Materiały źródłowe

• #1 Hypothyroidism | Nature Reviews Disease Primers

  https://www.nature.com/articles/s41572-022-00357-7

  Hypothyroidism is the common clinical condition of thyroid hormone deficiency and, if left untreated, can lead to serious adverse health effects on multiple organ systems, with the cardiovascular system as the most robustly studied target. Overt primary hypothyroidism is defined as elevated thyroid-stimulating hormone (TSH) concentration in combination with free thyroxine (fT4) concentration below the reference range. Subclinical hypothyroidism, commonly considered an early sign of thyroid failure, is defined by elevated TSH concentrations but fT4 concentrations within the reference range. Hypothyroidism is classified as primary, central or peripheral based on pathology in the thyroid, the pituitary or hypothalamus, or peripheral tissue, respectively. Acquired primary hypothyroidism is the most prevalent form and can be caused by severe iodine deficiency but is more frequently caused by chronic autoimmune thyroiditis in iodine-replete areas.

• #2 Epidemiology, Types, Causes, Clinical Presentation, Diagnosis, and Treatment of Hypothyroidism

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10613832/

  Hypothyroidism means an underactive thyroid gland. This leads to a decrease in the functioning of the thyroid gland. It is a very common endocrine disorder that causes under-secretion of thyroid hormones, mainly thyroxine (T4) and triiodothyronine (T3). It affects people of every age group but is more commonly found in women and older people. The prevalence rate of primary hypothyroidism in the general population varies from 0% to 4% and 4% to 8% in the population of the USA and from 0% to 3% and 4% to 7% in the European population. A meta-analytical study done across nine countries in Europe estimated that the prevalence of hypothyroidism that was not diagnosed, including both mild and overt cases, is estimated to be around 5%-6%. Impaired thyroid function is found more often in females, in old people of the age group greater than 65 years, and also in the White population, but the data on the ethnic differences are not much. Hypothyroidism is a very common pathological condition that is caused by a deficiency of the thyroxine hormone. The main risk factors for hypothyroidism are age and sex. Hypothyroidism is commonly seen in elderly people (65 years) and in the female population. The diagnosis of hypothyroidism is based on laboratory tests that measure the levels of thyroid hormones (T3 and T4) in the blood. The preferred treatment is swallowing a single tablet of levothyroxine on an empty stomach.

• #3 Hypothyroidism – Wikipedia

  https://en.wikipedia.org/wiki/Hypothyroidism

  Hypothyroidism is the most frequent endocrine disorder. Worldwide about one billion people are estimated to be iodine deficient; however, it is unknown how often this results in hypothyroidism. In large population-based studies in Western countries with sufficient dietary iodine, 0.30.4% of the population have overt hypothyroidism. A larger proportion, 4.38.5%, have subclinical hypothyroidism. […] Undiagnosed hypothyroidism is estimated to affect about 47% of community-derived populations in the US and Europe. Of people with subclinical hypothyroidism, 80% have a TSH level below the 10 mIU/L mark regarded as the threshold for treatment. […] Women are more likely to develop hypothyroidism than men. In population-based studies, women were seven times more likely than men to have TSH levels above 10 mU/L.

• #4 Hypothyroidism: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/122393-overview

  A retrospective study by Wyne et al using a medical/pharmacy claims database reported a steady increase in hypothyroidism in the United States, with the prevalence rising from 9.5% in 2012 to 11.7% in 2019. […] Iodine deficiency as a cause of hypothyroidism is more common in less-developed countries. Routine supplementation of salt, flour, and other food staples with iodine has decreased the rates of iodine deficiency, but even so, an estimated 35-45% of the worlds population is affected by iodine deficiency. […] According to a report released in 2024 by the World Health Organization (WHO) and the Iodine Global Network, the growing consumption of plant-based foods in the WHO European region (made up of over 50 countries) as a substitution for important sources of iodine, such as milk, dairy, and fish, is contributing to the problem of insufficient iodine intake.

• #5 Hypothyroidism – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK519536/

  Hypothyroidism results from low levels of thyroid hormone with varied etiology and manifestations. Hypothyroidism is primarily categorized as primary and secondary (ie, central) hypothyroidism. In primary hypothyroidism, the thyroid gland cannot produce adequate amounts of thyroid hormone. The less commonly seen secondary or central hypothyroidism occurs when the thyroid gland functions normally; however, hypothyroidism results from the abnormal pituitary gland or hypothalamus function. Autoimmune thyroiditis and iodine deficiency are the most common causes of the disease. Central hypothyroidism is rare. […] The National Health and Nutrition Examination Survey (NHANESIII) study found the prevalence of overt hypothyroidism among individuals aged 12 years and older in the US to be 0.3% and subclinical hypothyroidism 4.3%. Female gender and increasing age are associated with a higher risk for thyroid-stimulating hormone (TSH) and an increased prevalence of antithyroid antibodies. Hypothyroidism is more prevalent in women with small stature at birth and low body mass index in childhood.

• #6 Hypothyroidism: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/122393-overview

  A retrospective study by Wyne et al using a medical/pharmacy claims database reported a steady increase in hypothyroidism in the United States, with the prevalence rising from 9.5% in 2012 to 11.7% in 2019. […] Iodine deficiency as a cause of hypothyroidism is more common in less-developed countries. Routine supplementation of salt, flour, and other food staples with iodine has decreased the rates of iodine deficiency, but even so, an estimated 35-45% of the worlds population is affected by iodine deficiency. […] According to a report released in 2024 by the World Health Organization (WHO) and the Iodine Global Network, the growing consumption of plant-based foods in the WHO European region (made up of over 50 countries) as a substitution for important sources of iodine, such as milk, dairy, and fish, is contributing to the problem of insufficient iodine intake.

