Prevalence of Primary Hypothyroidism

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EP: 1.Prevalence of Primary Hypothyroidism

EP: 2.Prevalence of Subclinical vs Overt Hypothyroidism

EP: 3.Importance of TSH Target Ranges in Hypothyroidism Management

EP: 4.Key Data on Off Target TSH Levels in Patients with Hypothyroidism

EP: 5.Treatment Adherence and Compliance in Maintaining TSH Levels for Hypothyroidism

EP: 6.Impact of Age and Concomitant Drug Interactions on TSH Levels in Hypothyroidism

EP: 7.Key Takeaways for Optimizing TSH Levels in Elderly Patients With Hypothyroidism

EP: 8.Impact of Diet and Calorie Restriction on TSH Levels in Hypothyroidism

EP: 9.Levothyroxine Formulation Considerations in Hypothyroidism Management

EP: 10.Practical Considerations of Levothyroxine Administration for Hypothyroidism

EP: 11.Expert Perspectives on TSH Monitoring and Treatment Follow-up to Manage Hypothyroidism

EP: 12.Clinical Implications of Off Target TSH Levels and Importance of Patient Education in Managing Hypothyroidism

Antonio Bianco, MD, PhD: One thing that I keep hearing is the prevalence of hypothyroidism and how that changed over time. In my mind, I always have the number as 5% of the population. Is that the right number that you have in the US? It would be around 15 million people?

James Hennessey, MD, FACP: I believe that hypothyroidism is the most common disorder of thyroid dysfunction, and it affects somewhere in the vicinity of 5% of the US population, but that’s by the current use of thyroid function testing. Over 99% of hypothyroidism cases are primary thyroid failure. The most prevalent endogenous form is Hashimoto’s. Thyroid hormone replacement therapies have been utilized since the 1890s, so this is a problem that we thought we had a good handle on because we had a very effective treatment. Some of you might remember that thyroid hormone extracts were initially injected into people and then turned into tablets, etc., and there were some problems with manufacturing over the past 100 years. The current products are standard for the thyroid hormone content and have a ratio of about 4:1 of thyroxine to T3. Now synthetical thyroxine or levothyroxine sodium was introduced in the United States in the 1950s, and it was demonstrated in the 1970s that the body could convert T4 to T3, and therefore the need for combination treatments was diminished. Some of the observations along the time of that transition were that the dosing was a bit more precise, and that profiles of thyroid hormones after ingesting the thyroxine were more physiologic. By 1997, thyroxine was declared a new drug, go figure, but there was a positive side of this because FDA standards were set. This resulted in far more consistent products being made. We’ve got a good way of approaching hypothyroidism at this point in time and treating it.

Transcript edited for clarity