Rise in hypothyroidism calls for awareness and screening

CHENNAI: The most common thyroid disorder that is seen in clinical practice is hypothyroidism, which is the underactive thyroid. Hypothyroidism can be overt or subclinical hypothyroidism. All overt hypothyroidism and a few patients with subclinical hypothyroidism would be recommended thyroxine therapy for the underactive thyroid gland. The other clinical entity for which patients do seek treatment is overactive thyroid, hyperthyroidism treated with anti-thyroid medications.

There is a high prevalence of hypothyroidism in India. Hypothyroidism in newborns, which is called congenital hypothyroidism, is reported to be 1 in 2,000 births, with even higher incidences reported in iodine-deficient areas. Newborn screening helps identify congenital hypothyroidism and is widely implemented. In the adult population, it is estimated that at least 1 in 10 adults in India, or 10.95 per cent, are affected by hypothyroidism. The prevalence of hypothyroidism is higher than that in developed countries, which ranges between 2 per cent and 5 per cent.

Female gender and older age were found to have a significant association with hypothyroidism — nearly one-third of people living with hypothyroidism experience the disorder without diagnosis.

The prevalence of subclinical hypothyroidism was reported at 8 percent and antibody positivity at 21.85 per cent.

India has completed its transition from iodine deficiency to iodine-replete status

Thyroid disorders can be identified with a good history taking and physical examination. The thyroid blood test can then be requested with a pretest probability of identifying the problem. What we need is awareness and screening methods for a large proportion of the population experiencing thyroid disorders but may not be seeking treatment.