• #7 General Information/Press Room | American Thyroid Association

  https://www.thyroid.org/media-main/press-room/

  More than 12 percent of the U.S. population will develop a thyroid condition during their lifetime. […] An estimated 20 million Americans have some form of thyroid disease. […] Up to 60 percent of those with thyroid disease are unaware of their condition. […] Women are five to eight times more likely than men to have thyroid problems. […] One woman in eight will develop a thyroid disorder during her lifetime. […] Undiagnosed thyroid disease may put patients at risk for certain serious conditions, such as cardiovascular diseases, osteoporosis and infertility. […] Pregnant women with undiagnosed or inadequately treated hypothyroidism have an increased risk of miscarriage, preterm delivery, and severe developmental problems in their children. […] Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormone. Symptoms include extreme fatigue, depression, forgetfulness, and some weight gain. […] Mandatory screening of newborns for congenital hypothyroidism, and early treatment that has prevented mental retardation.

• #8 Epidemiology, Types, Causes, Clinical Presentation, Diagnosis, and Treatment of Hypothyroidism

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10613832/

  Hypothyroidism means an underactive thyroid gland. This leads to a decrease in the functioning of the thyroid gland. It is a very common endocrine disorder that causes under-secretion of thyroid hormones, mainly thyroxine (T4) and triiodothyronine (T3). It affects people of every age group but is more commonly found in women and older people. The prevalence rate of primary hypothyroidism in the general population varies from 0% to 4% and 4% to 8% in the population of the USA and from 0% to 3% and 4% to 7% in the European population. A meta-analytical study done across nine countries in Europe estimated that the prevalence of hypothyroidism that was not diagnosed, including both mild and overt cases, is estimated to be around 5%-6%. Impaired thyroid function is found more often in females, in old people of the age group greater than 65 years, and also in the White population, but the data on the ethnic differences are not much. Hypothyroidism is a very common pathological condition that is caused by a deficiency of the thyroxine hormone. The main risk factors for hypothyroidism are age and sex. Hypothyroidism is commonly seen in elderly people (65 years) and in the female population. The diagnosis of hypothyroidism is based on laboratory tests that measure the levels of thyroid hormones (T3 and T4) in the blood. The preferred treatment is swallowing a single tablet of levothyroxine on an empty stomach.

• #9 Epidemiology of Hypothyroidism, Hyperthyroidism and Positive Thyroid Antibodies in the Croatian Population

  https://www.mdpi.com/2079-7737/11/3/394

  Epidemiology of Hypothyroidism, Hyperthyroidism and Positive Thyroid Antibodies in the Croatian Population […] The aim of this paper was to analyse the prevalence of hypothyroidism and hyperthyroidism in the Croatian population. This is the first epidemiological study of its kind conducted in our population. It is important to correctly diagnose thyroid dysfunction due to the detrimental effects of thyroid dysfunction on human health (especially in pregnant women and patients with cardiovascular diseases). The results of our study conducted on 4402 individuals, showed a higher prevalence of hypothyroidism in our country (10.5%) compared to other countries, while the prevalence of hyperthyroidism was quite similar (1.3%). We also observed that a high proportion of thyroid disorders remained undiagnosed (as many as 92.6% subclinical hypothyroid, 93.9% clinical hypothyroid, 83% subclinical hyperthyroid and 71.4% clinical hyperthyroid participants). Therefore, our study indicates that investing in prevention programs is crucial.

• #10 Epidemiology of Hypothyroidism, Hyperthyroidism and Positive Thyroid Antibodies in the Croatian Population

  https://www.mdpi.com/2079-7737/11/3/394

  Thyroid dysfunction appears to be the leading endocrine disorder. We conducted a cross-sectional study on 4402 individuals from three Croatian cohorts. The aim of this study was to analyse the prevalence of diagnosed and undiagnosed hypothyroidism, hyperthyroidism (subclinical and clinical) and positive thyroid antibodies in the Croatian population. The results of the study indicated that 17.6% of participants were euthyroid with positive antibodies. The prevalence of clinical and subclinical hypothyroidism was 3% and 7.4%, respectively, while the prevalence of clinical and subclinical hyperthyroidism was 0.2% and 1.1%, respectively. Among them, 92.6% subclinical hypothyroid, 93.9% clinical hypothyroid, 83% subclinical hyperthyroid and 71.4% clinical hyperthyroid participants were undiagnosed. Finally, the prevalence of undiagnosed subclinical and clinical hypothyroidism in our population was 6.9% and 2.8%, respectively, while the prevalence of undiagnosed subclinical and clinical hyperthyroidism was 0.9% and 0.1%, respectively. Women showed a higher prevalence of thyroid disorders; 1.57 times higher odds of euthyroidism with positive antibodies, 2.1 times higher odds of subclinical hyperthyroidism, 2.37 times higher odds of clinical hypothyroidism and 1.58 times higher odds of subclinical hypothyroidism than men. These results indicate an extremely high proportion of undiagnosed cases, and therefore require investments in a prevention programme.

• #11 Hypothyroidism – Thyroid UK

  https://thyroiduk.org/if-you-are-hypothyroid/about-hypothyroidism/overview-of-hypothyroidism/

  Hypothyroidism occurs when the thyroid gland produces less thyroid hormone than it should – which then causes the metabolism to run too slow. Hypothyroidism is also known as myxoedema or an underactive thyroid. […] Hypothyroidism is mostly seen in women between the ages of 40-50 and is seen in women ten times more often than men. It often occurs during the menopausal years and symptoms are often ignored during the early stages by both patients and doctors if the patient is at this age. […] The prevalence of hypothyroidism is 1-2% (approximately 2 in every 100 people) but some doctors feel that the rate is much higher than this. […] Subclinical hypothyroidism is found in 8–10% of the population, is more common in women and increases with age. […] Blood tests should reveal whether the thyroid gland is underactive although some doctors may not do all the blood tests available.

