Demographic, Healthcare Access, and Dietary Factors Associated With Thyroid Hormone Treatments for Hypothyroidism
Authors' conclusion
The proportion of new TH therapies containing DTE for hypothyroidism doubled since 2010 while LT3 therapies remained stable. DTE treatment was associated with decreased physician density and increased dietary supplement use.
Study context
- Population
- Adults with primary or subclinical hypothyroidism, US national patient claims and National Health and Nutrition Examination Study (NHANES)average annual, new thyroid hormone (TH) prescription
- Participants
- 47,711 adults
- Exposure
- Levothyroxine (LT4) monotherapy vs liothyronine (LT3) therapy vs desiccated thyroid extract (DTE) therapy
- LT4n = 146reference
- DTEn = 73
- Outcome
- Share of new TH prescriptions, average annual
Methodological detailsparallel cross-sectional studies, 2 datasets: national patient claims (2010-2020) and NHANES (1999-2016), DTE-treated vs LT4-treated matched controls (NHANES)
- Parallel cross-sectional studies
- 2 datasets: national patient claims (2010-2020) and NHANES (1999-2016)
- DTE-treated vs LT4-treated matched controls (NHANES)
Main finding
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | LT4 | DTE | P value |
|---|---|---|---|
| Dietary supplements consumed (NHANES)DTE vs LT4 · more with DTE | 2.1 | 4.7 | P < 0.001 |
- Dietary supplements consumed (NHANES): LT4-treated matched controls
Proportion receiving DTE therapy over time · 2010 to 2020
- DTE share in 2010
- 5.4%
- DTE share in 2020
- 10.2%
Use of LT4 monotherapy by physician density (between states)
- High primary care physician density: OR for LT4 monotherapy
- 2.51, P < .001
- High endocrinology physician density: OR for LT4 monotherapy
- 2.71, P < .001
Original publication
Demographic, Healthcare Access, and Dietary Factors Associated With Thyroid Hormone Treatments for Hypothyroidism. J Clin Endocrinol Metab. Published 16 June 2023. doi:10.
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