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One in ten adults in India suffer from hypothyroidism: Study

Mumbai: Hypothyroidism is highly prevalent amongst the surveyed population with one out of ten people being diagnosed with the condition, reveals a multi-city study conducted to quantify prevalence of thyroid dysfunctions in the post iodization phase in Bangalore, Chennai, Delhi, Goa, Mumbai, Hyderabad, Ahmedabad and Kolkata.

Dr A G Unnikrishnan
Dr A G Unnikrishnan

The Thyroid Epidemiological Study was initiated by Abbott India and led by Dr A G Unnikrishnan, principal investigator of the study and CEO and endocrinologist, Chellaram Diabetes Institute, Pune. The study findings appear in the Indian Journal of Endocrinology and Metabolism.

According to a statement by Abbott, hypothyroidism was found to be a common form of thyroid dysfunction affecting 10.95 per cent of the study population. The older population (above the age of 35 years) seemed to be at higher risk of hypothyroidism than the younger population (13.11% vs. 7.53%).

Women were three times more likely to be affected by hypothyroidism than men (15.86% vs. 5.02%), especially those in midlife (46-54 years).

Almost one-third of the hypothyroid patients (3.47%) were not aware of the condition and were diagnosed for the first time during the course of study-related screening.

Hypertension (20.4%) and diabetes mellitus (16.2%) were the other common diseases observed in the study population.

Inland cities (Bangalore, Delhi, Kolkata, Ahmedabad, Hyderabad) had higher prevalence of hypothyroidism (11.73%) compared to coastal cities (Chennai, Goa, Mumbai) (9.45%). Kolkata recorded the highest prevalence of hypothyroidism (21.67%).

Approximately one-fifth of the study population had anti-thyroid peroxidase antibodies [TPO] positivity, an established autoimmune marker pointing toward a steady risk of thyroid disorders.

“Thyroid disorders in India are characterized by a high prevalence, minimal diagnosis, poor awareness and low involvement of doctors in treatment. There is a growing urgency to create awareness of thyroid disorders, the need for early and regular diagnosis and the importance of following a recommended treatment regime,” said Dr Unnikrishnan.

“The study findings call for a review of current practices in the management of thyroid disorders. There should be an emphasis on active screening of endocrine function among patients at greater risk along with regular monitoring of thyroid status and dose adjustments to provide effective therapy in patients with established diagnosis,” he said.

Dr Mahesh Padsalge, Mumbai investigator of the study and consultant diabetologist, Diabecare – Specialty Diabetes Centre, said, “Of the 1,259 people in Mumbai, 9.61 per cent were diagnosed with hypothyroidism, of which 2.86 per cent were screened for the disorder for the first time. Approximately one-fourth (25.42%) of the population from Mumbai tested positive for anti-TPO antibodies, hence putting them at a greater risk of developing thyroid disorders in the future. Increasing exposure to substances that have the potential to impair thyroid function, like industrial and agricultural contaminants, is identified as a growing health concern in India.”

Globally, thyroid disorders continue to be common yet one of the most under-diagnosed and neglected chronic health conditions. These disorders impair normal functioning of the thyroid gland causing abnormal production of hormones leading to hyperthyroidism or hypothyroidism. The prevalence of hypothyroidism in the developed world is estimated to be about 4-5 per cent.

If left untreated, hypothyroidism can cause elevated cholesterol levels, an increase in blood pressure, an increased rate of cardiovascular complications, decreased fertility, and depression; and in pregnant women, placental abnormalities and increased risks for the baby’s well-being. These symptoms are often confused with other disorders, thus making thyroid disorders one of the most underdiagnosed disorders in India.

Like diabetes, there is no permanent cure for most forms of thyroid disorders, but with medication and precise treatment, thyroid disorders can be controlled and patients can live normal lives.

Rehan A Khan, managing director, Abbott India, said, “Our objective of undertaking a nation-wide comprehensive epidemiological study is to get a true picture of the evolving profile of thyroid disorders in the post iodization phase in India. By partnering with various stakeholders, Abbott is seeking to advance understanding, increase awareness and support proper diagnosis of thyroid disorders in our country.”

The study assessed the nationwide prevalence of thyroid disorder, particularly hypothyroidism, in adults residing in various cities that represent diverse geographic origin, occupation, socio-economic status and food habits.

All men or women (residing in that area for at least 5 years) aged 18 years or over, were invited to participate in a general health check-up. More than 5,000 participants took part, giving a target population that constituted 0.01 per cent of the total population of the eight cities, according to 2001 national census data. Participants were excluded if they were pregnant, or had any acute or chronic systemic illnesses as judged by the study investigator.

Thyroid abnormalities were diagnosed by measuring the status of thyroid hormones – serum FT3, FT4 and thyroid stimulating hormone [TSH].

Hypothyroidism, commonly categorized under the cluster of iodine deficient disorders (IDDs), is a common health issue in India, as it is worldwide.

Since the time India adopted the universal salt iodization programme in 1983, there has been a decline in goitre prevalence in several parts of the country, which were endemic in the pre-iodization period. With a majority of households (83.2% urban and 66.1% rural) now consuming adequate iodized salt, India is supposedly undergoing a transition from iodine deficiency to sufficiency state.

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