Do you have an underactive thyroid?

Hypothyroidism - or an underactive thyroid - affects one in 70 women and one in 1,000 men according to the NHS. But it can be a tricky disease to diagnose and treat. Dr Michael Mosley, of Trust Me I'm a Doctor, asks if sufferers are slipping through the net.

Someone emailed me the other day to ask me if I had ever considered the possibility that I might have hypothyroidism; an underactive thyroid. The reason he contacted me is because he had seen me on television and noticed that I have quite faint eyebrows, which can be a sign of this disorder.

I have none of the other symptoms such as weight gain, tiredness and feeling the cold easily, so I've decided not to go and get myself tested.

But if you do - and you think you could you have it - what should you do about it?

To get some answers I've been talking to Dr Anthony Toft, who is a former president of the British Thyroid Association.

He tells me that the thyroid gland is a bit like the accelerator pedal on your car. It produces hormones which help control the energy balance in your body. If it's underactive, then your metabolic rate will be slower than it should be. This means that you are likely to put on weight. Other symptoms can include feeling too cold or too hot, lacking in energy, being constipated, low mood, poor attention or "brain fog".

The main hormones involved are thyroid stimulating hormone (TSH), T4 and T3. TSH is released by the pituitary gland and tells your thyroid to get going.

In response your thyroid should release the hormones T4 and T3. T4 is converted in your body into T3, the active hormone that revs up your cells.

If you have symptoms of hypothyroidism then your GP will probably test your blood. The signs they're looking for are high levels of TSH, together with low levels of T4.

If your TSH is higher than normal this suggests that the gland that produces this hormone - the pituitary gland - is working hard to tell the thyroid gland to produce more hormone, but for some reason the thyroid gland is not listening.

The pituitary then ups its game and produces more and more TSH, but T4 levels stay low.

So if you have a high TSH coupled with a low T4, it's likely that the body is saying "I need more thyroid hormone!" but the thyroid gland isn't doing what it's being told. The result is hypothyroidism.

When this happens patients are often prescribed levothyroxine (T4). Symptoms diminish and patients are happy.

So if it's so straightforward, why are there so many forums full of dissatisfied patients? Why do we at Trust Me get so many emails about this subject?

One of the issues with the blood tests is that there are no standard international reference ranges. In the UK, for example, we set the bar rather higher than many other countries. Certainly Dr Toft thinks that current UK guidelines are sometimes interpreted too rigidly.

"If the T4 is right down at the lower limit of normal," he says, "and the TSH is at the upper limit of normal, then that is suspicious. It doesn't often arouse suspicion in GPs, but it should."

He is also concerned that when a GP does diagnose an underactive thyroid, then patients are almost always prescribed a synthetic version of T4.

This works most of the time but in some cases the symptoms don't improve. This might be because with some patients the problem is not an underactive thyroid, but the fact that they can't convert enough T4 into the active hormone T3.

One way round this is to take T3 hormone in tablet form, but here price is a problem.

"The cost of T3 has escalated incredibly," says Dr Toft. "It's now about £300 for two months' supply of T3, whereas it costs pennies to make."

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Find out more

Underactive thyroid (NHS Choices)

Trust Me, I'm A Doctor is on BBC Two at 20:00 GMT, Wednesday 8 February -catch up on BBC iPlayer

How can I tell if I have a thyroid problem and what can I do about it?

From episode 1 -

Which foods can improve your gut bacteria?

The man with a titanium chest

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So if you have been put on T4 and it doesn't work, what about asking for a trial of T3? Because it is so expensive your GP may well say no.

So instead some patients are going online and buying T3 from foreign websites. But it's important that if you are taking T3 you are being properly monitored, because it can cause serious side effects, including heart problems.

A slightly less expensive hormone supplement taken from the glands of cows and pigs is available. It contains both the T3 and T4 hormones, and there is a growing call to prescribe it for patients who don't respond to T4 alone. So does Dr Toft think patients should be offered this combination?

"I suspect that in time that's what will happen," he says. "The trouble is the evidence base is not as strong as we would wish it to be, and I suspect it will be a long time before we have sufficient evidence."