• #12 Hypothyroidism: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/122393-overview

  The frequency of hypothyroidism, goiters, and thyroid nodules increases with age. The previously mentioned study by Wyne et al reported that between 2012 and 2019, hyperthyroidism maintained a consistent prevalence in persons aged less than 50 years, while in persons aged 50-59 years, the prevalence grew from 10.4% to 11.2%, and in individuals aged 60 years or older, from 16.2% to 17.8%. […] Community studies use slightly different criteria for determining hypothyroidism; therefore, female-to-male ratios vary. Generally, the prevalence of thyroid disease is reportedly 2-8 times higher in females. […] However, using the National Health and Nutrition Examination Survey (NHANES) from the 2009-2010 and 2011-2012 survey cycles, the above-mentioned report by Wyne and colleagues found 51.5% of persons in the United States with hypothyroidism to be female. […] Using the NHANES from the 2009-2010 and 2011-2012 survey cycles, the aforementioned study by Wyne and colleagues found 65.6% of persons in the United States with hypothyroidism to be non-Hispanic White.

• #13 Hypothyroidism – Thyroid UK

  https://thyroiduk.org/if-you-are-hypothyroid/about-hypothyroidism/overview-of-hypothyroidism/

  Hypothyroidism occurs when the thyroid gland produces less thyroid hormone than it should – which then causes the metabolism to run too slow. Hypothyroidism is also known as myxoedema or an underactive thyroid. […] Hypothyroidism is mostly seen in women between the ages of 40-50 and is seen in women ten times more often than men. It often occurs during the menopausal years and symptoms are often ignored during the early stages by both patients and doctors if the patient is at this age. […] The prevalence of hypothyroidism is 1-2% (approximately 2 in every 100 people) but some doctors feel that the rate is much higher than this. […] Subclinical hypothyroidism is found in 8–10% of the population, is more common in women and increases with age. […] Blood tests should reveal whether the thyroid gland is underactive although some doctors may not do all the blood tests available.

• #14 Epidemiology of Hypothyroidism, Hyperthyroidism and Positive Thyroid Antibodies in the Croatian Population

  https://www.mdpi.com/2079-7737/11/3/394

  Thyroid dysfunction appears to be the leading endocrine disorder. We conducted a cross-sectional study on 4402 individuals from three Croatian cohorts. The aim of this study was to analyse the prevalence of diagnosed and undiagnosed hypothyroidism, hyperthyroidism (subclinical and clinical) and positive thyroid antibodies in the Croatian population. The results of the study indicated that 17.6% of participants were euthyroid with positive antibodies. The prevalence of clinical and subclinical hypothyroidism was 3% and 7.4%, respectively, while the prevalence of clinical and subclinical hyperthyroidism was 0.2% and 1.1%, respectively. Among them, 92.6% subclinical hypothyroid, 93.9% clinical hypothyroid, 83% subclinical hyperthyroid and 71.4% clinical hyperthyroid participants were undiagnosed. Finally, the prevalence of undiagnosed subclinical and clinical hypothyroidism in our population was 6.9% and 2.8%, respectively, while the prevalence of undiagnosed subclinical and clinical hyperthyroidism was 0.9% and 0.1%, respectively. Women showed a higher prevalence of thyroid disorders; 1.57 times higher odds of euthyroidism with positive antibodies, 2.1 times higher odds of subclinical hyperthyroidism, 2.37 times higher odds of clinical hypothyroidism and 1.58 times higher odds of subclinical hypothyroidism than men. These results indicate an extremely high proportion of undiagnosed cases, and therefore require investments in a prevention programme.

• #15 Hypothyroidism: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/122393-overview

  The frequency of hypothyroidism, goiters, and thyroid nodules increases with age. The previously mentioned study by Wyne et al reported that between 2012 and 2019, hyperthyroidism maintained a consistent prevalence in persons aged less than 50 years, while in persons aged 50-59 years, the prevalence grew from 10.4% to 11.2%, and in individuals aged 60 years or older, from 16.2% to 17.8%. […] Community studies use slightly different criteria for determining hypothyroidism; therefore, female-to-male ratios vary. Generally, the prevalence of thyroid disease is reportedly 2-8 times higher in females. […] However, using the National Health and Nutrition Examination Survey (NHANES) from the 2009-2010 and 2011-2012 survey cycles, the above-mentioned report by Wyne and colleagues found 51.5% of persons in the United States with hypothyroidism to be female. […] Using the NHANES from the 2009-2010 and 2011-2012 survey cycles, the aforementioned study by Wyne and colleagues found 65.6% of persons in the United States with hypothyroidism to be non-Hispanic White.

• #16 Hypothyroidism and Heart Failure: Epidemiology, Pathogenetic Mechanisms & Therapeutic Rationale

  https://www.graphyonline.com/archives/IJCRT/2020/IJCRT-146/

  Hypothyroidism is a reversible cause of HF. Consequently, thyroid function should be evaluated in patients with HF and non-ischemic dilated cardiomyopathy. The American College of Cardiology guidelines for HF recommend screening for serum thyroid hormones levels for all newly diagnosed HF patients. […] Subclinical hypothyroidism is a biochemical diagnosis; it is defined as a normal T4 concentration while also having an elevated serum TSH concentration. Many patients usually do not have any symptoms; therefore, it is merely considered a laboratory diagnosis. Its prevalence ranges from 4 to 15 percent in the United States. […] Studies show that 7 out of 10 elderly women will have subclinical hypothyroidism with nearly the same changes in cardiovascular function, but less marked, than overt hypothyroidism.

