The Indian Thyroid Society (ITS) has mandated three guidelines for the management of Thyroid Dysfunction in Pregnancy, Dyslipidemia and Depression at the 10th Annual Conference ‘ITSCON – 2013’.
Thyroid disorders in India are characterised by a high prevalence around 11 per cent of adult population. There is also minimal diagnosis, low awareness and involvement of doctors in treatment.
The guidelines were developed by Elsevier, a global provider of scientific, technical and medical information, and endorsed by the Indian Thyroid Society, Endocrine Society of India (ESI), Federation of Obstetric and Gynaecological Societies of India (FOGSI) and The Association of Physicians of India (API). Abbott provided financial assistance for the development of these guidelines.
On the launch of the ITS Guidelines, Dr R V Jayakumar, president, Indian Thyroid Society (ITS), Professor of Endocrinology, AIMS, Cochin said, “Conditions such as depression, cardiovascular disorders, high cholesterol, obesity, osteoporosis, infertility and miscarriages are linked to thyroid disorders which are on the rise. The three independent guidelines will support the medical fraternity in diagnosis and treatment. Timely diagnosis of thyroid disorders in pregnant women is important for a healthy pregnancy and a healthy child. In addition, the guidelines for dyslipidemia and depression offer recommendations to minimize the risk of arising complications.”
Dr Mala Dharmalingam, Prof and HOD of Endocrinology, MS Ramaiah Medical College and Hospital, Bengaluru stated that hypothyroidism or low production of the hormone results in fatigue, weight gain, cold chills, dry skin, heavy menstrual periods, constipation, slowed thinking, brittle nails, swelling in arms and legs and hair loss. Ignoring these symptoms can develop into serious medical conditions of the heart and mental health. Through these guidelines we can create awareness amongst the general public about symptoms related to thyroid disorders and the complications that can arise if not diagnosed and treated in time.
The Thyroid Dysfunction and Pregnancy Guidelines recommend screening for hypothyroidism in pregnant women at the 1st antenatal visit by measuring TSH levels. In case overt hypothyroidism is diagnosed then expectant mothers should be treated with a full replacement dose of thyroxine to normalize thyroid function as rapidly as possible. It is also important to understand that; thyroid dysfunction by itself is not an indication for termination of pregnancy.
As per the Thyroid Dysfunction and Dyslipidemia Guidelines, overt hypothyroidism is associated with the risk of cardio vascular disease because it increases LDL cholesterol and hypertension. It is therefore advised that doctors screen patients with dyslipidemia for abnormal thyroid levels and accordingly prescribe treatment.
According to the Thyroid Dysfunction and Depression guidelines one of the co-morbidities associated with thyroid disorders is depression. Therefore patients treated for this condition should be referred to undergo a TSH test to detect hypothyroidism.
Dr KM Prasanna Kumar, chairman, organising committee, ITSCON-2013 confirmed that close to 500 speakers and key opinion leaders from across India were present. Till 2012, ITS had screened close to 12 lakh women for thyroid disorders at various diagnostic and education camps throughout India.