Take Charge of Your Thyroid: Simple steps every Indian should know

Quick facts

• Hypothyroidism (underactive thyroid) is common in India — roughly 1 in 10 people in population studies, and more common in people with diabetes. As many as 2 in 3 diabetics have thyroid dysfunction.
• Many people are undiagnosed or undertreated. If you have fatigue, weight gain, heavy periods, dry skin, hair thinning, or trouble concentrating — consider a thyroid test.
• An underactive thyroid can worsen cholesterol, raise blood pressure, slow metabolism and increase heart disease risk. For people with diabetes, these effects add to existing risks and make control harder.

Common symptoms

• Tiredness, low energy, cold sensitivity
• Weight gain or difficulty losing weight
• Constipation, dry skin, hair thinning
• Slower thinking or 'brain fog', low mood
• Heavy/irregular periods or fertility issues

How hypothyroidism is diagnosed

• The main test is TSH (thyroid stimulating hormone); if abnormal, a free T4 is measured.
• Overt hypothyroidism: high TSH, and low free thyroid hormones.
• Subclinical hypothyroidism: an elevated TSH in the presence of normal free thyroid hormones. Our own research showed benefits in a select group of patients with persistent symptoms with TSH between 2.5 and 5 who benefitted from treatment.

Treatment — what works

• Levothyroxine (T4) is the recommended, safe, and effective lifelong replacement for most patients.
• It improves energy, cholesterol levels and helps protect the heart when taken correctly.
• Do not stop your medicine without discussing with your doctor — stopping usually brings symptoms and risks back.

If symptoms remain despite 'normal' tests

• Many patients on levothyroxine remain symptomatic. They still feel unwell despite normal TSH.
• In these patients, doctors may consider liothyronine (T3) therapy, which is generally individualised at the discretion of the treating doctor.

Be cautious with alternative products

• Many people use Ayurvedic, homeopathic or herbal remedies. Some products have contained undeclared thyroid extracts or hormones and can be harmful.
• Always tell your doctor about any supplements or traditional remedies you use.

FAQ

At a glance

Our research in this area

Peer-reviewed publications and conference presentations by Dr. Vishal Gupta and colleagues.

1. Vishal Gupta. Comparison of Efficacy of Liothyronine (T3) 50mcg + Levothyroxine (T4) combination therapy Versus T4 Therapy alone on Cardiac markers In Patients With Hypothyroidism followed for 6 months. ENDO 2026, June 13–16, 2026, Chicago, IL.
2. Vishal Gupta, Vaishali Teli. EP1532 – ECE_1005 – Comparison of efficacy of Liothyronine (T3) 50 mcg + Levothyroxine (T4) combination therapy Vs T3 25 mcg + T4 therapy vs T4 therapy alone on body weight in patients with hypothyroidism followed for 6 months. European Journal of Endocrinology 2026;195(Suppl 1):lvag096.1688. doi:10.1093/ejendo/lvag096.1688
3. Gupta V, et al. Effect of oral semaglutide on weight & cardiac biomarkers in patients with hypothyroidism treated using liothyronine + levothyroxine combination therapy. Endocrine Abstracts 2023;94:P349. doi:10.1530/endoabs.94.P349
4. Gupta V, et al. Role of liothyronine/levothyroxine combination therapy in 70 overweight to obese patients with TSH 2.5–5.0 unable to lose weight. Endocrine Abstracts 2023;90:P235. doi:10.1530/endoabs.90.P235
5. Gupta V, et al. Compare the effects of levothyroxine therapy versus liothyronine/levothyroxine combination on cardiac biomarkers in 364 patients with hypothyroidism. Endocrine Abstracts 2022;81:P241. doi:10.1530/endoabs.81.P241
6. Gupta V. Block and replace therapy using propylthiouracil and levothyroxine for Graves' disease during pregnancy. Indian J Endocrinol Metab 2012;16(4):660–662. PMID:22837941. PMCID:PMC3401781. doi:10.4103/2230-8210.98039
7. Gupta V, Lee M. Central hypothyroidism. Indian J Endocrinol Metab 2011;15(Suppl 2):S99–S106. PMID:21966662. PMCID:PMC3169862. doi:10.4103/2230-8210.83337