• #17 Hypothyroidism – Wikipedia

  https://en.wikipedia.org/wiki/Hypothyroidism

  24% of people with subclinical hypothyroidism will progress to overt hypothyroidism each year. The risk is higher in those with antibodies against thyroid peroxidase. […] Subclinical hypothyroidism is estimated to affect approximately 2% of children; in adults, subclinical hypothyroidism is more common in the elderly, and in White people. […] Most hypothyroidism is primary in nature. Central/secondary hypothyroidism affects 1:20,000 to 1:80,000 of the population or about one out of every thousand people with hypothyroidism.

• #18 Hypothyroidism: An Update | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0801/p244.html

  Subclinical hypothyroidism is a biochemical diagnosis defined by a normal-range free T4 level and an elevated TSH level. Patients may or may not have symptoms attributable to hypothyroidism. On repeat testing, TSH levels may spontaneously normalize in many patients. However, in a prospective study of 107 patients older than 55 years, an initial TSH level greater than 10 to 15 mIU per L was the variable most strongly associated with progression to overt hypothyroidism.

• #19 Thyroid Disorders, Active Component, U.S. Armed Forces, 2008–2017 | Health.mil

  https://health.mil/News/Articles/2018/12/01/Thyroid-Disorders

  Between 2008 and 2017, the most common incident thyroid disorder among male and female service members was primary/NOS hypothyroidism and the least common were thyroiditis and other disorders of thyroid. […] Primary/NOS hypothyroidism was diagnosed among 8,641 females (incidence rate: 43.7 per 10,000 person years [p-yrs]) and 11,656 males (incidence rate:10.2 per 10,000 p-yrs). […] Overall incidence rates of thyroid disorders among females ranged from 4.3 (primary hypothyroidism) to 6.5 (other disorders of thyroid) times the rates of the respective conditions among males. […] Among both males and females, overall incidence rates of primary/NOS hypothyroidism and thyroiditis were higher among non-Hispanic white service members compared with service members in other race/ethnicity groups.

• #20

  https://journals.lww.com/trap/fulltext/2022/19010/thyrovigilance_for_hypothyroidism_in_india.1.aspx

  Among endocrine abnormalities, thyroid diseases are the commonest both in India and worldwide. However, the prevalence of hypothyroidism in India is more than twice as high compared to its Western counterparts. Therefore an efficient and effective strategy to manage the disease in India is necessary. […] A review of published literature indicates that nearly one-third of the patients with hypothyroidism across age groups remain undiagnosed and untreated in various regions of India. […] The prevalence of hypothyroidism in India is 11%, compared with only 2%4.6% in the Western population. […] Inland states have a higher prevalence of hypothyroidism compared to coastal states (11.7% vs. 9.5%), probably due to iodine deficiency. […] Nearly one-third of the patients with hypothyroidism remain undiagnosed and untreated.

• #21 Hypothyroidism – Hormones Australia

  https://www.hormones-australia.org.au/endocrine-diseases/hypothyroidism/

  Hypothyroidism is the most common thyroid disorder in Australia, affecting around 1 in 33 Australians. It is more common in women than men, and in those aged more than 60 years. […] In Australia, the most common cause of hypothyroidism is Hashimotos disease. This is an autoimmune disorder that causes the immune system to attack the thyroid gland. […] If you have subclinical hypothyroidism and few or no symptoms, you will require follow-up blood tests to ensure that you are not developing clinical hypothyroidism. Depending on the level of TSH and if thyroid antibodies are found, these tests should initially be performed every 6-12 months.

• #22 Clinical features and detection of congenital hypothyroidism – UpToDate

  https://www.uptodate.com/contents/clinical-features-and-detection-of-congenital-hypothyroidism

  Congenital primary hypothyroidism, occurring in approximately 1:2000 to 1:4000 newborns, is one of the most common preventable causes of intellectual disability worldwide. […] For these reasons, newborn screening programs were developed to detect this condition as early as possible by measuring either thyroxine (T4) or thyrotropin (thyroid-stimulating hormone [TSH]) in heel-stick blood specimens. […] This topic will review the epidemiology, causes, clinical manifestations, and diagnosis of congenital hypothyroidism and its detection by newborn screening in full-term infants.

• #23 Hypothyroidism and Your Infant | Texas DSHS

  https://www.dshs.texas.gov/newborn-screening-program/newborn-screening-parent-resources/hypothyroidism-your-infant

  About one in 4,000 newborn babies is born with hypothyroidism. […] Most states require babies to have a blood test shortly after birth to check for hypothyroidism. […] The likelihood of having another baby with hypothyroidism is only slightly higher than the one in 4,000 chance. […] There is currently no reliable way of detecting hypothyroidism before birth. […] The effects of hypothyroidism are seen in different ways in different babies. […] Starting a hypothyroid baby on treatment as soon as possible after birth is aimed at preventing permanent brain damage and intellectual disabilities. […] The treatment is daily replacement of the missing thyroid hormone with synthetic thyroid hormone tablets (also called sodium levothyroxine or L-thyroxine). […] For the rest of their life. Thyroid hormone is especially important for brain development in the first two years of life. […] As long as thyroid hormone pills are taken regularly, babies with congenital hypothyroidism usually show perfectly normal growth and development and can enter any adult occupation and have a family.

• #24 Thyroid disease – Wikipedia

  https://en.wikipedia.org/wiki/Thyroid_disease

  In the United States, autoimmune inflammation is the most common form of thyroid disease while worldwide hypothyroidism and goiter due to dietary iodine deficiency is the most common. According to the American Thyroid Association in 2015, approximately 20 million people in the United States alone are affected by thyroid disease. Hypothyroidism affects 3-10% percent of adults, with a higher incidence in women and the elderly. An estimated one-third of the world’s population currently lives in areas of low dietary iodine levels. In regions of severe iodine deficiency, the prevalence of goiter is as high as 80%. […] In areas where iodine-deficiency is not found, the most common type of hypothyroidism is an autoimmune subtype called Hashimoto’s thyroiditis, with a prevalence of 1-2%. […] As for hyperthyroidism, Graves’ disease, another autoimmune condition, is the most common type with a prevalence of 0.5% in males and 3% in females. […] Although thyroid nodules are common, thyroid cancer is rare. Thyroid cancer accounts for less than 1% of all cancer in the UK, though it is the most common endocrine tumor and makes up greater than 90% of all cancers of the endocrine glands.

