Hypothyroidism prevalence in the United States: a retrospective study combining National Health and Nutrition Examination Survey and claims data, 2009-2019.

Wyne, Kathleen L; Nair, Lekshmi; Schneiderman, Chris P; Pinsky, Brett; Antunez Flores, Oscar; Guo, Dianlin; Barger, Bruce; Tessnow, Alexander H

doi:10.1210/jendso/bvac172

Cited by 111Thyroid Disorders and TreatmentsThyroid and Parathyroid SurgeryThyroid Cancer Diagnosis and Treatment

Hypothyroidism prevalence in the United States: a retrospective study combining National Health and Nutrition Examination Survey and claims data, 2009-2019.

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Wyne, Kathleen L, Nair, Lekshmi, Schneiderman, Chris P, Pinsky, Brett, Antunez Flores, Oscar, Guo, Dianlin, Barger, Bruce, Tessnow, Alexander H·2022·Journal of the Endocrine Society

DOI 10.1210/jendso/bvac172PMC PMC9706417

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Abstract

Previous estimates determined prevalence of hypothyroidism (HT) to be 4.6% of the US population. This study aimed to update estimates of HT prevalence in the United States by retrospective analysis of 2 datasets. Data on HT type (overt or subclinical HT) and treatment were collected from the 2009-2010 and 2011-2012 National Health and Nutrition Examination Survey (NHANES) cycles. From the Optum administrative claims database, medical and pharmacy claims were collected between January 1, 2012, and December 31, 2019. Patients were defined as having HT if, per given year, they had >1 prescription for HT treatment, >1 claim indicating an HT diagnosis, or thyroid-stimulating hormone levels >4.0 mIU/L (NHANES arm). For both studies, treatment was defined as any evidence of synthetic or natural thyroid hormone replacement, identified by pharmacy claims or patient surveys. Data are reported as percentage of patients with HT and treatments received. Between 2009 and 2012, HT prevalence remained around 9.6% of the US population. The administrative claims dataset showed that HT prevalence grew from 9.5% in 2012 to 11.7% in 2019 and that >78% of patients received thyroxine (T4) monotherapy. Similarly, the NHANES dataset showed that T4 replacement therapy was the most common treatment for HT. From 2012-2019, patients with untreated HT grew from 11.8% to 14.4%. The prevalence of HT in the United States has steadily increased since 2009. Likewise, the percentage of hypothyroid-diagnosed patients not receiving treatment also increased, suggesting that the increased prevalence may be due to increased cases of subclinical HT.

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Hypothyroidism is more frequent in Asian and White individuals compared with Black individuals.
“Hypothyroidism is more frequent in Asian and White individuals compared with Black individuals, 21,22 whichmaybeduetoenvironmentalfactors(eg,areas with inadequate nutritional iodine levels), genetic factors, or both ( Box ). 22-25”
From Hypothyroidism: A Review (2025) · cites this paper as [21]
Results, Table 2 (page not available), reports overall hypothyroidism in 12.4% of non-Hispanic White individuals versus 3.4% of non-Hispanic Black individuals. The paper groups other racial categories as “Other” and does not report a separate prevalence for Asian individuals, so it cannot establish that comparison. (LLM, conf=0.88)
Experimental — accuracy not yet measured
Prevalence of hypothyroidism in the USA increased from 9.5% in 2012 to 11.7% in 2019, with over 78% receiving LT4 alone.
“prevalence in the USA increased from 9.5% (2012) to 11.7% (2019), with over 78% receiving LT4 alone (9)”
From Designing a combined liothyronine (LT3), L- thyroxine (LT4) trial in symptomatic hypothyroid subjects on LT4 - the importance of patient selection, choice of LT3 and trial design (2023) · cites this paper as [9]

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FRI514 Treatment Of Hypothyroidism By Age And Sex In The United States: A National Health And Nutrition Examination Survey (NHANES) And Optum Claims Data Analysis
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Treatment of Hypothyroidism by Age and Sex in the United States: A NHANES and Optum Claims Data Analysis
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Serum TSH and Total T 4 in the United States Population and Their Association With Participant Characteristics: National Health and Nutrition Examination Survey (NHANES 1999–2002)
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Hypothyroidism Prevalence in Children Aged 0 to 17 Years in the United States: A Real-World Study Using 2 National Claims Databases, 2013-2022
Conrad, D., Bianco, A. C., Bauer, A. J., Gregg, B., Josefson, J. L., SHAH, A. S., Trivedi, S., Huisingh, C., Mantis, S., Flores, O. A., et al. (2026) · Endocrine Practice · doi:10.1016/j.eprac.2026.08.003

Authors: Wyne, K. L., Nair, L., Schneiderman, C. P., Pinsky, B., Antunez Flores, O., Guo, D., Barger, B., & Tessnow, A. H.
Affiliations: The Ohio State University Wexner Medical Center (US)
AbbVie (United States) (US)
AbbVie, Inc. , Chicago, IL , USA
Division of Endocrinology, Diabetes, and Metabolism, University of Texas Southwestern Medical Center , Dallas, TX , USA
ORCID: Wyne, Kathleen L
Nair, Lekshmi
Schneiderman, Chris P
Guo, Dianlin
Tessnow, Alexander H
Venue: Journal of the Endocrine Society
Publisher: The Endocrine Society
Published: 2022-11-10
Volume: 7
Issue: 1
Pages: bvac172-bvac172
ISSN: 2472-1972 (ISSN-L)
DOI: 10.1210/jendso/bvac172
PMC: PMC9706417
OpenAlex: W4308881891
Cited by: 111
References: 28
Citations by year: 2026: 28 · 2025: 34 · 2024: 34 · 2023: 15
FWCI: 15.38
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by-nc-nd
creativecommons.org/licenses/by-nc-nd/4.0/ (vor)
Locations: Journal of the Endocrine Society (publishedVersion, cc-by-nc-nd)
PubMed Central (publishedVersion, cc-by-nc-nd)
PubMed (publishedVersion)
Funders: AbbVie
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: hypothyroidism, prevalence, subclinical hypothyroidism, overt hypothyroidism, thyroid hormone replacement, levothyroxine monotherapy, untreated hypothyroidism, thyroid-stimulating hormone, United States

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Hypothyroidism prevalence in the United States: a retrospective study combining National Health and Nutrition Examination Survey and claims data, 2009-2019.

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