Study Identifies Disparities in the Treatment of Hypothyroidism

The human thyroid gland
Human thyroid anatomy. 3d illustration
A team of investigators sought to identify sociodemographic disparities associated with the treatment of hypothyroidism.

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Treatment of hypothyroidism occurs less frequently among men, those of Hispanic ethnicity, and younger adults, according to study results presented at the 30th Annual Scientific and Clinical Congress of the American Association of Clinical Endocrinologists (ENVISION 2021).

This cross-sectional study included 8436 adult participants aged 20 years and older derived from the National Health and Nutrition Examination Survey (NHANES) database and whose data were entered from 2007 to 2012. Among this population, 536 had treated hypothyroidism, 115 had untreated subclinical hypothyroidism, and 47 had untreated clinical hypothyroidism. Thyroid function testing and use of thyroid hormone were used to identify hypothyroidism. Other data assessed included sociodemographic characteristics such as age, gender, education level, race/ethnicity, access to routine health care, and household income. The study researchers followed NHANES analytical guidelines and performed proper sample weighting when conducting statistical analysis.

The use of thyroid hormone was found to be more common among women than men (odds ratio [OR] 2.66; 95% CI, 1.42-4.99), although this association was not sustained with the exclusion of participants with mild subclinical hypothyroidism (OR 1.17; 95% CI, 0.35-3.84). Use of thyroid hormone was more likely among older vs younger participants (45-69 years, OR 7.25 [95% CI, 4.15-12.67]; ≥70 years, OR 11.00 [95% CI, 5.30-22.79]). Routine healthcare access was associated with the use of thyroid hormone (OR 14.32 [95% CI, 3.63-56.58]). Among the patients who received treatment, being Hispanic vs being non-Hispanic White was associated with less-adequate treatment (OR 2.42 [95% CI, 1.14-5.14]).

The study researchers concluded that “Male gender, younger age, and lack of routine healthcare access were associated with untreated hypothyroidism” and that those of Hispanic ethnicity were receiving inadequate treatment. Since “…women more than men are being treated for mild subclinical hypothyroidism,” the study researchers concluded that “Strategies to improve treatment of hypothyroidism in men, younger adults, and Hispanics are likely warranted.”

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Ettleson MD, Bianco AC, Zhu M, Laiteerapong N. Sociodemographic disparities in the treatment of hypothyroidism: NHANES 2007-2012. Poster presented at: 30th Annual Scientific and Clinical Congress of the American Association of Clinical Endocrinologists (ENVISION 2021); May 26-29, 2021; virtual.