Thyroid hormone therapy in a population cohort over two decades indicates persistent overtreatment
Authors' conclusion
TH therapy in the study population increased over the past two decades. TSH measurements revealed persistent overtreatment, particularly among older individuals. These findings highlight a concerning gap between updated guideline recommendations for TH therapy and its implementation in routine clinical practice. Greater emphasis is needed on translating scientific evidence into patient care through improved education of both physicians and patients, promoting a more restrictive approach to thyroid function testing, TH therapy, regular review of ongoing TH treatment, and age-adjusted TH dosing.
Study context
- Population
- Participants of the German population-based Heinz Nixdorf Recall (HNR) study, 2000–2023; mean age 53.8 ± 15.1 to 68.7 ± 7.3 years, 45.8–49.6% males
- Participants
- 7,711 participants
- Outcome
- Prevalence of reported thyroid disease, TH therapy and TSH concentrations
- Follow-up
- 2000-2023
Methodological detailsdescriptive analysis, stratified by age, sex and educational attainment
- Descriptive analysis
- Stratified by age, sex and educational attainment
Main finding
As reported in the abstract
TH prescription increased over two decades
from 9.2 to 15.3%
Observational data: associations, not effects.
Further findings
Median TSH concentrations
- Median TSH lower in participants receiving TH therapy vs those without thyroid disease or with untreated thyroid disease; greatest reduction in older individuals
TH treatment among participants with TSH <0.45 mIU/L
- At baseline
- 35%
- During 20-year follow-up
- 25%
Original publication
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