Thyroid disorders are among the most common endocrine problems in India, and among the most frequently mismanaged — usually through incorrect dosing, testing at the wrong time, or treating a borderline result that did not need treatment.
Common presentations
Hypothyroidism (underactive) causes fatigue, weight gain, cold intolerance, dry skin and low mood. Hyperthyroidism (overactive) causes palpitations, weight loss, tremor, anxiety and heat intolerance. Nodules and goitre are often found incidentally and need assessment to determine whether they are harmless.
Assessment
Testing typically includes TSH with free T4 and free T3 where relevant, thyroid antibodies when autoimmune disease is suspected, and ultrasound for any palpable swelling or nodule. Nodules with concerning features may need an FNAC biopsy.
Subclinical thyroid disease
A mildly raised TSH with normal T4 is common and does not always need treatment. The decision depends on age, symptoms, antibody status, cholesterol, pregnancy plans and how far above range the value sits — which is exactly the kind of judgement a specialist review is for.
Thyroid and pregnancy
Thyroid targets in pregnancy are tighter than at other times, and dose requirements usually rise. Women with known thyroid disease should be reviewed as soon as pregnancy is confirmed, ideally before conception.