• #25

  https://step2.medbullets.com/endocrine/120098/hypothyroidism-vs-hyperthyroidism

  Hypothyroidism […] Epidemiology […] iodine deficiency is the most common cause of hypothyroidism worldwide […] Hashimoto thyroiditis is the most common cause of hypothyroidism in iodine-sufficient areas.

• #26 Hypothyroidism: Pathophysiology and Management | IntechOpen

  https://www.intechopen.com/online-first/1177435

  Hypothyroidism is a result of thyroid hypofunction. It can be described as a primary or central disorder. Primary disorders are dysfunctions of the thyroid gland itself, whereas central disorders occur due to disruptions in the HPT axis. Primary hypothyroidism has a higher incidence compared to central. It is predicted that 4.6% of Americans have hypothyroidism without knowing. […] According to the American Thyroid Association (ATA), it is estimated that 20 million Americans have a thyroid disorder with almost 60% being unaware of the presence. The ATA estimates that 1 in 8 women are likely to manifest a thyroid disease during their lifetime. Epidemiology estimates predict women are 58 times more prone than men to present with a thyroid disorder. […] Hypothyroidism is defined as high serum TSH in the presence of low serum-free T4. Hypothyroidisms prevalence varies between 0.1% and 2.0%. However, its predicted around 4.6% of people in the United States have hypothyroidism without them knowing. Women are up to 8-times more likely to have hypothyroidism compared to men. Other risk factors include personal or family history of autoimmune diseases, increased age, anti-thyroid peroxidase antibodies (TPOAb), genetic diseases like Down Syndrome or Turner Syndrome, and Caucasian and Asian ethnicities. […] This review describes the epidemiology, etiology, pathophysiology, and clinical manifestations of hypothyroidism.

• #27 General Information/Press Room | American Thyroid Association

  https://www.thyroid.org/media-main/press-room/

  More than 12 percent of the U.S. population will develop a thyroid condition during their lifetime. […] An estimated 20 million Americans have some form of thyroid disease. […] Up to 60 percent of those with thyroid disease are unaware of their condition. […] Women are five to eight times more likely than men to have thyroid problems. […] One woman in eight will develop a thyroid disorder during her lifetime. […] Undiagnosed thyroid disease may put patients at risk for certain serious conditions, such as cardiovascular diseases, osteoporosis and infertility. […] Pregnant women with undiagnosed or inadequately treated hypothyroidism have an increased risk of miscarriage, preterm delivery, and severe developmental problems in their children. […] Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormone. Symptoms include extreme fatigue, depression, forgetfulness, and some weight gain. […] Mandatory screening of newborns for congenital hypothyroidism, and early treatment that has prevented mental retardation.

• #28 Context | Thyroid disease: assessment and management | Guidance | NICE

  https://www.nice.org.uk/guidance/ng145/chapter/Context

  Hypothyroidism is a condition of thyroid hormone deficiency and is usually caused by autoimmune Hashimoto’s thyroiditis. […] Hypothyroidism is found in about 2% of the UK population and in more than 5% of those over 60. Women are 5 to 10 times more likely to be affected than men. Long-term consequences of hypothyroidism include cardiovascular disease and an increase in cardiovascular risk factors, including hypercholesterolaemia. […] Standardisation in thyroid hormone replacement strategies for people with hypothyroidism is currently lacking.

• #29 Critically ill severe hypothyroidism: a retrospective multicenter cohort study | Annals of Intensive Care | Full Text

  https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-023-01112-1

  Severe hypothyroidism (SH) is a rare but life-threatening endocrine emergency. […] The most frequent SH triggers were levothyroxine discontinuation (28%), sepsis (15%), and amiodarone-related hypothyroidism (11%). […] In-ICU and 6-month mortality rates were 26% and 39%, respectively. […] SH is a rare life-threatening emergency with various clinical presentations. […] The very high mortality prompts early diagnosis and rapid levothyroxine administration with close cardiac and hemodynamic monitoring. […] Although the prevalence of overt hypothyroidism is estimated at 12% of the general population, hypothyroidism may result in a wide range of severity from subclinical hypothyroidism to exceptional life-threatening myxedema coma (MC). […] Prognosis has been markedly improved by thyroid hormone replacement therapy, with in-hospital mortality reaching 30-40% in the most recent series.

• #30 Critically ill severe hypothyroidism: a retrospective multicenter cohort study | Annals of Intensive Care | Full Text

  https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-023-01112-1

  To date, data on these severe patients admitted to ICU are limited. […] Herein, we report clinical characteristics, management, and outcomes of a large cohort of SH patients treated in French ICUs. […] Among this population, SH diagnosis was confirmed for 82 of them (incidence of 5.6 per 100,000 patients admitted). […] The main causes of hypothyroidism were thyroiditis (29%) and thyroidectomy (19%), while no evident cause was defined in nearly one-quarter of patients. […] Importantly, hemodynamic impairment, defined as SOFA cardiovascular component 2, was reported in 47 (57%) patients. […] ICU mortality was 26% among critically-ill patients with SH. […] Among 72 patients for whom 6-month survival status was available, mortality reached 39%. […] Older age, hemodynamic and respiratory failure, but not neurological failure were strongly associated with fatal outcomes.

