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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.
Open accessAbstract
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, 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]
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“prevalence in the USA increased from 9.5% (2012) to 11.7% (2019), with over 78% receiving LT4 alone (9)”
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InfluentialPremawardhana, L. D., Taylor, P. N., Okosieme, O. E., Adlan, M. A., Obuobie, E. K., & Dayan, C. M. (2023) · Frontiers in Endocrinology · doi:10.3389/fendo.2023.1282608 · Cited by 6
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Dementia Due to Other Medical Conditions
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Mbuyi, J., Bhana, S., & Daya, R. (2024) · Journal of Endocrinology Metabolism and Diabetes of South Africa · doi:10.1080/16089677.2024.2392977 · Cited by 2
8188 Pituitary hyperplasia resulting from primary hypothyroidism: A case report
Aziz, M., Manolas, M. I., Tabatabaie, V., & Rincón, L. (2024) · Journal of the Endocrine Society · doi:10.1210/jendso/bvae163.1304
Ali, Z., Abdulridha, M. K., & Alzajaji, Q. B. (2024) · Al Mustansiriyah Journal of Pharmaceutical Sciences · doi:10.32947/ajps.v24i4.1089
Deng, Z., Davison, K., Cartier, M. S., MacNeil, A., & Fuller‐Thomson, E. (2025) · Archives of Gerontology and Geriatrics Plus · doi:10.1016/j.aggp.2025.100129
Namulanda, G., Condon, S. K., Palmer, T. L., Ellis, E., Yip, F. Y., Reh, C. M., & Breysse, P. N. (2025) · Environmental Epidemiology · doi:10.1097/ee9.0000000000000368
“Some health outcomes, e.g., thyroid diseases, may be better identified using both diagnosis codes and prescription information, 56 while others, e.g., hyperlipidemia, hypercholesterolemia, and high tri-glycerides, may be best captured using laboratory test results in addition to diagnosis codes or…”
Kashul, S. V., & Хухліна, О. С. (2025) · Reports of Vinnytsia National Medical University · doi:10.31393/reports-vnmedical-2025-29(1)-10 · Cited by 1
Chen, Y., Wildman, B., Rehan, M., Mishra, S., Khan, S., Afreen, L. H., & Hassan, Q. (2025) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2025.04.14.647401
Violante-Ortiz, R., Fernández-Ordóñez, N., Gallifa, E. N., Molina, E. E. H., Cárdenas, J. E. G., Reyna‐Beltrán, E., Hernández, D. C., Martínez, L. S. D., Grijalva, I. N. B., & Sánchez, J. M. B. (2025) · Cureus · doi:10.7759/cureus.82923
“In the United States, the Third National Health and Nutrition Examination Survey (NHANES III) reported a prevalence of 4.3% [4], although more recent studies indicate lower rates due to variations in study methodology [5].”
InfluentialHoermann, R., & Dietrich, J. W. (2025) · Springer eBooks · doi:10.1007/978-981-96-3682-2_1
Patterns of Inequity in the Diagnosis and Treatment of Hypothyroidism
Brenta, G. (2025) · Clinical Thyroidology · doi:10.1089/ct.2025;37.204-207
Weitzner, Y., Xu, P., Jain, A., Spirollari, E., Vazquez, S. M., Subah, G., Sacknovitz, A., Alsaeed, R., Elmashad, A., Ramakrishnan, P., et al. (2025) · Interventional Neuroradiology · doi:10.1177/15910199251341379
Tabakoğlu, N. T., Ay, A., Alkanlı, N., & Çelik, M. (2025) · Current Issues in Molecular Biology · doi:10.3390/cimb47100794
Cosmo, C. D., Pignata, L., Bagattini, B., Agretti, P., Marco, G. D., Ferrarini, E., Santini, F., Montanelli, L., & Tonacchera, M. (2025) · Journal of Endocrinological Investigation · doi:10.1007/s40618-025-02718-x
Kretli-Souza, D., Gomes, B. H., Selvatici‐Tolentino, L., Damasceno, Y. O., Peixoto-Dias, A. F., Iost, A. F., Oliveira, L. B. F., Brunetto, E. L., Guarnieri, L. D. O., Garcia, R. A. P., et al. (2025) · American Journal of Physiology-Renal Physiology · doi:10.1152/ajprenal.00241.2025
Hypothyroidism and Degenerative Spine Disease: A Literature Review
Murugan, V., Chu, T., Ali, M. M., & Akbik, O. S. (2025) · The Journal of Spinal Surgery · doi:10.4103/joss.joss_24_25
POYRAZER, M., Mühürdaroğlu, A. M., Çelik, M. E., Gökbulut, P., & Fırat, S. N. (2025) · doi:10.2196/preprints.90401
Naran, P., Daya, R., Roux, M., & Bayat, Z. (2026) · Journal of Endocrinology Metabolism and Diabetes of South Africa · doi:10.1080/16089677.2025.2590258
Chandrupatla, S. R., Rumalla, K. C., & Singh, J. A. (2026) · Journal of Experimental Orthopaedics · doi:10.1002/jeo2.70413
“The prevalence of hypothyroidism is increasing in the United States, and its treatment success may be decreasing [45].”
InfluentialRoh, M., Yum, S., Joo, G., Jang, J., & Im, H. (2026) · Frontiers in Public Health · doi:10.3389/fpubh.2026.1747762
Wen, J., Hu, J., & Zou, G. (2026) · Journal of Diabetes & Metabolic Disorders · doi:10.1007/s40200-026-01931-6
Trager, R. J., Makineni, P. S., & Wright, D. S. (2026) · Health Science Reports · doi:10.1002/hsr2.72161
“%) is corroborated by data from 2019, which similarly found that 76.2% of patients with AT were female [4].”
InfluentialCurrent status of hypothyroidism control in Guangzhou area, China: a cross-sectional survey
Chen, B., Wang, S., Huang, Y.-L., Liu, D., Chen, R., Zhang, H., Wang, W., Zhou, Q., Lie, L., Ran, J., et al. (2026) · BMC Endocrine Disorders · doi:10.1186/s12902-026-02214-0
“The prevalence of hypothyroidism in the United States increased from 9.5% in 2012 to 11.7% in 2019, indicating a steady rise in the prevalence of hypothyroidism [3].”
InfluentialHasani, M. A., Salman, R. D., & Shari, F. H. (2026) · European Journal of Clinical and Experimental Medicine · doi:10.15584/ejcem.2026.1.22
Distribution of Outpatient Visits Among Adults With Hypothyroidism: NAMCS 2010-2019
Ramírez, M., Bianco, A. C., Laiteerapong, N., & Ettleson, M. D. (2026) · AACE Endocrinology and Diabetes · doi:10.1016/j.aed.2026.04.005
Defining Features of Gabriele‐de Vries Syndrome in Adults: A Case Report and Literature Review
Hollingsworth, E. W., & Xiao, C. (2026) · American Journal of Medical Genetics Part A · doi:10.1002/ajmg.a.70179
“(Wyne et al. 2022); heart malformations (0.97”
InfluentialТимуровна, С. Ш., & Inoyatova, N. A. (2023) · Eurasian Scientific and Medical Journal Sino · doi:10.54538/2707-5265-2023-4-4-25-31
Liu, M. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-21917-7.00027-6
Fanciulli, G., Baldazzi, G., Manfrini, I., Pagani, A., Tessari, M., & Zamboni, P. (2026) · Phlebology The Journal of Venous Disease · doi:10.1177/02683555261458150
Metadata
- 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
- 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)
- 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
- 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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