Thyroid health awareness surges in China amid rising diagnoses

Joan Chen, a 24-year-old teacher, still receives new comments on a 2022 social media post detailing her struggle with hyperthyroidism.

On the Chinese platform Xiaohongshu, she shared striking before-and-after photos documenting her journey with the condition, highlighting physical changes such as bulging eyes and neck swelling – hallmark symptoms of the disorder. Chen also revealed that she gained 10 kilograms due to medication.

"Not only did my appearance change, but I became emotionally withdrawn and lost confidence," she explained.

Her candid account resonated deeply, drawing thousands of comments from users sharing similar struggles. Many uploaded photos seeking advice on thyroid-related symptoms, turning the thread into a hub for collective support and awareness.

Once a lesser-discussed endocrine issue, thyroid disorders are now trending on Chinese social media, particularly among younger users, as personal stories like Chen's fuel public dialogue and education.

Symptoms such as facial puffiness, significant weight changes, hair thinning, dry or oily skin, and emotional volatility have pushed thyroid disorders into the spotlight.

At the same time, improved health screening and growing public health awareness have led to a sharp rise in the detection of thyroid nodules, with many individuals first learning of their condition during routine checkups.

The thyroid gland – a butterfly-shaped organ located at the base of the neck – plays a central role in regulating metabolism, heart rate, body temperature, emotional stability and reproductive health.

It produces two key hormones, T3 and T4, which affect nearly every cell in the body. In children and adolescents, proper thyroid function is essential for both cognitive and physical development. Any imbalance –whether an excess or deficiency – can cause systemic dysfunction.

According to the European Society of Endocrinology, thyroid disorders are the second most common endocrine diseases worldwide, surpassed only by diabetes.

In China, more than 200 million people are believed to suffer from some form of thyroid dysfunction. A national survey led by the Chinese Society of Endocrinology across 31 provinces found that the prevalence of hyperthyroidism stands at 1.22 percent, hypothyroidism at 13.95 percent, and thyroid nodules at a striking 20.43 percent. Overall, an estimated 40 percent of China's adult population may be affected by thyroid-related conditions.

Clinically, thyroid disorders are categorized as either functional or structural. Functional disorders include hypothyroidism and hyperthyroidism, which are often caused by autoimmune conditions, but can also result from viral infections, iodine imbalances or certain medications.

Structural changes primarily involve thyroid nodules, typically detected through imaging. While most nodules are benign, some can cause hormonal imbalances or indicate malignancy.

Effective diagnosis and management require evaluating both hormone levels and nodule characteristics – such as size and cancer risk – to determine appropriate, individualized treatment.

Dai Weide, director of the Ultrasound Department at Beijing Hospital, said in an interview with China Media Group that thyroid nodules are "extremely common," with a prevalence exceeding 20 percent.

"If the nodule is smaller than 2 centimeters and not causing pressure symptoms such as difficulty swallowing or breathing, there is generally no need for treatment. Regular follow-up is enough," he explained.

Chen has now lived with hyperthyroidism for nearly three years. While some changes to her appearance may be irreversible, she has come to terms with them. "I've gotten used to it," she said.

In addition to following her doctor's advice on medication, she has made significant lifestyle changes – cutting out coffee and milk tea, eating a lighter diet and avoiding late nights. For her, the journey has been not only about managing a chronic condition but also about rediscovering a sense of autonomy and resilience in everyday life.