The National Health and Nutrition Examination Survey (NHANES) in the US suggests that the prevalence of overt primary hypothyroidism and subclinical hypothyroidism is 0.3% and 4.3%, respectively, using data from 1988-1994.[5]Hollowell JG, Staehling NW, Flanders WD, et al. Serum TSH, T(4) and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab. 2002 Feb;87(2):489-99.
https://academic.oup.com/jcem/article/87/2/489/2846568
http://www.ncbi.nlm.nih.gov/pubmed/11836274?tool=bestpractice.com
More recent NHANES data from 2009-2012 estimated the prevalence of overt hypothyroidism to be 2.1% using laboratory data.[6]Wyne KL, Nair L, Schneiderman CP, et al. Hypothyroidism prevalence in the United States: a retrospective study combining National Health and Nutrition Examination Survey and Claims Data, 2009-2019. J Endocr Soc. 2022 Nov 17;7(1):bvac172.
https://pmc.ncbi.nlm.nih.gov/articles/PMC9706417
http://www.ncbi.nlm.nih.gov/pubmed/36466005?tool=bestpractice.com
The prevalence of overt and subclinical hypothyroidism is higher in white people (5.1%) than in black people (1.7%), or Hispanic people (4.2%).[5]Hollowell JG, Staehling NW, Flanders WD, et al. Serum TSH, T(4) and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab. 2002 Feb;87(2):489-99.
https://academic.oup.com/jcem/article/87/2/489/2846568
http://www.ncbi.nlm.nih.gov/pubmed/11836274?tool=bestpractice.com
The prevalence of hypothyroidism is higher in women and increases with age.[7]Taylor PN, Albrecht D, Scholz A, et al. Global epidemiology of hyperthyroidism and hypothyroidism. Nat Rev Endocrinol. 2018 May;14(5):301-16.
http://www.ncbi.nlm.nih.gov/pubmed/29569622?tool=bestpractice.com
It ranges from 4% in women ages 18-24 years, to 21% in women older than 74 years, and 3% to 16% in men of the same age groups.[8]Canaris GJ, Manowitz NR, Mayor G, et al. The Colorado thyroid disease prevalence study. Arch Intern Med. 2000 Feb 28;160(4):526-34.
http://www.ncbi.nlm.nih.gov/pubmed/10695693?tool=bestpractice.com
In Europe, the prevalence of overt hypothyroidism in the general population ranges between 0.2% and 5.3%.[7]Taylor PN, Albrecht D, Scholz A, et al. Global epidemiology of hyperthyroidism and hypothyroidism. Nat Rev Endocrinol. 2018 May;14(5):301-16.
http://www.ncbi.nlm.nih.gov/pubmed/29569622?tool=bestpractice.com
The incidence of primary hypothyroidism in the UK is estimated to be 0.41% per year in women and 0.06% per year in men.[9]Vanderpump MP, Tunbridge WM, French JM, et al. The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham survey. Clin Endocrinol. 1995 Jul;43(1):55-68.
http://www.ncbi.nlm.nih.gov/pubmed/7641412?tool=bestpractice.com
Differences in iodine status affect the prevalence of hypothyroidism as both severe iodine deficiency and iodine excess may cause hypothyroidism.[1]Chaker L, Razvi S, Bensenor IM, et al. Hypothyroidism. Nat Rev Dis Primers. 2022 May 19;8(1):30.
http://www.ncbi.nlm.nih.gov/pubmed/35589725?tool=bestpractice.com
Global efforts to universally iodize salt have diminished the magnitude of this problem.[10]Han X, Ding S, Lu J, et al. Global, regional, and national burdens of common micronutrient deficiencies from 1990 to 2019: a secondary trend analysis based on the Global Burden of Disease 2019 study. EClinicalMedicine. 2022 Feb;44:101299.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8850322
http://www.ncbi.nlm.nih.gov/pubmed/35198923?tool=bestpractice.com
[11]Dold S, Zimmermann MB, Jukic T, et al. Universal salt iodization provides sufficient dietary iodine to achieve adequate iodine nutrition during the first 1000 days: a cross-sectional multicenter study. J Nutr. 2018 Apr 1;148(4):587-98.
https://www.sciencedirect.com/science/article/pii/S0022316622108102?via%3Dihub
http://www.ncbi.nlm.nih.gov/pubmed/29659964?tool=bestpractice.com
However, iodine intake is still inadequate in some countries and in high-risk individuals, such as pregnant women.[12]Zimmermann MB, Andersson M. Global endocrinology: global perspectives in endocrinology: coverage of iodized salt programs and iodine status in 2020. Eur J Endocrinol. 2021 Jun 10;185(1):R13-21.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8240726
http://www.ncbi.nlm.nih.gov/pubmed/33989173?tool=bestpractice.com
[13]Lazarus JH. The importance of iodine in public health. Environ Geochem Health. 2015 Aug;37(4):605-18.
http://www.ncbi.nlm.nih.gov/pubmed/25663362?tool=bestpractice.com
[14]Caldwell KL, Pan Y, Mortensen ME, et al. Iodine status in pregnant women in the National Children's Study and in US women (15-44 years), National Health and Nutrition Examination Survey 2005-2010. Thyroid. 2013 Aug;23(8):927-37.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3752509
http://www.ncbi.nlm.nih.gov/pubmed/23488982?tool=bestpractice.com
IGN: global scorecard of iodine nutrition 2023
Opens in new window Autoimmune thyroiditis (Hashimoto disease), the most common cause of primary hypothyroidism in iodine-sufficient areas, has been estimated to have a global prevalence of 0.075%, affect women up to nine times as often as men, and have a peak incidence between the ages of 30 and 50 years.[15]Pearce EN, Farwell AP, Braverman LE. Thyroiditis. N Engl J Med. 2003 Jun 26;348(26):2646-55.
http://www.ncbi.nlm.nih.gov/pubmed/12826640?tool=bestpractice.com
[16]Hu X, Chen Y, Shen Y, et al. Global prevalence and epidemiological trends of Hashimoto's thyroiditis in adults: a systematic review and meta-analysis. Front Public Health. 2022 Oct 13;10:1020709.
https://pmc.ncbi.nlm.nih.gov/articles/PMC9608544
http://www.ncbi.nlm.nih.gov/pubmed/36311599?tool=bestpractice.com