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Diagnosis and Management of Hypothyroidism: Addressing the Knowledge–Action Gaps

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Abstract

Hypothyroidism presents a large epidemiological burden in India. As a result of subtle and nonspecific clinical symptoms and signs, the condition often goes undiagnosed and is not adequately treated when it is detected. There is heterogeneity in the diagnostic and treatment approaches to hypothyroidism. As a result of the physiological changes in thyroid hormones with age and illness, it is important to tailor the diagnosis and management of this condition in specific populations including pregnant women, infants, children, geriatric patients, and those with comorbid conditions. Enhanced understanding and education of physicians and patients can help to improve the outcomes of treatment in hypothyroidism which should be focused on patient-centered care. Policies and reforms should be crafted and implemented at the national level to curb public health challenges of hypothyroidism. This publication summarizes the recommendations of a national advisory board meeting to identify and bridge the gaps in understanding of the diagnosis and treatment of hypothyroidism in India. As a complement to clinical judgment, these recommendations will foster the diagnosis and management of hypothyroidism in the community and clinics for the benefit of the patients.

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Merck Ltd, India.

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Acknowledgements

Funding

The meeting of the advisory board members for discussion of the current topics was funded by Merck Ltd, India. The sponsor also funded the article processing charges for this manuscript.

Medical Writing Assistance

The authors thank Dr. Tarveen Jandoo and Dr. Punit Srivastava of Mediception Science Pvt Ltd for providing medical writing support in the preparation of this publication. Funding for medical writing support was provided by Merck Ltd, India, an affiliate of Merck KGaA, Darmstadt, Germany.

Authorship

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work, and have given their approval for this version to be published.

Disclosures

Sanjay Kalra received honoraria as a consultant for Merck Ltd, Mumbai, India for this advisory board meeting. A K Das received honoraria as a consultant for Merck Ltd, Mumbai, India for this advisory board meeting. Banshi Saboo received honoraria as a consultant for Merck Ltd, Mumbai, India for this advisory board meeting. Deepak Khandelwal received honoraria as a consultant for Merck Ltd, Mumbai, India for this advisory board meeting. Mangesh Tiwaskar received honoraria as a consultant for Merck Ltd, Mumbai, India for this advisory board meeting. Navneet Agarwal received honoraria as a consultant for Merck Ltd, Mumbai, India for this advisory board meeting. Pritam Gupta received honoraria as a consultant for Merck Ltd, Mumbai, India for this advisory board meeting. Rakesh Sahay received honoraria as a consultant for Merck Ltd, Mumbai, India for this advisory board meeting. Sameer Aggarwal received honoraria as a consultant for Merck Ltd, Mumbai, India for this advisory board meeting. Sujoy Ghosh received honoraria as a consultant for Merck Ltd, Mumbai, India for this advisory board meeting. Harshal Chaudhari is an employee of Merck Ltd, India, an affiliate of Merck KGaA, Darmstadt, Germany. Nitin Mulgaonkar is an employee of Merck Ltd, India, an affiliate of Merck KGaA, Darmstadt, Germany.

Compliance with Ethics Guidelines

This article is based on previously published articles and does not contain any studies with human participants or animals performed by any of the authors.

Data Availability

Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study.

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Authors and Affiliations

  1. Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India

    Sanjay Kalra

  2. Department of Medicine, JIPMER, Puducherry, India

    A. K. Das

  3. Department of Medicine, MLN Medical College, Allahabad, UP, India

    Sarita Bajaj

  4. Department of Medicine, Diacare, Ahmedabad, Gujarat, India

    Banshi Saboo

  5. Department of Endocrinology, Maharaja Agrasen Hospital, Punjabi Bagh, Delhi, India

    Deepak Khandelwal

  6. Department of Medicine, Shilpa Medical Research Centre, Mumbai, Maharashtra, India

    Mangesh Tiwaskar

  7. Department of Medicine, Diabetes, Obesity and Thyroid Center, Gwalior, Madhya Pradesh, India

    Navneet Agarwal

  8. Department of Medicine, Dr. Pritam Gupta’s Clinic, New Delhi, India

    Pritam Gupta

  9. Department of Endocrinology, Osmania Medical College, Hyderabad, Telangana, India

    Rakesh Sahay

  10. Department of Endocrinology, PGIMS, Rohtak, Haryana, India

    Sameer Aggarwal

  11. Department of Endocrinology, IGPGMR, Kolkata, West Bengal, India

    Sujoy Ghosh

  12. Department of Medicine, Diabetes and Thyroid Specialities Center, Thane, Maharashtra, India

    Vijay Negalur

  13. Chellaram Diabetes Institute, Pune, Maharashtra, India

    A. G. Unnikrishnan

  14. Department of Endocrinology, St. Johns Medical College, Bengaluru, Karnataka, India

    Ganapathi Bantwal

  15. Department of Thyroid and Endocrine Research, Institute of Nuclear Medicine and Allied Sciences, Timarpur, New Delhi, India

    Rashmi Aggarwal

  16. Merck Ltd, India (An affiliate of Merck KGaA, Darmstadt, Germany), Godrej One, 8th floor, Pirojshah Nagar, Eastern Express Highway, Vikhroli (E), Mumbai, 400079, India

    Harshal Chaudhari & Nitin Mulgaonkar

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Correspondence to Sanjay Kalra.

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Kalra, S., Das, A.K., Bajaj, S. et al. Diagnosis and Management of Hypothyroidism: Addressing the Knowledge–Action Gaps. Adv Ther 35, 1519–1534 (2018). https://doi.org/10.1007/s12325-018-0744-7

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