Background: Recent reports suggest that prescriptions for thyroid hormones have increased. Recent trends in and determinants of the prevalence of treated hypothyroidism across the United Kingdom were therefore analyzed.
Methods: Data covering the whole of the United Kingdom held by the National Health Service and the Office of National Statistics were examined. The main outcome measured was trends in the prevalence of treated hypothyroidism between 2005 and 2014. In addition, linear trend forecasting was performed to estimate projected trends in the prevalence of treated hypothyroidism up to the year 2025. Furthermore, determinants of variation of treated hypothyroidism prevalence across each of the 237 health areas in the United Kingdom in 2014 and its association with other health conditions were explored by multivariate linear regression analyses.
Results: The prevalence of treated hypothyroidism increased from 2.3% (1.4 million) to 3.5% (2.2 million) of the total British population between the years 2005 and 2014 and is projected to rise further to 4.2% (2.9 million) by 2025. There was large geographical variation of treated hypothyroidism across the United Kingdom, with London having the lowest (1.4%) and the Western Isles of Scotland having the highest (6.3%) prevalence. This variation was attenuated, but did not completely disappear, after some potential determinants were accounted for. The prevalence of treated hypothyroidism was independently related to health areas, with a higher proportion of individuals who were female, white, and obese, and negatively associated with prevalent cigarette smoking. The prevalence of treated hypothyroidism was significantly associated with the frequency of prevalent atrial fibrillation but not with other major health conditions, including ischemic heart disease and osteoporosis.
Conclusions: Between 2005 and 2014, the prevalence of treated hypothyroidism increased across the United Kingdom, has wide geographical variation, and is likely to increase further for the foreseeable future. Clinical effects and cost-effectiveness of the trend in increasing treatment of hypothyroidism remains to be evaluated.
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diogenes
Remembering
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It would be good to know more about: “The prevalence of treated hypothyroidism was significantly associated with the frequency of prevalent atrial fibrillation”. What exactly is the association, I wonder?
I think this may occur because a patient is not restored properly to their individual requirements. Perhaps if a) we knew a patient's healthy FT4/3 and b) took whatever steps necessary to try to restore that by either T4. T4/T3 or NDT or mixtures of these, the possibly the problem would be much reduced. You do not have to be formally overdosed with hormone (above the range), but rather inappropriately dosed possibly even within the range.
"You do not have to be formally overdosed with hormone (above the range), but rather inappropriately dosed possibly even within the range." I agree completely with that statement.
Our heart and brain need the most T3. My heart was affected through palpitations which quite a few people get, I believe, and was resolved when T3 was added to T4. A number of people may develop Atrial Fibrillation. diogenes will state if I am wrong.
It is hard enough to get diagnosed and quite a number on this forum have to self-diagnose and by that time (myself 100 TSH) one can feel very unwell but not one diagnosed me (even paying). I was saved by a first aider. How ridiculous.
Yes, I have noted it. I wonder though if you looked at thyroid cancer patients whether a link would emerge? Could be more to do with loss of calcitonin or disruption to parathyroid glands?
Thank you for bringing this research paper to my attention.
If in the Scottish Isles the current 6.3% of population with hypothyroidism rises yet further will this trend overtake the percentage population that has diabetes - for which the World Health Organization has asked all governments to try and treat? If as is assumed that over 3% of the population by 2025 will have hypothyroidism, would this be considered an epidemic? And do you think governments will be persuaded to properly look at what is actually happening and put money into better and proper treatment? I shall make an foi request.
Is it due to people self-diagnosing as their continuing symptoms may cause them to search the internet because doctor denies hypo, as TSH hasn't reached 10. Few doctors seem to know symptoms. Definitely I can confirm that whoever I saw I got different diagnosis for things I didn't have.
But how was this measured, by what criteria? We all know people who are complaining of symptoms and have an out of range TSH, and in some cases very low in range hormone levels and the doctor tells them that their results are normal. Would these people have been included in the study? Could the numbers be even higher?
I suppose it was measured using the guideline criteria, as nearly all doctors subscribe to this. A lot of socalled subclinical hypos with TSH between 4.5 and 10 may well not be included.
Yes - the numbers are higher. How much higher? By the amount of people who die young of heart disease + the people who just give up and suffer (mostly women). I personally know 2 of them (for sure - diagnosed with SOMETHING - Drs can’t quite put their finger on it!!). One of them is very poor, and can not afford private. One of them trusting in Drs completely - this same one? Her dog is being treated for a thyroid disorder / vet prescribed T4. Informally, I do my own poll when I am in group situations. Results? 3 in 5 have been diagnosed with thyroid disorders, but may or may not receive thyroid medication (various reasons). Of the remaining 2, 1 has been “tested” - and diagnosed as normal thyroid. This 1 - still has symptoms that sound all too familiar! They have chosen to “just live with it”. I live in Missouri, USA. These informal polls cone from a tri-state area.
The high prevalence in the Western Isles of Scotland given the size of it's population makes me think it's linked to nuclear fall out from Chernobyl. The link with AF is clear for both under and overactive thyroid. I really believe everyone should have thyroid screening periodically so that if going on to develop the desease the correct levels are on record as we are all so individual. Finding the right dose is a lottery and the difference between living life to the full or just surviving. Genetic testing will also have a huge role to play now and in the future. Bit late for me though.
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