The Incidence and Prevalence of Thyroid Dysfunction in Europe: A Meta-Analysis
Abstract
CONTEXT: Thyroid dysfunction is one of the leading endocrine disorders. Previous data show that about half of the population with thyroid dysfunction remains undiagnosed. OBJECTIVE: Our objective was to estimate epidemiologic data on thyroid dysfunction in Europe. DATA SOURCES: PubMed, EMBASE, and SCOPUS databases were searched to identify studies that evaluated the prevalence and/or incidence of thyroid dysfunction in Europe published between 1975 and 2012. STUDY SELECTION: Of the 541 identified abstracts examined, 178 were considered for evaluation and 17 were included. Studies were excluded if they included participants with an underlying disease or were limited by age or gender. DATA EXTRACTION: Results were grouped into 3 categories: 1) prevalence of undiagnosed thyroid dysfunction, 2) prevalence of thyroid dysfunction, and 3) incidence of thyroid dysfunction. Extraction was conducted independently by 2 investigators. DATA SYNTHESIS: An empirical Bayesian random-effects model was used. The prevalence of undiagnosed thyroid dysfunction was assessed in 7 studies with a mean result of 6.71% (95% credibility interval, 6.49%-6.93%): 4.94% (4.75%-5.13%) and 1.72% (1.66%-1.88%) for undiagnosed hypothyroidism and hyperthyroidism, respectively. The prevalence of both previously diagnosed and undiagnosed thyroid dysfunction was assessed in 9 studies with a mean result of 3.82% (3.77%-3.86%): 3.05% (3.01%-3.09%) and 0.75% (0.73%-0.77%) for hypothyroidism and hyperthyroidism, respectively. The incidence rate of thyroid dysfunction was assessed in 7 studies with a mean result of 259.12 (254.39-263.9) per 100 000 per year: 226.2 (222.26-230.17) and 51 (49.23-52.88) per 100 000 per year for hypothyroidism and hyperthyroidism, respectively. CONCLUSION: This meta-analysis provides extensive data on the prevalence and incidence of thyroid dysfunction in Europe.
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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 [3]
The “Prevalence of thyroid dysfunction” section reports hypothyroidism prevalence of 3.05% in Europe, above the claimed 2% upper bound. The Discussion also reports unknown hypothyroidism in 4.6% of a U.S. sample. The paper does not support a 0.3%–2% range for hypothyroidism across North America and Europe. (LLM, conf=0.88)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredPrimary hypothyroidism has a female:male ratio of approximately 5:1.
“Primary hypothyroidism has a female:male ratio of approximately5:1. 3”
From Hypothyroidism: A Review (2025) · cites this paper as [3]
The Incidence of thyroid dysfunction section reports hypothyroidism rates of 369.96 per 100,000 per year in females and 72.48 in males, approximately a 5:1 ratio. The paper reports this for hypothyroidism in Europe but does not specify that the ratio applies to primary hypothyroidism. (LLM, conf=0.87)
Experimental — accuracy not yet measuredUndiagnosed thyroid disease may be common among the general population.
“There is less of a consensus regarding screening of the population for undiagnosed thyroid disease, which may be common among the general population.”
From Challenges in Interpreting Thyroid Stimulating Hormone Results in the Diagnosis of Thyroid Dysfunction (2019) · cites this paper as [5]
A meta-analysis of studies from Europe found a prevalence of undiagnosed hyperthyroidism of about 2%.
“A meta-analysis of studies from Europe found a high prevalence of undiagnosed hypothyroidism of about 5% and of undiagnosed hyperthyroidism of about 2% [5].”
From Challenges in Interpreting Thyroid Stimulating Hormone Results in the Diagnosis of Thyroid Dysfunction (2019) · cites this paper as [5]
A meta-analysis of studies from Europe found a prevalence of undiagnosed hypothyroidism of about 5%.
“A meta-analysis of studies from Europe found a high prevalence of undiagnosed hypothyroidism of about 5% and of undiagnosed hyperthyroidism of about 2% [5].”
From Challenges in Interpreting Thyroid Stimulating Hormone Results in the Diagnosis of Thyroid Dysfunction (2019) · cites this paper as [5]
Similar rates have been reported in studies from Europe, with higher levels in women and older subjects.
“Similar rates have been reported in studies from Europe, with higher levels in women and older subjects (366,367).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [366]
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- Authors
- Garmendia Madariaga, A., Santos Palacios, S., Guillén-Grima, F., & Galofré, J. C.
- Affiliations
- Departments of Endocrinology and Nutrition (A.G.M., S.S.P., J.C.G.), 31008 Pamplona, Spain
- Preventive Medicine (F.G.-G.), Clínica Universidad de Navarra, University of Navarra, 31008 Pamplona, Spain
- Corresponding author
- Galofré, Juan C.
- ORCID
- Galofré, Juan C.
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2014-03-01
- Volume
- 99
- Issue
- 3
- Pages
- 923-931
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2148501322
- Cited by
- 800
- References
- 13
- Citations by year
- 2026: 58 · 2025: 84 · 2024: 93 · 2023: 105 · 2022: 120 · 2021: 94 · 2020: 66 · 2019: 70 · 2018: 56 · 2017: 31 · 2016: 11 · 2015: 6 · 2014: 5
- FWCI
- 2.81
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Universidad de Navarra
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Keywords
- thyroid dysfunction, hypothyroidism, hyperthyroidism, prevalence, incidence, Europe, thyroid screening
- MeSH terms
- Adult, Child, Europe, Female, Humans, Hyperthyroidism, Hypothyroidism, Male, Pregnancy, Pregnancy Complications, Thyroid Diseases, Thyroid Function Tests, Incidence, Prevalence, Delayed Diagnosis
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