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it is now well - known that thyroid disorders are common in india . in the past focus have been on iodine deficiency disorders ( idds ) .
it has been more than three decades since universal salt iodization program was introduced in india .
studies looking at the prevalence of thyroid disorders in the post - iodization era are far and few .
did a country - wide study in school children in india to look at the prevalence of thyroid disorders , two decades after salt - iodization .
the most recent nationwide study showed that hypothyroidism was common in india ; in this population 88% was consuming iodized salt .
this study focuses on young women attending college and this is a female population likely to become pregnant in future .
hypothyroidism in young women is also linked to menstrual irregularities , polycystic ovaries , and infertility .
the prevalence of hypothyroidism in young women is unknown and we present the first report from india .
the study was conducted in seven colleges in the area of madurai district . this was representative of the mix of the urban plus rural population .
we visited each college and all female students in the above age group were invited to participate in the study . only those who were willing to give blood samples
thyroid - stimulating hormone ( tsh ) assay was done in all blood samples as a screening test for thyroid disease .
tsh assay was performed using electrochemiluminescence immunoassay on the elecys 2010 analyzer ( roche diagnostics ) it is a sandwich assay and the method has been standardized against the 2 irp who reference standard 80/558 .
the laboratory 's reference value for tsh was 0.44.5 miu / ml . all the subjects with abnormal tsh were requested to come for follow - up for further testing .
abnormal tsh values were grouped into three categories : 
 mild tsh elevation : tsh of 4.510 miu / mlsignificant tsh elevation : tsh > miu / mlsuppressed tsh : tsh < 0.4 miu / ml . 
 
mild tsh elevation : tsh of 4.510 miu / ml significant tsh elevation : tsh > miu / ml suppressed tsh : tsh < 0.4 miu / ml .
a total of 1292 subjects were screened with tsh from seven colleges , and the results were analyzed .
the number of subjects with abnormal tsh and the number of subjects in each tsh category are discussed below . among the 1292 subjects ,
abnormal tsh was seen in 161 subjects and the overall prevalence of abnormal tsh was 12.5% .
of 161 subjects with abnormal tsh , 77.6% ( 125 ) had tsh values between 4.510 miu / ml . the overall prevalence of mild tsh elevation among the 1292 subjects was 9.7% . totally , 17/161 subjects ( 10.6% ) had tsh values > 10 miu / ml .
the overall prevalence of tsh values > 10 was 1.3% in the study population . among the 161 subjects with tsh abnormality
among the 1292 subjects , abnormal tsh was seen in 161 subjects and the overall prevalence of abnormal tsh was 12.5% .
of 161 subjects with abnormal tsh , 77.6% ( 125 ) had tsh values between 4.510 miu / ml . the overall prevalence of mild tsh elevation among the 1292 subjects was 9.7% .
totally , 17/161 subjects ( 10.6% ) had tsh values > 10 miu / ml .
among the 161 subjects with tsh abnormality , 19 had a tsh value < 0.4 miu / ml ( 11.8% ) .
the prevalence of thyroid disorders depends on various factors such as age , sex , geographical factors , and iodine intake .
thyroid disorders need to be addressed as a priority in two important age groups  neonates and pregnant women .
we decided to focus on women in early reproductive age group . in the present study
, we assessed the prevalence of thyroid disorders based on tsh in female college students in madurai district of south india .
goiter survey done under national idds control program in madurai district in 2000 showed a goiter prevalence of 6.3% .
a cross - sectional survey in central kerala found the overall prevalence of thyroid function abnormalities in 19.6% of the population . in a study on the prevalence of thyroid disorders in women of pondicherry , 15.8% had thyroid dysfunction .
of the 11% , the majority ( 9.7% ) had mild tsh elevation ( 4.510 miu / ml ) .
a small number in this group could also have overt hypothyroidism ( with low free t4 ) and rarely may have central hypothyroidism .
the prevalence of hypothyroidism ( clinical + subclinical ) was 13.3% and 11.5% in the study from kerala and pondicherry , respectively .
in the most recent nationwide study in india , the prevalence of overt undiagnosed hypothyroidism was 3.5% and the prevalence of subclinical hypothyroidism was 8.5% .
in a study from delhi in 2012 by marwaha et al . , subclinical hypothyroidism was present in 19.3% of subjects and 4.2% had overt hypothyroidism .
low tsh ( < 0.4 miu / ml ) was seen in 1.5% of the study population .
the prevalence of thyrotoxicosis in women of pondicherry was found to be 1.8% . in the epidemiological study in eight cities of india ,
the prevalence of clinical plus subclinical thyrotoxicosis was 1.9% . who assessment of global iodine status classified india as having optimal iodine nutrition in 2004 .
the reasons for the high prevalence of thyroid disease in spite of the improvement in iodine status need to be looked at .
it has been argued but not convincingly , that iodine supplementation may precipitate the emergence of thyroid autoimmunity . in the epidemiological study of eight cities ,
88% of the population was taking iodized salt . in a countrywide screening of goitrous young girls by marwaha et al .
, the prevalence of juvenile autoimmune thyroiditis was 7.5% . in a study among school children in delhi
this is the first large - scale study in madurai district , south india to look the prevalence of thyroid disorders .
thyroid dysfunction was seen in one out of every eight young women in this region ( 12.5% ) .
nonrandomized design and lack of clinical data are an important limitation in this study and some patients with low or normal tsh may have taking levothyroxine .
furthermore , we were not able to do ft4 and thyroid antibodies do to economic constraints . nevertheless given that one out of eight women has thyroid dysfunction , our study does raise some clinical issues .
for instance , given the high prevalence of hypothyroidism in young women , some of whom are destined to conceive in the years to come , is there a role for more aggressive screening of the population ?
this young population is at risk of infertility , reproductive dysfunction and possibly fetal abnormalities  all important enough to deserve further study and research .
one out of every eight young women had abnormal tsh with the most common abnormality being mild tsh elevation .
background : thyroid disorders are common in india but scarce data exists on its prevalence in young women.materials and methods : this study was conducted in female college students in seven colleges in madurai district , tamil nadu . 
 thyroid - stimulating hormone ( tsh ) was used as the screening test to diagnose thyroid dysfunction . 
 the abnormal tsh values were classified as mild tsh elevation ( tsh 4.510 miu / ml ) , significant tsh elevation ( tsh > 10 miu / ml ) , and low tsh ( tsh < 0.4 miu / ml).results : a total of 1292 subjects were screened of whom 161 subjects ( 12.5% ) had abnormal tsh . 
 the overall prevalence of elevated tsh was 11% out of which 9.7% had mild tsh elevation . 
 a low tsh was seen in 1.3% of the study population.conclusion:thyroid dysfunction was common in young women in south india . 
 one out of every eight young women had thyroid dysfunction , and mild tsh elevation was the most common abnormality .