Pathak Namita*, Kothiyal Preeti, Dr. Prashant Mathur
Department of Clinical Pharmacy,
Shri Guru Ram Rai Institute of Technology and Sciences,
Dehradun, Uttarakhand, India, 248001
The prevalence of hypothyroidism is three times higher among women than men. The prevalence in an unselected community population of young, middle aged and elderly individuals is about 1.4 percent and the estimated annual incidence rate is one to two per 1,000 women. Surveys of geriatric populations have yielded estimated prevalence rates for overt hypothyroidism of 0.2 percent to 3 percent. The presentation of symptoms in the elderly may be atypical or absent. The prevalence of subclinical hypothyroidism is estimated to be between 4.0–8.5% of the adult US population without known thyroid disease, and the prevalence increases with age. Up to 20% of women over the age of 60 are estimated to have subclinical hypothyroidism. Caucasians are more likely to have subclinical hypothyroidism than non-Caucasians. The risk is highest in those with type I diabetes mellitus, a family history of thyroid disease or head/neck cancers treated with external beam radiation. Other risk factors include previous radioactive iodine treatment or thyroid surgery. Interestingly, about 20% of patients on thyroid medications are both over replaced and under replaced. Because of the high incidence of thyroid disease, The American Thyroid Association recommends measuring thyroid function on all adults beginning at age 35 years and every 5 years thereafter noting that more frequent screening may be appropriate in high risk groups. The treatment of subclinical hypothyroidism has been controversial but more recent data suggest there are increased risks of ischemic heart disease in untreated patients and that a more aggressive approach to treat ment would be appropriate.7 In contrast, subclinical hyperthyroidism has more well understood risks of atrial fibrillation and flutter and so should be more aggressively treated.