Its amazing what multinational phaarmaceuticals can do. Every month we read about a new statin, and agonize about new guidelines issued by a medical association/regulatory authority, that suddenly brings us into a "range";. Heart disease and diabetes, not to speak of AIDS seem to rule the roost, cllosely followed by hypertension, arthritis, and stuff like parkinsons, The first two have almost become fashionable diseases of lifestyle abuse in India.

It is therefore not very surprising that comparatively little attention is paid to stuff like thyroid diseases.

Its like paying more attention to car features like fancy brakes, and power steering , and automatic snazzy car stuff, when the carburettor itself is not at peak performance. Only a dedicated automobile purist would advise toning up the carburettor and/or attending to it in various ways.

The first thing that comes to mind when someone asks you to do thyroid tests is "Oh! But they are expensive!"

You talk to a doctor on why routine screening of women's thyroid is not done , say annually, (just like you do lipids, cardiac stuff, mammograms, smears and stuff), and one hears an argument of how in a country like India , spending on preventive tests , on stuff like thyroid, is a "luxury " .


In India, attributing womens' health problems to anything like a thyroid imbalance , is a complicated thing. Majority of India's people live in small towns and villages. Its not uncommon, to find that most woman will hesitate to go to a doctor for themselves; one reason is sociological conditioning , where women simply dont communicate with outsiders.

If the woman has any problems, its her fate. If you are a male in the family, you are entitled to have the whole family worry about you, you get to see the doctors and the family will even consider going into debt, so you can get the required medical care and yes, nutrition.

Women take their children to the local primary health centre for the vaccinations and stuff, thanks to the huge publicity those campaigns get. But they suppress their own Gynaec and other problems; and as far as psychological problems go, one doesnt talk ; there are always know-it-all elders in the family.

Even in educated people of certain communities, the husband will accompany the wife to the doctor. The doctor gets his information about the medical problem by asking the husband questions , and he answers . A gynaec doctor probably deserves a prize for reaching a correct diagnosis from this, particularly as talking about intimate personal things in front of your husband and a total outsider is not something a woman is looking forward to.

So we see cases where women have withdrawn into shells, become uncommunicative. They are actually depressed . But local experts declare them as affected with spirits.

If its a question of childlessness, its even worse. She is psyched into taking all the blame, and the husband gets married again with her complete blessings, and they get an extra guilty helper around the house.

A woman's well being is decided by 3 major systems : the endocrine system, the immune system, and the brain. Its not clear which of these comes first or what causes what. What is very clear is that all your hormones must exist in a harmonius balance if you are to exist as a healthy woman.

What we find today, is that most of the time "symptoms" get treated by doctors. Its fashionable in upwardly mobile cultures to say you are suffering and taking treatment for depression or whatever. The infertile types are encouraged to go in for fancy sounding acronym protocols. Lack of understanding of stages in a womans reproductive life, cause taut-wire tensions.

Many times, its a thyroid imbalance. And its rarely checked. When it is, its considered expensive.

It has been found that sociocultural factors often affect what a woman considers a "bothering health problem". Stress, menopausal problems, psychological problems, are all "felt" at different levels in different sociocultural environments. ( See : D. J. Cooke and J. G. Green," Types of life events in relation to symptoms , at the Climacterium, ", Journal of Psychosomatic Research 25(1981):5-11.

Studies done in the himalayan foothills area indicate that a lot of metabolic problems faced may be attributed to environmental causes. Rampant flouridation of water, lack of iodine in the diet, ignorance of the fact that endocrine, psychological, and gynaec problems can all be intricately related, makes it imperative that this problem be tackled on an emergency level.

Here are the statistics.:

The total national burden of endocrine disorders in India is 108 million; out which thyroid disorders top the list at 42 million.

  • Countrywide prevalence in millions

  • Thyroid disorders 42

  • Diabetes Mellitus 25

  • Metabolic bone disease 15

  • Reproductive endocrine disorders 12

  • Clinically significant growth disorders 8

  • Adrenal-Pituitary problems 4

  • Miscellaneous rare disorders 2

  • Total national endocrine burden 108 million
Dr N. Kochupillai, at the All India Institute of Medical Sciences , New Delhi, in a study published in Current Science, Oct 2000, indicates that today, in India, a whopping 108 million people suffer from endocrine and metabolic diseases, the brunt mainly being borne by the economically disadvantaged. Several of these disorders (thyroid problems head the list) are caused by environmntal problemsand it is possible to treat them in an affordable way .

Given the studies conducted on developmental problems in new borns due to underperforming thyroids, and particularly womens problems , given the traditional "second class " categorization of women, he says that the problem of setting up affordable, cost effective immunoassay technologies needs to be tackled at a national level on a priority basis.

The inventors of the immunoassay technologies were awarded the Nobel Prize in 1977. Multinationals give us this imported technolgy at a huge cost, and as the technology improves , so do the testing systems which we keep importing , if we continue to use the same immunoassay technolgy.

Dr Kochupillai states that it is possible to reduce the cost of an immunoassyay from Rs 150/- per test to Rs 10/- per test using indegineously developed technologies.

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