A prevalência do hipotireoidismo evidente na população geral varia entre 0.2% e 5.3% na Europa.[4]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.[5]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
Nos EUA, a prevalência de hipotireoidismo primário manifesto é de 0.3% e do hipotireoidismo subclínico é de 4.3%.[6]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 manifesto e subclínico é maior em pessoas brancas (5.1%) que em pessoas negras (1.7%) ou em hispânicos (4.2%).[6]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.[4]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 para 21% em mulheres com 74 anos ou mais, e de 3% a 16% em homens nas mesmas faixas etárias.[7]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, Bianco AC, Jonklaas J, et al. Hypothyroidism. Lancet. 2017 Sep 23;390(10101):1550-62.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6619426
http://www.ncbi.nlm.nih.gov/pubmed/28336049?tool=bestpractice.com
A deficiência de iodo é a principal causa de hipotireoidismo no mundo todo.[8]American Association of Clinical Endocrinologists; American Thyroid Association. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocr Pract. 2012 Nov-Dec;18(6):988-1028.
https://www.endocrinepractice.org/article/S1530-891X(20)43030-7/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/23246686?tool=bestpractice.com
Embora seja menos comum no mundo desenvolvido, a ingestão de iodo é inadequada em alguns países europeus, incluindo Alemanha, Noruega e Finlândia.[9]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
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 baixa em muitos países e em indivíduos de alto risco, como gestantes.[12]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
[13]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 in 2021
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