Thyroid Disorders in India: Hypothyroidism, Hyperthyroidism & When to See a Doctor

Thyroid disorders are among the most common endocrine conditions in India — affecting approximately 42 million people. Women are 5–8 times more likely to develop thyroid disease than men. Despite being common, thyroid disorders are frequently undiagnosed for years — as their symptoms overlap with stress, ageing, and depression.

The Thyroid Gland — What Does It Do?

The thyroid gland (butterfly-shaped gland in the front of the neck) produces thyroxine (T4) and triiodothyronine (T3) — hormones that regulate virtually every system in the body: metabolism, heart rate, body temperature, digestion, brain function, and reproductive health.

The pituitary gland controls thyroid function via Thyroid Stimulating Hormone (TSH). TSH is the most important blood test for thyroid function — high TSH means an underactive thyroid; low TSH means an overactive thyroid.

Hypothyroidism — Underactive Thyroid

The most common thyroid disorder in India. The thyroid does not produce enough hormone, slowing down the body's functions.

Symptoms

• Fatigue and sluggishness — even with adequate sleep
• Weight gain — despite no change in diet
• Cold intolerance — feeling cold when others are comfortable
• Dry skin, brittle nails, hair thinning or loss
• Constipation
• Slow heart rate
• Depression and poor concentration ('brain fog')
• Heavy or irregular periods in women
• High cholesterol (often)
• Neck swelling (goitre) in some cases

Causes

• Hashimoto's thyroiditis: Autoimmune — the most common cause. TPO antibodies attack the thyroid. Iodine deficiency (less common in India now with iodised salt)
• Post-thyroid surgery or radioiodine treatment
• Congenital hypothyroidism in newborns — detected on newborn screening

Treatment

Levothyroxine (synthetic T4) — taken once daily on an empty stomach. Dose is adjusted based on TSH levels, checked every 6–8 weeks until stable, then annually. Pregnancy requires more frequent monitoring.

Hyperthyroidism — Overactive Thyroid

The thyroid produces too much hormone — accelerating the body's functions.

Symptoms

• Weight loss despite increased appetite
• Palpitations — rapid or irregular heartbeat
• Heat intolerance — feeling hot and sweating excessively
• Tremor — fine shaking of the hands
• Anxiety, irritability, restlessness, insomnia
• Diarrhoea
• Goitre (enlarged thyroid)
• Bulging eyes (exophthalmos) in Graves' disease
• Hair thinning

Causes

• Graves' disease: Autoimmune — most common cause of hyperthyroidism. TSH receptor antibodies stimulate the thyroid
• Toxic multinodular goitre
• Toxic adenoma (single overactive nodule)
• Thyroiditis (temporary thyroid hormone release)

Treatment

Antithyroid drugs (carbimazole or propylthiouracil), radioactive iodine ablation, or surgery — depending on cause, severity, and patient preference.

Thyroid Nodules — When to Worry

Thyroid nodules are very common (found in up to 65% of people on ultrasound). Most are benign. Features that require further evaluation (fine needle aspiration cytology — FNAC):

• Nodule growing rapidly
• Hard, fixed nodule
• Hoarse voice
• Difficulty swallowing
• Lymph node enlargement in the neck
• Family history of thyroid cancer

Thyroid and Neurological Symptoms

Both hypo- and hyperthyroidism cause neurological symptoms:

• Hypothyroidism: peripheral neuropathy (numbness/tingling), carpal tunnel syndrome, cognitive decline, cerebellar ataxia (rarely)
• Hyperthyroidism: tremor, muscle weakness (thyrotoxic myopathy), anxiety, insomnia

Dr. Anand Karnam at Sri Anand CNC routinely checks thyroid function in patients presenting with neuropathy, tremor, cognitive change, or mood symptoms.

For thyroid testing and management: Sri Anand CNC, Chanda Nagar, Hyderabad. Call +91 90633 66983.