Dealing with thyroid problems can be complicated. If you've had a blood test and the results have come back normal, then you can ask to look at the actual numbers. But you may also have to accept that medication is not for you and lifestyle changes may be more appropriate.

When neo-Nazis started trolling Whitefish, Montana, the town had to make a definitive stand against hate. But the deepest-rooted intolerance in places like Whitefish isn’t the kind that makes headlines.

“I’ll tell you why these neo-Nazis and fascists move here,” a man named Phil, who’d moved up to Glacier National Park after graduating from a liberal arts college, told me over dinner. “During the summer, I’d work at this place that rented all sorts of stuff to tourists in the park. So this woman comes in with a Southern accent, I ask where she’s from, she says Georgia. She rents one of those infant backpacks — the kind you put your kid in. And then she says, ‘This place is just so great — did you move here because there’s no black people?’

“I pause, look at her, and say, ‘Well, Kalispell has the most black people in Montana.’ This isn’t true, but I wanted to throw her. Then she says, ‘Well, what about Whitefish?’ And I say, ‘Well, it’s just all gay people.’ Again, not true. ‘Columbia Falls?’ she asks, and I say ‘Filled with Hispanics.’”

“‘Well, we just want to get away from some of the, well, drama down there,’ this woman said, referring, you know, to Georgia.

“So she takes off with her husband and her baby, and I don’t see her again — until, months later, she comes back for a 9 mm unmarked pistol they’d forgotten in the little pouch on that infant backpack. ‘We moved here!’ she exclaimed. ‘We’re homeschooling our kids!’”

The woman in Phil’s story may not be a neo-Nazi, but she arrived in the Flathead Valley for the same reason that so many neo-Nazis, “Patriots,” and other fascists have: Flathead County, population 96,000, is one of the whitest places in the nation (95.2%).

There are other allures for people at odds with mainstream American culture: the large pockets of open space, the ability to live off the grid, the lack of restriction when it comes to gun ownership. The Montana political ethos — some mix of libertarian, conservative, and “don’t fuck with me” — is inviting that way. As a local pastor put it, “It’s a place where people can feel safe when they say outrageous things.”

The winters are frigid and last forever, but the summers are exquisite. Any direction you look, there are mountains. You can get a big house in the backwoods for under $100,000. For decades, tourists have come to town and asked shop owners the same thing: “How can I live here?” Starting in the early 2000s, white supremacists wanted in too.

Gradually, Montana became home to the highest concentration of hate groups in the nation. In the Flathead — which includes Kalispell (more industrial, more sprawling, population 22,000), Whitefish (a quaint grid of a resort town, population 7,000), and Columbia Falls (a former timber town, now filling with those priced out of Whitefish, population 5,000) — they mostly keep to themselves. Sometimes there’ll be a piece of Nazi propaganda slipped between pairs of expensive jeans in clothing boutiques; other times there’ll be flyers for “A Nature-Based, Race-Centered Religion for White People” folded in children’s books at the local bookstore. “Every place in town has a story like that,” one business owner told me.

But some things can’t be ignored. Like in 2010, when April Gaede — better known as the “Nazi stage mom” to twin girl group Prussian Blue and a member of Pioneer Little Europe, an organization of whites-only intentional communities — began showing Holocaust denial films at the Whitefish library. Or this past December, when a neo-Nazi site, theDaily Stormer, launched a campaign to troll local Jews as revenge for perceived attacks on the mother of “academic racist” (and Whitefish resident) Richard Spencer.

In the post-election tumult, the story of the troll storm quickly made the national news. A neo-Nazi march was threatened. Counterprotests were declared. Residents of Whitefish had to decide: How could they fight hate, and definitively declare their town infertile to the messages of these groups, without defining the town in the public imagination by that fight?

These questions concern more than just the residents of this rural corner of Montana. The online trolls who threatened Whitefish may have been terrifying in their anonymity, but like other fascists and neo-Nazis, they were easy to decry. Meanwhile, other forms of hate — more subtle, and more culturally normalized — flourish, virtually unassailed, across the nation. Moving forward, Whitefish and other towns will have to ask themselves: When does hate cross a line, and what responsibility does a community, and the nation that witnesses it, have to react when it happens?

