Natural course of subclinical hyperthyroidism in primary care in the Netherlands
Authors' conclusion
This study highlights that a small subset of SHT patients progress to overt hyperthyroidism. Factors increasing the odds for progression included lower baseline TSH and female sex. Our findings indicate a need for improved guideline adherence.
Study context
- Population
- Primary care patients with biochemically confirmed SCH...
- Participants
- 11,163 patients
- Outcome
- Incidence and natural course of subclinical hyperthyroidism
- Follow-up
- Median 5 years
Methodological detailsgeneral practitioner data, PHARMO Data Network
- General practitioner data
- PHARMO Data Network
Main finding
As reported in the abstract
Annual subclinical hyperthyroidism (SHT) incidence
≈200 per 100,000 person-years
Recovered
47%
Persisted
11%
Progressed to overt hyperthyroidism
8%
Observational data: associations, not effects.
Further findings
Factors associated with recovery
| OR (95% CI) | ||
|---|---|---|
| TSH <0.1 mU/LLower odds of recovery | 0.50 (0.43–0.58) | |
| WomenLower odds of recovery | 0.82 (0.70–0.96) | |
| 0.512Odds ratio (log scale) |
Factors associated with progression to overt hyperthyroidism
| OR (95% CI) | ||
|---|---|---|
| TSH <0.1 mU/LHigher odds of progression | 2.36 (1.97–2.83) | |
| WomenHigher odds of progression | 1.69 (1.32–2.17) | |
| 0.20.5125Odds ratio (log scale) |
Guideline adherence
- Follow-up thyroid-stimulating hormone (TSH) within 6 months
- 33%
- TRAb testing
- 4%
Original publication
Natural course of subclinical hyperthyroidism in primary care in the Netherlands. Eur Thyroid J. Published 5 November 2025. doi:10.
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