Prevalence of undiagnosed hypothyroidism in Europe: a systematic review and meta-analysis.
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Abstract Background: Patients with undiagnosed hypothyroidism are not treated for the disease and are at high risk of developing serious complications, with major impact on public health. There is a need to systematically review the available evidence on this topic. Objective: To identify the prevalence of undiagnosed hypothyroidism in Europe. Methods: A systematic review of the literature (Medline, EMBASE, and Cochrane Central) was performed to identify epidemiological studies on the prevalence of undiagnosed hypothyroidism among European populations published between January 2008 and April 2018. The Newcastle-Ottawa Scale was used to assess the methodological quality of the included studies. Random-effects meta-analyses were performed to pool estimates of proportions (with 95% confidence intervals [CIs]) of undiagnosed (1) subclinical, (2) overt, and (3) total hypothyroidism. Results: The search returned 15,565 citations (4,526 duplicates). Twenty papers were included in the study. Fourteen and 6 studies were of good and moderate methodological quality, respectively. The results of the meta-analyses were as follows for the prevalence of undiagnosed hypothyroidism: subclinical, 4.11% (95% CI 3.05–5.31%, I2 = 99.32%); overt, 0.65% (95% CI 0.38–0.99%, I2 = 96.67%); and total, 4.70% (95% CI 2.98–6.79%, I2 = 99.53%). According to the sensitivity analysis, the prevalence of hypothyroidism tends to be higher in female patients, in those aged ≥65 years, among studies with lower sample sizes, in those with thyroid-stimulating hormone levels <4.5 mIU/L, and in Eastern and Southern Europe. Conclusions: The current evidence suggests that a considerable proportion of the European population has hypothyroidism, particularly subclinical hypothyroidism, which is undiagnosed. This issue deserves further investigation because of possible deleterious consequences for public health.
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The prevalence of hypothyroidism in North America and Europe ranges from 0.3% to 2%.
“The prevalence in North America and Europe ranges from 0.3%to2%, 3-5 but may affect up to 12% of the population, primarily as subclinical hypothyroidism,withhigherprevalenceinareaswith inadequate nutritional iodine levels. 2,6”
From Hypothyroidism: A Review (2025) · cites this paper as [5]
The Results report a pooled prevalence of 4.70% for total undiagnosed hypothyroidism in Europe, above the claimed 0.3–2% range. The paper does not estimate prevalence in North America; its 0.65% figure applies specifically to undiagnosed overt hypothyroidism, not hypothyroidism overall. (LLM, conf=0.86)
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Seifert, R. (2025) · Springer eBooks · doi:10.1007/978-3-662-70594-0_37
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Borissova, A.-M., Trifonova, B., Dakovska, L. N., & Vukov, M. I. (2025) · Clinical Medicine Research · doi:10.11648/j.cmr.20251403.14
Mishchuk, V. G., Kozinchuk, H. V., Венгрович, О., Shalamai, U. P., & Salyzhyn, T. (2025) · INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine) · doi:10.22141/2224-0721.21.4.2025.1564
The Relationship Between Hypothyroidism and Pneumonia and Possible Prevention and Treatment Measures
Hao, Y., Zheng, H., Xiang, W., Chen, F., & Qiang, G. (2025) · International Journal of General Medicine · doi:10.2147/ijgm.s529705
Undas, K. W., Dąbrowa, J., Natorska, J., Mazur, P. K., Hubalewska–Dydejczyk, A., & Undas, A. (2025) · Journal of Thrombosis and Thrombolysis · doi:10.1007/s11239-025-03180-5
- Authors
- Mendes, D., Alves, C., Silverio, N., & Batel Marques, F.
- Affiliations
- Association for Innovation and Biomedical Research on Light and Image (PT)
- 3Merck S.A., Algés, Portugal
- 1Center for Health Technology Assessment and Drug Research, Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- Venue
- European Thyroid Journal
- Publisher
- Bioscientifica
- Published
- 2019-05-17
- Volume
- 8
- Issue
- 3
- Pages
- 130-143
- ISSN
- 2235-0640 (ISSN-L)
- 2235-0802
- PMC
- PMC6587201
- OpenAlex
- W2945169289
- Cited by
- 113
- References
- 84
- Citations by year
- 2026: 12 · 2025: 24 · 2024: 15 · 2023: 17 · 2022: 12 · 2021: 22 · 2020: 11
- FWCI
- 1.73
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- European Thyroid Journal (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
- Keywords
- undiagnosed hypothyroidism, subclinical hypothyroidism, overt hypothyroidism, thyroid-stimulating hormone, thyroid screening
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