Anti-fascist groups march in downtown Whitefish, Montana, Jan. 16, 2017

Hate can gather in the most banal of places. Like a conference room at the Kalispell Hilton Garden Inn, outfitted with about a hundred chairs, a simple podium, and bad ’90s carpet. That’s where Chuck Baldwin’s church, Liberty Fellowship, gathers every Sunday from 2 to 5 p.m., and where his message is livestreamed to hundreds of loyal followers across the country. On a Sunday in January, the service started with a haunting hymn, sung in harmony by several women, before Baldwin took the pulpit to preach, without notes, for two hours.

Baldwin looks like a mix of a church dad and a real estate agent: He has a thick head of golden hair and a Mona Lisa smile that looks kind from one vantage point, scheming from another. For 35 years, he helmed a church in Pensacola, Florida, where his anti-gay, anti-abortion, fundamentalist preaching drew thousands.

Baldwin believes the South should’ve won the Civil War. He believes that the “castrated churches” of America are terrified of “Judaizers” and hamstrung by political correctness. For his various explicitly homophobic, anti-Semitic, and anti-Muslim preachings, Baldwin and his church have been designated a hate group by the Southern Poverty Law Center.

Hate can gather in the most banal of places.

But Baldwin believes he is not a racist, and he declares as much on his website. A section entitled “Is Chuck Baldwin a Racist?” features a single video testimony from a black man who, according to Baldwin’s caption, grew up in the church. When I visited, there were more people of color (at least eight) than I’d seen elsewhere in the valley. A Hispanic family had driven an hour to visit the church for the first time. “I didn’t know you all were so close by,” the father told a greeter. “I’ve been listening for months.”

In 2010, Baldwin decided he and his extended family needed to relocate to a place that truly understood the meaning of freedom, and where he and his flock could ready themselves for the fight to come. “America is headed for an almost certain cataclysm,” hewrote. “We believe that this cataclysm will most certainly include a fight between Big-Government globalists and freedom-loving, independent-minded patriots.”

True liberty, Baldwin believed, could be found in the Flathead Valley — where he could stockpile arms, proselytize that “there is no liberty without the semi-automatic rifle,” and preach against the evils of gay people, Islam, Israel, moderate Republicans, and abortion. Inside the two entrances to the conference room, two large men positioned themselves for the duration of the service. Call them ushers, call them bouncers, call them people who wanted to make sure no one came and took issue with what Baldwin was preaching. The parking lot was filled with four-wheel-drive vehicles plastered with bumper stickers for Liberty Fellowship and “The Trump Train.”

Still, most people in Kalispell haven’t heard of Baldwin. They might have heard of church attendees like Randy Weaver (made infamous by the 1992 Ruby Ridge standoff in Northern Idaho) or Gaede, who has taken to online neo-Nazi forums to encourage readers to flock to the area. But that sort of anonymity is part of the point: Baldwin aims to build a mini civilization, free from any oversight other than his own — and God’s.

Male contraceptive gel passes monkey test

An experimental new type of male contraceptive that blocks sperm flow with a gel has been successful in monkey trials.

Vasalgel acts as a physical barrier once injected into the tubes that sperm would swim down to the penis.

The company behind it says a two-year trial, published in Basic and Clinical Andrology, shows the gel works and is safe - at least in primates.

It hopes to have enough evidence to begin tests in men within a few years.

If those get funding and go well - two big "ifs" - it will seek regulatory approval to make the gel more widely available to men.

It would be the first new type of male contraceptive to hit the market in many decades.

Male birth control

mage 

At the moment, men have two main options of contraceptive - wear a condom to catch the sperm, or have a sterilising operation (vasectomy) to cut or seal the two tubes that carry sperm to the penis from where they are made in the testicles.

Vasalgel has the same end effect as vasectomy, but researchers hope it should be easier to reverse if a man later decides he wants to have children.

