Academic Journal
Thyroid hormone therapy in a population cohort over two decades indicates persistent overtreatment.
| Τίτλος: | Thyroid hormone therapy in a population cohort over two decades indicates persistent overtreatment. |
|---|---|
| Συγγραφείς: | Zwanziger D; Department of Endocrinology, Diabetes and Metabolism and Clinical Chemistry - Division of Laboratory Research, University Hospital Essen, University Duisburg-Essen, Essen, Germany., Kowall B; Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany., Klose JM; Department of Endocrinology, Diabetes and Metabolism and Clinical Chemistry - Division of Laboratory Research, University Hospital Essen, University Duisburg-Essen, Essen, Germany., Schmidt B; Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany., Stang A; Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany., Führer D; Department of Endocrinology, Diabetes and Metabolism and Clinical Chemistry - Division of Laboratory Research, University Hospital Essen, University Duisburg-Essen, Essen, Germany. |
| Πηγή: | European thyroid journal [Eur Thyroid J] 2026 May 07; Vol. 15 (3). Date of Electronic Publication: 2026 May 07 (Print Publication: 2026). |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Bioscientifica Ltd Country of Publication: England NLM ID: 101604579 Publication Model: Electronic-Print Cited Medium: Internet ISSN: 2235-0802 (Electronic) Linking ISSN: 22350640 NLM ISO Abbreviation: Eur Thyroid J Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2022- : [Bristol] : Bioscientifica Ltd. Original Publication: Basel : S. Karger |
| Ιατρικοί όροι (MeSH): | Thyroid Hormones*/therapeutic use , Thyroid Diseases*/drug therapy , Thyroid Diseases*/epidemiology , Overtreatment*, Thyrotropin/blood ; Germany/epidemiology ; Hypothyroidism/drug therapy ; Hypothyroidism/epidemiology ; Humans ; Female ; Middle Aged ; Male ; Aged ; Adult ; Undertreatment ; Cohort Studies ; Prevalence |
| Περίληψη: | Objective: Thyroid hormones (THs) are among the most prescribed medications worldwide, and regular monitoring of thyroid function is required to ensure optimal management. Both over- and undertreatment with THs is associated with health risks, including increased cardiovascular morbidity and mortality, as well as higher socioeconomic costs. We investigated how changes in treatment concepts and guideline recommendations over two decades have influenced the frequency and quality of TH treatment in a high-income country. Methods: Data from 7,711 participants in the German population-based Heinz Nixdorf Recall (HNR) study were descriptively analyzed to assess the prevalence of reported thyroid disease, TH therapy, and thyrotropin (TSH) concentrations measured by immunoassay over the period 2000-2023. The mean age differed from 53.8 ± 15.1 years to 68.7 ± 7.3 years (45.8-49.6% males). Descriptive analyses were also stratified by age, sex, and educational attainment. Results: The prevalence of reported thyroid disease remained stable throughout the study period, whereas TH prescription increased from 9.2 to 15.3% over two decades. TH therapy was more common among women and older participants. Compared with individuals without thyroid disease or those with thyroid disease not treated with THs, median TSH concentrations were lower in participants receiving TH therapy, with the greatest reduction observed in older individuals. At study baseline, 35% of participants with TSH concentrations <0.45 mIU/L reported TH treatment, and this proportion remained high (25%) during the 20-year follow-up. 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. |
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| Contributed Indexing: | Keywords: age; gender; health risk; hypothyroidism; overtreatment; thyroid hormone therapy |
| Substance Nomenclature: | 0 (Thyroid Hormones) 9002-71-5 (Thyrotropin) |
| Entry Date(s): | Date Created: 20260410 Date Completed: 20260714 Latest Revision: 20260921 |
| Update Code: | 20260921 |
| PubMed Central ID: | PMC13178427 |
| DOI: | 10.1530/ETJ-25-0259 |
| PMID: | 41961727 |
| Βάση Δεδομένων: | MEDLINE |
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