• #31 Hypothyroidism: Causes, Symptoms, and Treatment | Doctor

  https://patient.info/doctor/hypothyroidism

  A review of UK national databases found the prevalence of treated hypothyroidism increased from 2.3% to 3.5% of the total UK population between 2005 and 2014. The prevalence of treated hypothyroidism was positively associated with female sex, white ethnicity, and obesity. […] The British Thyroid Association notes that subclinical hypothyroidism affects 5-10% of the population. […] The true prevalence of subclinical hypothyroidism may have been overestimated in older people, due to the physiological increase in TSH levels with increasing age, that may be misinterpreted as thyroid disease. […] Secondary hypothyroidism is rare. The estimated incidence varies between 1 per 20,000 and 1 per 80,000 people. […] The European Thyroid Association guidelines state that the prevalence of overt hypothyroidism in pregnancy is 0.2-0.5%, and subclinical hypothyroidism in pregnancy is 2-2.5%. […] The prevalence of postpartum thyroiditis in iodine-sufficient areas is stated as being about 5-7%.

• #32 Thyroid Disorders, Active Component, U.S. Armed Forces, 2008–2017 | Health.mil

  https://health.mil/News/Articles/2018/12/01/Thyroid-Disorders

  Among females, with the exception of thyroiditis, crude annual incidence rates of each type of thyroid disorder decreased between 2008 and 2017. […] The most pronounced decrease in annual rates among female service members was observed for primary/NOS hypothyroidism (42.5 per 10,000 p-yrs in 2008 to 36.0 per 10,000 p-yrs in 2017). […] The finding that higher incidence of all thyroid disorders was observed among health care personnel is likely related to increased medical awareness, easier access to care, and, perhaps, older age compared to their respective counterparts in other occupations.

• #33 Hypothyroidism | Nature Reviews Disease Primers

  https://www.nature.com/articles/s41572-022-00357-7

  There is a large variation in clinical presentation and the presence of hypothyroid symptoms, especially in pregnancy and in children. […] Further research is needed regarding the appropriateness of currently applied reference ranges and treatment thresholds, particularly in pregnancy, and the potential benefit of LT4/liothyronine combination therapy for thyroid-related symptom relief, patient satisfaction and long-term adverse effects. […] The epidemiology of thyroid disease. […] The incidence and prevalence of thyroid dysfunction in Europe: a meta-analysis. […] The Colorado Thyroid Disease Prevalence study. […] The temporary nature of the inhibitory action of excess iodine on organic iodine synthesis in the normal thyroid. […] The association of maternal thyroid autoimmunity during pregnancy with child IQ.

• #34 Epidemiology of thyroid disorders in the Lifelines Cohort Study (the Netherlands) | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0242795

  In the Lifelines Cohort Study, we showed that the overall prevalence of diagnosed and treated thyroid disorders (hypothyroidism plus thyrotoxicosis), assessed by medication use, is 3.1%. […] Thyroid hormone measurements in a subset of almost 40000 participants showed that the prevalence of unknown / undetected subclinical hypothyroidism was 9.4%, while the prevalence of undetected overt hypothyroidism was 0.7%. […] The population prevalence of treated thyroid disorders in Lifelines is 3.1%. In those not known to have a thyroid disorder, the prevalence of primary hypothyroidism is 0.7%, and of subclinical hypothyroidism is 9.4%. Furthermore, 0.7% has a suppressed TSH. Only 59.3% of those participants who use levothyroxine have a TSH level in the normal range. Reliable ascertainment of previous and new thyroid disorders is not possible based on the currently used questionnaires.

• #35 Hypothyroidism | Nature Reviews Disease Primers

  https://www.nature.com/articles/s41572-022-00357-7

  There is a large variation in clinical presentation and the presence of hypothyroid symptoms, especially in pregnancy and in children. […] Further research is needed regarding the appropriateness of currently applied reference ranges and treatment thresholds, particularly in pregnancy, and the potential benefit of LT4/liothyronine combination therapy for thyroid-related symptom relief, patient satisfaction and long-term adverse effects. […] The epidemiology of thyroid disease. […] The incidence and prevalence of thyroid dysfunction in Europe: a meta-analysis. […] The Colorado Thyroid Disease Prevalence study. […] The temporary nature of the inhibitory action of excess iodine on organic iodine synthesis in the normal thyroid. […] The association of maternal thyroid autoimmunity during pregnancy with child IQ.

• #36 Thyroid function in individuals living with human immunodeficiency virus: the concern and debate about regular screening – Ibrahim – Annals of Thyroid

  https://aot.amegroups.org/article/view/4948/html

  Abnormal thyroid functions are common among individuals living with human immunodeficiency virus (HIV). […] Increasing prevalence of thyroid dysfunction has been reported in individuals living with HIV (LWHIV). […] HIV can be associated with hypothyroidism, hyperthyroidism and also may increase the risk of thyroid cancer. […] Therefore, it is a good clinical practice to screen for thyroid function once every 12-24 months. […] The ambiguous presentation of hypothyroidism can be easily attributed to symptoms related to HIV or HIV therapy or even related to opportunistic infections. […] Therefore, its important that clinician treating individuals LWHIV have broader understanding of different conditions and screen for thyroid function. […] Hypothyroidism presented as overt, subclinical and reduced FT4 levels.

• #37 Thyroid function in individuals living with human immunodeficiency virus: the concern and debate about regular screening – Ibrahim – Annals of Thyroid

  https://aot.amegroups.org/article/view/4948/html

  Since the introduction of HAART, thyroid dysfunction, particularly subclinical hypothyroidism, appears to be quite prevalent. […] Amongst untreated HIV infected patients prevalence of subclinical hypothyroidism is between 8-10%, whereas the prevalence is up to 12.6% amongst HAART users. […] The mechanism behind the development of hypothyroidism and the progressive use of HAART remains unclear and necessitates further investigations. […] Importantly, in well treated individuals LWHIV, no changes in thyroid functions were reported. […] Due to the fact that the epidemiology of thyroid malignancy in HIV infected individuals and the cases reported are very few, further research is required to understand the association between HIV and thyroid malignancy.