In theory, another injection should dissolve the gel plug.

That worked in early tests in rabbits, but the researchers have yet to prove the same in monkeys and man.

Under anaesthetic

The idea behind Vasalgel is not new.

Another experimental male birth control gel - RISUG (reversible inhibition of sperm under guidance) - that works in a similar way to Vasalgel is being tested in men in India.

Unlike RISUG, Vasalgel is not designed to impair the swimming sperm.

It merely blocks their path while still letting other fluid through, according to the manufacturer.

Both gels are given as an injection, under anaesthetic, and are meant to offer long-acting contraception.

The monkey trial

The University of California researchers tested the gel on 16 adult male monkeys, 10 of whom were already fathers.

The monkeys were monitored for a week after getting the injection and were then released back into their an enclosure to rejoin some fertile females.

Mating did occur, but none of the female monkeys became pregnant over the course of the study, which included two full breeding periods for some of the animals.

Few of the male monkeys had side-effects, although one did need an operation because the injection did not go to plan and damaged one of his tubes.

Alec Baldwin's Trump act fools newspaper

Actor Alec Baldwin's impression on Saturday Night Live of Donald Trump tricked a national newspaper into thinking he was the real thing.

El Nacional in the Dominican Republic has now apologised for accidentally publishing a still of Alec Baldwin, captioned as the US president, next to Israeli PM Benjamin Netanyahu.

The image accompanied an article about Israeli settlements.

The paper has said sorry to readers and "anyone affected".

The picture was sent to the newspaper along with information about Saturday Night Live, the long-running US satirical programme.

No-one spotted the mistake, says El Nacional.

Saturday Night Live is not Mr Trump's favourite TV programme. He says Baldwin's frequent impressions of him "stink".

"Not funny, cast is terrible, always a complete hit job. Really bad television!" he once tweeted.

Just to make it clear...the apology

A Bookshop Is Tweeting -Philosopher’s Stone- To Piers Morgan After He Said He’d Never Read A Word Of Harry Potter

On Saturday, J.K. Rowling got into a Twitter beef with Piers Morgan.

Twitter: @jk_rowling

Morgan retaliated by saying that he had never read a single Harry Potter book.

Twitter: @piersmorgan

But people found evidence to show he had previously made Potter references in his columns.

Man who claims to have never read a word of Harry Potter quotes liberally from Harry Potter book https://t.co/DhSD0bck9q

— Barry Glendenning (@bglendenning)

Something Morgan said was down to his son being a fan.

Twitter: @piersmorgan

In response, a bookshop based in north London decided to tweet Harry Potter and the Philosopher’s Stone at Morgan, word by word.

.@piersmorgan Mr. and Mrs. Dursley, of number four, Privet Drive, were proud to say that they were perfectly normal, thank you very much.

— Big Green Bookshop (@Biggreenbooks)

Tweeting 140 characters at a time.

.@piersmorgan They were the last people you'd expect to be involved in anything strange or mysterious..2/32567

— Big Green Bookshop (@Biggreenbooks)

Every. Single. Line.

.@piersmorgan Mr. Dursley, however, had a perfectly normal, owl-free morning. He yelled at five different people. 47/32567

— Big Green Bookshop (@Biggreenbooks)

People praised Big Green Bookshop for their trolling.

Twitter: @Lukemackaycooks

Twitter: @Clare_L_Wallace

The bookshop clarified that a real person and not a bot was behind the tweets.

Hi. Just so you know, i'm not a computer program. It's me typing stuff. Piers Morgan is a twat. JK Rowling is incredible. I shall continue.

— Big Green Bookshop (@Biggreenbooks)

They’ve since taken a break after reaching 100 tweets.

.@piersmorgan He cleared his throat nervously. "Er -- Petunia, dear -- you haven't heard from your sister lately, have you? 100/32567

— Big Green Bookshop (@Biggreenbooks)

BuzzFeed News reached out to the person behind the account, but they said they’d decided to enjoy their Sunday afternoon at a museum.

I am at @sciencemuseum with my family today. More HP later. Have the best day and thanks for all the lovely messages.

