Epidemiology and prevention of clinical and subclinical hypothyroidism.
Level 5 - mechanism / opinion, no new human data
Narrative review of epidemiology and clinical practice without systematic review methodology
PubMed 12487765 · doi:10.1089/105072502761016458
What was done
This was a narrative review examining the causes, global and regional prevalence, and potential screening strategies for congenital, overt, and subclinical hypothyroidism based on published clinical and epidemiological literature.
What was found
Iodine deficiency was identified as the primary worldwide cause, while autoimmune disease and iatrogenic factors predominated in iodine-replete regions. Spontaneous hypothyroidism prevalence was reported between 1% and 2%, occurring 10 times more frequently in women than in men, with higher frequency in older women. Subclinical hypothyroidism affected 8% of women (10% of women over 55 years) and 3% of men. Approximately one third of newly diagnosed overt cases arose after destructive therapy for hyperthyroidism. The author noted universal adult screening remained controversial, but suggested targeted case finding in menopausal women or patients presenting with nonspecific symptoms.
Why it matters
It outlines the population distribution of thyroid failure and provides clinical context for targeted case finding versus universal screening.
Limits
The abstract describes a narrative review without explicit systematic search criteria, meta-analytic pooling, study quality appraisal, or primary sample sizes. Specific confidence intervals and quantitative effect estimates were not reported.
Cited by
- context Eighty to ninety percent of women diagnosed with hypothyroidism have Hashimoto's thyroiditis.