Thyrovigilance for hypothyroidism in India

Abstract

ABSTRACT Among endocrine abnormalities, thyroid diseases are the commonest both in India and worldwide. However, the prevalence of hypothyroidism in India is more than twice as high compared to its Western counterparts. Therefore an efficient and effective strategy to manage the disease in India is necessary. We reviewed published literature to determine the prevalence, and identify the challenges in the screening and management of hypothyroidism in India. A review of published literature indicates that nearly one-third of the patients with hypothyroidism across age groups remain undiagnosed and untreated in various regions of India. Based on the critical evaluation of these data from India, we have suggested certain best practices for screening, timely diagnosis, and the treatment of hypothyroidism. Primarily non-specific presentation necessitates a high index of suspicion to detect hypothyroidism in neonates and the juvenile population. An individualized approach is key in managing adult patients with hypothyroidism. In elderly patients recognizing hypothyroidism and its treatment, are challenging due to comorbidities and concomitant medications respectively. When managing any age group with hypothyroidism or subclinical hypothyroidism, clinicians should encourage patients for regular follow-up visits. With timely diagnosis delays in treatment and serious sequelae can be averted.