• #38 Risk of hypothyroidism in meat-eaters, fish-eaters, and vegetarians: a population-based prospective study | BMC Medicine | Full Text

  https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-025-04045-7

  In the present study, we found a moderately higher risk of hypothyroidism among vegetarians, after controlling for BMI, a potential collider. This slightly higher risk of hypothyroidism among vegetarians requires further investigation, taking iodine status and thyroid hormone levels into account. […] Overall, the findings from our study indicate that a vegetarian diet may be associated with a moderately higher risk of hypothyroidism. This finding is consistent with findings from a previous study and warrants further investigation in studies with data on iodine status and thyroid function prior to diagnosis.

• #39 Post-thyroidectomy hypothyroidism and thyroid hormone supplementation: a narrative review of the history, treatment, and patient experience – Brooks – Annals of Thyroid

  https://aot.amegroups.org/article/view/7323/html

  Hypothyroidism is a common concern, with incidence of overt hypothyroidism afflicting approximately 4% of the general population; this figure is much higher (15%) when accounting for subclinical hypothyroidism. […] Thyroidectomy, either partial or total, is a primary iatrogenic cause of hypothyroidism. […] Rates of hypothyroidism following thyroid lobectomy are historically cited around 20%. However, certain studies demonstrate elevated rates following hemithyroidectomy for benign disease (47%), and even higher rates (73%) for patients being treated via partial surgery in the setting of small, non-aggressive differentiated thyroid cancers (DTCs), given the goal of low-normal TSH levels in these patients. […] Regular assessment of QoL may guide providers toward new treatment methods and optimize patient experience in the setting of post-operative hypothyroidism.

• #40 Hypothyroidism – Wikipedia

  https://en.wikipedia.org/wiki/Hypothyroidism

  Hypothyroidism is the most frequent endocrine disorder. Worldwide about one billion people are estimated to be iodine deficient; however, it is unknown how often this results in hypothyroidism. In large population-based studies in Western countries with sufficient dietary iodine, 0.30.4% of the population have overt hypothyroidism. A larger proportion, 4.38.5%, have subclinical hypothyroidism. […] Undiagnosed hypothyroidism is estimated to affect about 47% of community-derived populations in the US and Europe. Of people with subclinical hypothyroidism, 80% have a TSH level below the 10 mIU/L mark regarded as the threshold for treatment. […] Women are more likely to develop hypothyroidism than men. In population-based studies, women were seven times more likely than men to have TSH levels above 10 mU/L.

• #41

  https://journals.lww.com/trap/fulltext/2022/19010/thyrovigilance_for_hypothyroidism_in_india.1.aspx

  Among endocrine abnormalities, thyroid diseases are the commonest both in India and worldwide. However, the prevalence of hypothyroidism in India is more than twice as high compared to its Western counterparts. Therefore an efficient and effective strategy to manage the disease in India is necessary. […] A review of published literature indicates that nearly one-third of the patients with hypothyroidism across age groups remain undiagnosed and untreated in various regions of India. […] The prevalence of hypothyroidism in India is 11%, compared with only 2%4.6% in the Western population. […] Inland states have a higher prevalence of hypothyroidism compared to coastal states (11.7% vs. 9.5%), probably due to iodine deficiency. […] Nearly one-third of the patients with hypothyroidism remain undiagnosed and untreated.

• #42 Epidemiology of Hypothyroidism, Hyperthyroidism and Positive Thyroid Antibodies in the Croatian Population

  https://www.mdpi.com/2079-7737/11/3/394

  In conclusion, the correct diagnosis of thyroid dysfunction is extremely important due to the detrimental effects of thyroid dysfunction on human health (possible complications in patients with cardiovascular diseases and pregnant women). Our current study showed that a high proportion of thyroid dysfunction remained undiagnosed (as much as 92.6% subclinical hypothyroid, 93.9% clinical hypothyroid, 83% subclinical hyperthyroid, and 71.4% clinical hyperthyroid participants). Another important finding is the high prevalence of hypothyroidism among Croatians. Our study shows that we need to monitor all thyroid disorders because their impact on health depends on how early they are discovered. It is of most importance to invest in prevention programs because thyroid disorders are the leading endocrine disorders today.

• #43

  https://journals.lww.com/trap/fulltext/2022/19010/thyrovigilance_for_hypothyroidism_in_india.1.aspx

  Among endocrine abnormalities, thyroid diseases are the commonest both in India and worldwide. However, the prevalence of hypothyroidism in India is more than twice as high compared to its Western counterparts. Therefore an efficient and effective strategy to manage the disease in India is necessary. […] A review of published literature indicates that nearly one-third of the patients with hypothyroidism across age groups remain undiagnosed and untreated in various regions of India. […] The prevalence of hypothyroidism in India is 11%, compared with only 2%4.6% in the Western population. […] Inland states have a higher prevalence of hypothyroidism compared to coastal states (11.7% vs. 9.5%), probably due to iodine deficiency. […] Nearly one-third of the patients with hypothyroidism remain undiagnosed and untreated.

