Worldwide, 1.6 billion people are thought to be at risk of thyroid disorders, with one in eight women developing thyroid problems in their lifetimes.[i][ii]
The thyroid gland is a butterfly-shaped organ located at the base of the neck, in front of the windpipe. It is the ‘master controller’ of metabolism and plays a key role in health and wellbeing. Underproduction of thyroid hormone (hypothyroidism) or overproduction (hyperthyroidism) can lead to severe health issues.
Health complications can be easily avoided by timely diagnosis and appropriate treatment with levothyroxine.
Patients with an underactive thyroid need continuous care, as poor health management can lead to several health complications, including fatigue, weight gain, obstipation, depressive spectrum disorders, cardiovascular disorders, infertility, and, in female patients, pregnancy complications.[iii] In congenital hypothyroidism, delayed or no treatment leads to severe physical and intellectual impairment. These health complications can be easily avoided by timely diagnosis and appropriate treatment with levothyroxine.
Nevertheless, thyroid disorders such as hypothyroidism are not yet considered as noncommunicable diseases (NCD). The NCD Alliance policy brief on thyroid as a NCD shows that significant barriers exist in terms of NCDs outside the ‘5×5’ approach, by putting a spotlight on endocrine health and providing case studies on thyroid disorders and kidney disease. Barriers exist across a number of fronts: health care professional awareness, patient prevention, testing, diagnosis, treatment, data collection, research and funding.
The European Society of Endocrinology and European Thyroid Association have put forward a policy call to action, proposing to formulate a petition addressed to the European Commission stressing the necessity to acknowledge thyroid diseases as NCDs.[iv] One positive step would be for the European Commission to publish a policy roadmap targeting individual NCDs and including endocrine conditions.
The challenge is not only to gain political recognition and support, but also to guarantee implementation of proven policies.
As the NCDA policy brief states, the challenge is not only to gain political recognition and support, but also to guarantee implementation of proven policies and actions, and mobilize sufficient investment. This requires a multistakeholder response at global, regional, national and local levels.
Governments need accurate and regularly updated data on disease burden, which are often missing in low- and middle-income countries. The lack of such data and the facing of competing demands for illnesses with better-defined estimates (such as diabetes, hypertension, cardiovascular disease and cancer) have prevented health policymakers from delivering effective health systems responses to NCDs outside the ‘5×5’ approach, such as, thyroid and kidney diseases.
Systematically, person-centered approach to health services should be adopted that ensures the early identification of people at risk of, or living with, NCDs, including endocrine-related conditions, and supports them to effectively manage and monitor risk factors, complications and multimorbidity.
More recommendations to include thyroid disorders as part of the global NCD policy agenda can be found here.
[i] Khan A, Khan MM, Akhtar S. Thyroid disorders, etiology and prevalence. J Med Sci 2002; 2: 89–94; http://www.scialert.net/fulltext/?doi=jms.2002.89.94&org=11
[ii] Thyroid Awareness: What Happens When This Little Gland Goes Haywire, 2020; https://www.healthywomen.org/content/article/thyroid-awareness-what-happens-when-little-gland-goes-haywire
[iii] Womens Health Rep (New Rochelle). 2021; 2(1): 182–194, Improving the Quality of Life of Patients with an Underactive Thyroid Through mHealth: A Patient-Centered Approach; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8243709/
[iv] See Page 34, European Society of Endocrinology. Hormones in European Health Policies: How endocrinologists can contribute towards a healthier Europe, 2021; https://www.ese-hormones.org/media/3220/ese-white-paper_04052021-web.pdf
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