— Big Green Bookshop (@Biggreenbooks)

But promised to return later, with 32,000 tweets remaining.

.@piersmorgan OK Piers, that'll do for the time being. We'll read some more later shall we?

— Big Green Bookshop (@Biggreenbooks)

'Braid chains' are going to be everywhere in 2017

From Cosmopolitan UK

2017 is shaping up to be the year of all things heavy metal. First, Kim K brought back the nail ring. Now? Hair's getting in on the action with "braid chains."

We first spotted the look on the 2017 SAG Awards red carpet, where The Crown's Vanessa Kirby wore a braided updo with a tangle of silver chains elegantly woven through it. The look was created by hairstylist and Adir Abergel, who used a silver chain piece from his newmetal hair accessories line-a collaboration with Sara Bieler Sasson of Lelet NY.

"A chain can be worked into any type of braid," explains Abergel. "For the SAG Awards, I wove the silver chain into Vanessa's textured and deconstructed braid. I wanted to create a duality in textures with the soft romantic braid and edgy and sleek chain."

The chain that Abergel designed is attached to a comb, which makes it easier to secure in the hair. To really keep the hold, he suggests backcombing the part of the hair where you're going to insert it. "I designed this piece specifically so that it could work with different lengths and be incorporated into any hairstyle," he explains.

The metal link accessory will debut as part of the Adir x Lelet NY collaboration, which utilizes luxe materials like 14-karat gold, rhodium, antique gold, rose gold, oxidized silver, and brass. It has yet to be released to the public, but we have a feeling this won't be the last heavy metal hair look we see this award's season.

Greenery makeup: Rock Pantone's 2017 colour trend on your eyes

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Pantone, the world’s colour authority and trend predictor, has declared the 2017 colour of the year as Greenery. “A fresh and zesty yellow-green shade that evokes the first days of spring when nature’s greens revive, restore and renew”.

From makeup and fashion, to homeware, you’re going to see this colour everywhere. Green eye makeup might sound scary, but it’s actually very wearable as you can go all out with a heavy smokey eye alongside darker greens, or pare things back with just a hint of eyeliner. Here are some tips on how to wear this colour – there really is a look here for everyone.

When They Lost Their Baby, They Got To Do Something With Her That May Shock You

Just four weeks after 21-year-old Charlotte Szakacs and her husband, Attila, welcomed their daughter, Evlyn, into the world, the infant girl passed away.

Twenty weeks into Charlotte's pregnancy, doctors told the York, England, residents that their baby hadunbalanced chromosome translocation, a rare genetic chromosome abnormality. When she was born on December 13, she had an underdeveloped brain, couldn't breathe on her own, and had a narrow aorta. She spent most of her short life hooked up to a ventilator. About a month after her birth, she was moved into hospice care and died on January 10. 

The parents were devastated after saying goodbye to their little girl, but they found an unusual way to cope with their loss that some may find shocking.

Facebook / Charlotte Szakacs

After Evlyn's death, the Szakacs were given an option to spend time with their daughter before burying her.

Facebook / Charlotte Szakacs

The hospice provided a cold cot, or "cuddle cot" -- a small cooling unit that allows families to spend extra time with their deceased babies.

Facebook / Charlotte Szakacs

Charlotte and Attila were able to spend 16 days with their daughter before her funeral, sometimes even taking her out on walks in a stroller. They also got to take her home with the cuddle cot for four days during that period.

Facebook / Charlotte Szakacs

"I know it might not be the best option for everyone. But for us it was so important to be able to have that family time and just properly cuddle our little girl. I think having the time with her made such a difference. Being able to do so many of the things you imagine like taking her out in her pram, it really helped emotionally," Charlotte said.

Facebook / Charlotte Szakacs

"I would love to have her here, I would give so much to have that, but we have no idea what her life would have been like. At least now she isn't suffering," she added.

Facebook / Charlotte Szakacs

Personally, I think it's amazing that these parents got to do something that clearly meant so much to them before their final farewell. Be sure to SHARE their story if you're glad they got to spend more time with their baby.