A prevalência do hipotireoidismo evidente na população geral varia entre 0.2% e 5.3% na Europa.[5]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
Estima-se que a incidência de hipotireoidismo primário no Reino Unido seja de 0.41% por ano nas mulheres e de 0.06% por ano nos homens.[6]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
A National Health and Nutrition Examination Survey (NHANES; pesquisa nacional de avaliação da saúde e nutrição) nos EUA sugere que a prevalência de hipotireoidismo primário evidente e hipotireoidismo subclínico é de 0.3% e 4.3%, respectivamente, com base em dados de 1988-1994.[7]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
Dados mais recentes da NHANES de 2009-2012 estimaram a prevalência de hipotireoidismo evidente em 2.1%, usando dados laboratoriais.[8]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
A prevalência de hipotireoidismo manifesto e subclínico é maior em pessoas brancas (5.1%) que em pessoas negras (1.7%) ou em hispânicos (4.2%).[7]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
A prevalência de hipotireoidismo é maior nas mulheres e aumenta com a idade.[5]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
Ela varia de 4% em mulheres com 18 a 24 anos a 21% em mulheres com 74 anos ou mais, e de 3% a 16% em homens nas mesmas faixas etárias.[9]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
As diferenças no estado do iodo afetam a prevalência do hipotireoidismo, pois tanto a deficiência grave de iodo quanto o excesso de iodo podem causar hipotireoidismo.[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
Esforços globais para adicionar iodo ao sal diminuíram a magnitude desse problema.[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
No entanto, a ingestão de iodo ainda é inadequada em alguns países e em indivíduos de alto risco, como gestantes.[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.
https://www.doi.org/10.1007/s10653-015-9681-4
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 A tireoidite autoimune (doença de Hashimoto), a causa mais comum de hipotireoidismo primário em áreas com ingestão insuficiente de iodo, teve a prevalência global estimada em 0.075%, afeta mulheres até nove vezes mais do que homens, e tem pico de incidência entre 30 e 50 anos de idade.[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