* Hypothyroidism: Usually treated with daily thyroid hormone replacement medication (levothyroxine).
* Hyperthyroidism: Treatment options include anti-thyroid medications, radioactive iodine therapy, or surgery (thyroidectomy) in some cases. Beta-blockers may be used for symptom management.
9. What can women do to maintain thyroid health?
While not all thyroid conditions are preventable, certain lifestyle choices can support thyroid health:
* Balanced diet: Rich in iodine (e.g., iodized salt, fish, dairy), selenium (e.g., Brazil nuts, tuna, eggs), and zinc. Avoid excessive intake of iodine.
* Stress management: Chronic stress can negatively impact thyroid function. Practice techniques like yoga, meditation, or deep breathing.
* Regular exercise: Helps maintain a healthy weight and can improve thyroid function.
* Sufficient sleep: Aim for 7-9 hours of quality sleep.
* Limit exposure to environmental toxins: Certain chemicals and pollutants can interfere with thyroid function.
* Avoid processed foods and excessive sugar.
* Regular check-ups and medication adherence: If diagnosed with a thyroid condition, consistent monitoring and taking prescribed medication as directed are crucial.
By understanding these key aspects, women can be more proactive about their thyroid health and seek timely medical attention if they suspect a problem.

India faces a complex balancing act between its historical strategic partnership with Russia, including significant defense ties and discounted oil imports, and the potential economic repercussions of US secondary sanctions threatened by the current US administration.
Here’s a breakdown of the situation:
1. India’s Reliance on Russian Oil:
* Since the Ukraine conflict began in February 2022, India has significantly increased its imports of discounted Russian oil, which now accounts for approximately one-third of its total oil imports, compared to less than 1% before the war. This has been a pragmatic economic decision for India, a major oil importer.
* Indian refiners have been able to process this discounted crude into refined products like diesel and jet fuel, some of which have been re-exported, including to Europe.
2. Trump’s Threat of Secondary Sanctions:
* President Trump has announced a threat of 100% tariffs on Russian exports, including oil, and an “equivalent secondary tariff” on countries importing Russian shipments. This threat comes with a 50-day deadline for Russia to end the war in Ukraine.
* Crucially, these proposed secondary tariffs, unlike previous ones, could apply to all merchandise exports from a country, not just entities directly dealing with sanctioned Russian entities. This could severely impact India’s $45.7 billion trade surplus with the US, affecting key sectors like textiles, pharmaceuticals, electronics, and IT services.
* US senators have also proposed even more severe tariffs, potentially up to 500%, on imported goods from countries that continue to purchase Russian oil, gas, and other products.
* NATO’s Secretary General has also warned India, China, and Brazil about potential secondary sanctions for their continued commercial relations with Russia.
3. India’s Response and Options:
* Official Stance: India’s Oil Minister Hardeep Singh Puri has stated confidence in India’s ability to meet its energy requirements, even if Russian oil imports face sanctions or secondary tariffs. He indicated that alternative supplies are available globally, albeit at a higher cost.
* Economic Impact: While Russian oil offers discounts, the potential cost of tariffs on India’s merchandise exports to the US could far outweigh these benefits. Indian refiners might be forced to revert to traditional West Asian suppliers and explore new sources like Brazil, which would likely lead to higher import costs.
* Strategic Maneuvering: Some Indian oil industry officials interpret Trump’s threat as a negotiation tactic, suggesting it might have minimal actual impact on global oil trade or India’s Russian crude purchases. India and the US are also in ongoing discussions for a bilateral trade deal, and imposing such tariffs could derail these negotiations.
* Adaptation: Indian refiners might consider segregating their output, using Russian oil for domestic sales or Asian exports, and sourcing from other nations for European markets, though this would not be seamless.
4. India’s Strategic Relationship with Russia:
* Beyond oil, India and Russia share a “special and privileged strategic partnership” with deep historical roots, particularly in defense, civil nuclear energy, and anti-terrorism cooperation. Russia remains a crucial supplier of defense equipment to India.
* Both countries are members of BRICS, G20, and SCO, and Russia supports India’s bid for a permanent seat on the UN Security Council.
Can India stop trade with its old ally under American pressure?
It’s a difficult decision for India. Completely halting trade with Russia, especially oil imports, would be a significant economic and strategic shift.
* Pressure to Comply: The threat of broad secondary tariffs targeting all of India’s exports to the US is a powerful economic leverage. Given the significant volume of trade between India and the US, and India’s aspirations for a trade deal, the pressure is substantial.
* Maintaining Strategic Autonomy: India highly values its strategic autonomy and non-alignment. Yielding completely to US pressure might be seen as compromising this principle and abandoning a long-standing ally.
* Finding a Balance: India will likely seek to navigate this situation by exploring options that minimize economic damage while attempting to maintain its strategic relationships. This could involve gradually reducing dependence on Russian oil, diversifying its import sources, and emphasizing its own national interests in energy security.
Ultimately, India’s decision will be a careful calculation of economic costs, strategic imperatives, and its commitment to maintaining a multi-aligned foreign policy in a complex geopolitical landscape.

Daratumumab, also known by the brand name Darzalex, is a targeted cancer drug classified as a monoclonal antibody. It is primarily used to treat multiple myeloma, a cancer of plasma cells found in the bone marrow.
How it Works (Mechanism of Action)
Daratumumab works by targeting a specific protein called CD38, which is abundantly present on the surface of multiple myeloma cells. By binding to CD38, daratumumab initiates several anti-cancer mechanisms:
* Direct cell death (apoptosis): It can directly induce myeloma cell death.
* Immune system activation: It recruits various immune cells to destroy the cancer cells:
* Complement-dependent cytotoxicity (CDC): It activates the complement system, a part of the immune system that can directly kill cells.
* Antibody-dependent cell-mediated cytotoxicity (ADCC): It tags cancer cells for destruction by natural killer (NK) cells.
* Antibody-dependent cellular phagocytosis (ADCP): It signals macrophages to engulf and destroy the cancer cells.
* Immune modulation: It can also help to decrease immune system suppression, allowing the body’s own defenses to work more effectively against the cancer.
How it is Used
Daratumumab is administered by a healthcare provider, either as an intravenous (IV) infusion (into a vein) or a subcutaneous injection (under the skin). The dosing schedule varies depending on the specific regimen and whether it’s used as a single therapy or in combination with other drugs.
It is used in various scenarios for multiple myeloma:
* Newly diagnosed multiple myeloma: Often in combination with other standard treatments (e.g., bortezomib, melphalan, prednisone, thalidomide, lenalidomide, dexamethasone), both for patients who are eligible or ineligible for autologous stem cell transplant.
* Relapsed or refractory multiple myeloma: For patients whose cancer has returned or has not responded to previous therapies, sometimes as a single agent (monotherapy) or in combination with other medications.
Common Side Effects
Like all medications, daratumumab can cause side effects. Some common side effects include:
* Infusion-related reactions: These can occur during or shortly after administration and may include symptoms like cough, headache, nausea, chills, chest tightness, or shortness of breath. Pre- and post-infusion medications are often given to help prevent these reactions.
* Low blood cell counts: This can include a decrease in white blood cells (increasing infection risk) and platelets (increasing bleeding risk).
* Upper respiratory tract infections (cold-like symptoms)
* Fatigue
* Diarrhea or constipation
* Peripheral neuropathy (nerve damage causing tingling, numbness, or pain)
* Swelling (e.g., in hands, ankles, or feet)
It’s important for patients to discuss any side effects or concerns with their healthcare provider.