• #44 Hypothyroidism: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/122393-overview

  The frequency of hypothyroidism, goiters, and thyroid nodules increases with age. The previously mentioned study by Wyne et al reported that between 2012 and 2019, hyperthyroidism maintained a consistent prevalence in persons aged less than 50 years, while in persons aged 50-59 years, the prevalence grew from 10.4% to 11.2%, and in individuals aged 60 years or older, from 16.2% to 17.8%. […] Community studies use slightly different criteria for determining hypothyroidism; therefore, female-to-male ratios vary. Generally, the prevalence of thyroid disease is reportedly 2-8 times higher in females. […] However, using the National Health and Nutrition Examination Survey (NHANES) from the 2009-2010 and 2011-2012 survey cycles, the above-mentioned report by Wyne and colleagues found 51.5% of persons in the United States with hypothyroidism to be female. […] Using the NHANES from the 2009-2010 and 2011-2012 survey cycles, the aforementioned study by Wyne and colleagues found 65.6% of persons in the United States with hypothyroidism to be non-Hispanic White.

• #45 Hypothyroidism | Nature Reviews Disease Primers

  https://www.nature.com/articles/s41572-022-00357-7

  There is a large variation in clinical presentation and the presence of hypothyroid symptoms, especially in pregnancy and in children. […] Further research is needed regarding the appropriateness of currently applied reference ranges and treatment thresholds, particularly in pregnancy, and the potential benefit of LT4/liothyronine combination therapy for thyroid-related symptom relief, patient satisfaction and long-term adverse effects. […] The epidemiology of thyroid disease. […] The incidence and prevalence of thyroid dysfunction in Europe: a meta-analysis. […] The Colorado Thyroid Disease Prevalence study. […] The temporary nature of the inhibitory action of excess iodine on organic iodine synthesis in the normal thyroid. […] The association of maternal thyroid autoimmunity during pregnancy with child IQ.

• #46 Global epidemiology of hyperthyroidism and hypothyroidism -ORCA

  https://orca.cardiff.ac.uk/id/eprint/112564/

  Thyroid hormones are essential for growth, neuronal development, reproduction and regulation of energy metabolism. Hypothyroidism and hyperthyroidism are common conditions with potentially devastating health consequences that affect all populations worldwide. […] In this report, we review the global incidence and prevalence of hyperthyroidism and hypothyroidism, highlighting geographical differences and the effect of environmental factors, such as iodine supplementation, on these data. We also highlight the pressing need for detailed epidemiological surveys of thyroid dysfunction and iodine status in developing countries.

• #47 Subclinical Hypothyroidism and Cardiovascular Disease

  https://www.e-enm.org/journal/view.php?doi=10.3803/enm.2015.30.3.246

  Subclinical hypothyroidism (SCH) is a common disorder that is characterized by elevated thyroid-stimulating hormone levels in conjunction with free thyroxine concentrations within the normal reference range. […] The prevalence of SCH varies according to population, age, sex, race, region, and method of TSH measurement. […] The prevalence of SCH is relatively high and ranges from 4% to 20% in the adult population with women, elderly people, and iodine-sufficient populations being affected more often. […] In a recent study using Korean population-based cohorts, the prevalence of SCH was reported to be 11.3%. […] A systemic review by Iwen et al. found convincing evidence supporting the major impact of SCH on all components of MetS and a cross-sectional analysis of cohort studies highlighted the fact that the odds of having MetS are positively associated with TSH levels within the reference range.

• #48 Subclinical Hypothyroidism and Cardiovascular Disease

  https://www.e-enm.org/journal/view.php?doi=10.3803/enm.2015.30.3.246

  In Korea, high normal TSH levels were significantly associated with the increased prevalence of MetS in 7,270 euthyroid men and women. […] A pooled analysis from six prospective cohorts also found that the risk of heart failure events increases in conjunction with higher TSH levels. […] In a Korean cohort that was followed for 10 years, elevated serum TSH levels significantly increased the risk of CVD by approximately 20% per one standard deviation in males. […] The indications for the screening of SCH and the determination of TSH threshold levels for the treatment of SCH have remained a clinical controversy for over many years.

• #49 Epidemiology of Hypothyroidism, Hyperthyroidism and Positive Thyroid Antibodies in the Croatian Population

  https://www.mdpi.com/2079-7737/11/3/394

  In conclusion, the correct diagnosis of thyroid dysfunction is extremely important due to the detrimental effects of thyroid dysfunction on human health (possible complications in patients with cardiovascular diseases and pregnant women). Our current study showed that a high proportion of thyroid dysfunction remained undiagnosed (as much as 92.6% subclinical hypothyroid, 93.9% clinical hypothyroid, 83% subclinical hyperthyroid, and 71.4% clinical hyperthyroid participants). Another important finding is the high prevalence of hypothyroidism among Croatians. Our study shows that we need to monitor all thyroid disorders because their impact on health depends on how early they are discovered. It is of most importance to invest in prevention programs because thyroid disorders are the leading endocrine disorders today.

• #50 Prevalence of Undiagnosed Hypothyroidism in Europe: A Systematic Review and Meta-Analysis in: European Thyroid Journal Volume 8 Issue 3 (2019)

  https://etj.bioscientifica.com/view/journals/etj/8/3/ETJ499751.xml

  Patients with undiagnosed hypothyroidism are not treated for the disease and are at high risk of developing serious complications, with major impact on public health. […] The current evidence suggests that a considerable proportion of the European population has hypothyroidism, particularly subclinical hypothyroidism, which is undiagnosed. This issue deserves further investigation because of possible deleterious consequences for public health. […] The prevalence of hypothyroidism varies considerably across the general population. […] The prevalence of undiagnosed hypothyroidism in European countries is presented in Table 2. […] The prevalence of undiagnosed total (subclinical plus overt) hypothyroidism was ascertained in 11 studies, with estimates ranging between 2.7% and 12.8%. […] The estimated prevalence of undiagnosed subclinical hypothyroidism was 4.11%. The prevalence of undiagnosed overt hypothyroidism was 0.65%. Undiagnosed total hypothyroidism was estimated with a prevalence of 4.70%.

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