Raju Kamra, 38, had heard of thyroid disease but gave little thought to it thinking it only happened to women. His life changed a year ago when he tested for thyroid dysfunction. "I was shocked when my doctor told me my Thyroid Function Test (TFT) results were abnormal. The Thyroid Stimulating Hormone (TSH) levels had crossed 15 uIU/mL when the normal range is under five," says Kamra.
His physician said the symptoms of fatigue, weakness, shortness of breath, sleepiness and hairloss that he had been ignoring were caused by hypothyroidism, a disorder where the thyroid gland cannot produce adequate amounts of hormone. "I had had these symptoms for a long time but I never put it down to thyroid dysfunction. I thought it was just overwork and stress and I finally consulted a doctor only after I found no improvement in my condition," he says.It has been a year since Kamra has been under treatment and life is back on track. "My day begins with having medicine on an empty stomach. I'm better but I have to take the medicine for life," he says.
A year ago, Mumbai businessman Ram Krishna, 36, became concerned about his sudden weight gain - 10 kg over just six weeks, despite no change in his diet - and went to see a physician. A blood test revealed Type-1 diabetes, but despite treatment, the symptoms persisted. Krishna continued to gain weight, and his sugar levels refused to stabilise. He also felt increasingly lethargic and, as visits to multiple diabetologists failed to yield results, he became depressed.
Finally, three months ago, he visited Dr Pradeep Gadge, a diabetologist and endocrinologist at Breach Candy Hospital, and found the answer: His diabetes was being compounded by a thyroid imbalance. "I suspected hypothyroidism after learning about Ram's sedentary lifestyle and lethargy. My suspicion increased when I noticed signs of vitiligo or leucoderma, as this and hypothyroidism are both autoimmune diseases," says Dr Gadge.
Hypothyroidism, categorised under the cluster of iodine deficient disorders (IDDs), is highly prevalent in India. An estimated 200 million people have thyroid disorders worldwide, of which 42 million are in India.
Pan India data is scarce, with an epidemiological study in the Indian Journal of Endocrinology and Metabolism in 2011 put prevalence among men at 6.2% after testing 971 adults in Cochin, Kerala.
Diagnostic labs are using data-mining to throw up trends. Of the 14,24,008 men tested at SRL diagnostics over three years, 22.68% had abnormal hormonal levels.
Most men consider the TSH test for thyroid imbalance as a last resort. "The popular conception is that it occurs exclusively in women. This is not so," says Dr Sanjiv Shah, consultant diabetologist and endocrinologist at Mumbai's Nanavati Super Speciality Hospital. "As much as 1% of men suffer from thyroid imbalances."
Often, the symptoms go unnoticed in men because a key symptom - excessive hairfall - is mistaken for premature balding, which is much more common among men than women. Other key symptoms such as dry skin and lethargy are also dismissed as unimportant and not worth seeking medical advice for.
"Men tend not to take these symptoms seriously, but all men showing such signs must be screened for thyroid imbalances," says Dr Shah. "It's more common today compared to a decade ago, but more cases are being reported primarily because people are getting tested for it," said Dr SV Madhu, professor and head, endocrinology and metabolism department, University College of Medical Sciences, Delhi University. "There's no way to prevent it except for taking iodised salt to meet the iodine deficiency, which's one of the latent causes for hypothyroidism," he adds.
Some experts, however, say that increasingly unhealthy lifestyles are seeing more men seek out the test. "This prompts us to call for a T3 T4 TSH test, because, of course, thyroid imbalances are often a result of unhealthy lifestyle," Dr Shah says.