May 25 is observed as World Thyroid Day across the globe, including in Bangladesh, to raise awareness about thyroid-related diseases. Since 2009, this day has been dedicated to educating the public on the importance of thyroid health. In Bangladesh, nearly 5 million people are estimated to be affected by thyroid problems, and alarmingly, more than half remain undiagnosed. Women are four to five times more likely to suffer from thyroid issues than men. Given the severity and prevalence, it is essential to make thyroid screening mandatory immediately after birth. Around 30 percent of Bangladesh's population may have thyroid disorders, many of whom are unaware of their condition. Among adults, approximately 2 percent of women and 0.2 percent of men experience hyperthyroidism, which is most commonly seen in people aged 20 to 30. Hypothyroidism is also prevalent among adults, with 9.4 percent of women and 3.9 percent of men affected.
Roughly 7 percent of people suffer from subclinical hypothyroidism. Newborns can also be born with thyroid hormone deficiency, affecting 2 to 8 per 10,000 live births. Children with such deficiencies may face disrupted physical and mental development. Even if physical growth is eventually achieved, intellectual development may not recover. If hypothyroidism is not treated promptly in children and adolescents, their cognitive development can be permanently impaired. Bangladesh, historically known as a "golm" or goiter-prone country, still shows high rates of visible goiter, with about 8.5 percent of adults affected. Thyroid cancer is also increasing, though there is a lack of precise statistics. It is estimated that around 4.5 percent of goiter patients may develop thyroid cancer.
Thyroid hormone levels can fluctuate from normal to abnormal due to various causes. In many cases, iodine deficiency results in an enlarged thyroid or goiter, commonly referred to as "ghag disease." Recent studies reveal that many school-going children and pregnant women in Bangladesh lack adequate iodine, which is crucial for thyroid hormone production. Globally, 2 billion people still suffer from iodine deficiency.
The thyroid gland is located at the front of the neck and resembles a butterfly in shape. Though small in size, its role is crucial as it produces hormones that regulate metabolism and support the body's growth and repair. These hormones are vital from the embryonic stage and influence physical development and mental well-being. Imbalances in thyroid hormone levels can lead to obesity, menstrual irregularities, skin issues, cardiac problems, and even infertility. Maintaining the right level of thyroid hormone is essential, as both excess and deficiency can lead to significant health issues. While thyroid diseases cannot be completely cured, they can be controlled with proper awareness and treatment.
Thyroid disorders are mainly categorized as hyperthyroidism and hypothyroidism. Hyperthyroidism occurs when there is an excess of thyroid hormone in the blood, causing symptoms like palpitations, weight loss, bulging eyes, heat intolerance, and menstrual irregularities. Hypothyroidism results from low thyroid hormone levels, leading to symptoms such as fatigue, weight gain, cold sensitivity, goiter, muscle and joint pain, hair loss, constipation, and irregular menstruation. In pregnant women, hypothyroidism can affect the fetus, and in newborns, it can hinder the natural development of intelligence and growth.
The reduction in thyroid hormone secretion can be attributed to autoimmune diseases, thyroid surgery, side effects of certain medications, and excessive consumption of certain foods such as broccoli, cauliflower, sweet potatoes, and strawberries. Conversely, thyroid hormone secretion may increase due to autoimmune disorders, thyroid nodules, or tumors in the thyroid gland.
Women are more prone to thyroid problems than men. One in every eight women may suffer from thyroid disorders. Hence, it is recommended to include thyroid hormone tests in routine checkups for women. Thyroid dysfunction can complicate pregnancy and childbirth, so women planning to conceive should consult a specialist for proper evaluation.
Thyroid disorders are diagnosed using T3, T4, and TSH blood tests, ultrasonography of the thyroid gland, and tests for thyroid-stimulating immunoglobulin.
Managing thyroid problems requires a healthy lifestyle and dietary changes. Processed and junk foods, which are rich in fats, salts, and artificial additives, should be avoided. These foods negatively impact health and can worsen thyroid conditions. Reducing stress is also crucial, as it is a major contributor to both physical and mental health problems. Regular exercise helps burn excess calories and improves overall well-being.
Eating mindfully is essential. Eating slowly and chewing food thoroughly improves metabolism and supports the thyroid gland's function. Certain raw vegetables such as cabbage, broccoli, and cauliflower can disrupt thyroid function, so they should be cooked before consumption. Using unheated coconut oil is beneficial for weight loss and metabolic activity, thanks to its medium-chain fatty acids that support thyroid function and help regulate body temperature.
Apple cider vinegar aids in hormone balance, metabolism, fat control, and detoxification. Ginger tea, rich in minerals like potassium and magnesium, can also help regulate thyroid function. Vitamin B, particularly B12, is important for people with hypothyroidism. Foods rich in B vitamins, such as eggs, fish, meat, milk, and nuts, should be included in the diet.
Vitamin D deficiency is another contributor to thyroid issues. Exposure to sunlight for at least five minutes daily helps the body produce vitamin D, absorb calcium, and boost immunity. Foods rich in vitamin D include salmon, mackerel, dairy products, orange juice, and egg yolks. If vitamin D levels are very low, supplements may be required with medical advice.
Iodine-rich foods such as milk, cheese, and yogurt are essential for thyroid health. Processed and packet foods, including chips, cakes, and soft drinks, often contain harmful levels of sugar and salt. These foods hinder digestion and should be avoided. Caffeinated beverages and gluten-containing foods like wheat, barley, and rye can exacerbate thyroid issues. Gluten-free diets are more suitable for those with thyroid problems. Certain vegetables like cauliflower, broccoli, mustard greens, sweet potatoes, and root vegetables should be eaten in moderation. High-iodine foods like sea fish, shrimp, fruits, and eggs are beneficial. In some cases, iodine supplements may be necessary.
Thyroid disorders primarily result from hormonal imbalances. Although these conditions may cause discomfort and complications, with proper diagnosis and treatment, they can be effectively managed. It is essential to raise awareness about thyroid diseases and take proactive steps to prevent and treat them.
The writer is Founding Chairman, Jatiya Rogi Kaliyan Society
