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Epidemiology

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Hashimoto's thyroiditis disorder is thought to be the most common cause of primary hypothyroidism in North America. Within person, place, and time descriptive trends of epidemiology, it becomes more clear on how Hashimoto's thyroiditis develops in and impacts differing populations.

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Overall, Hashimoto's thyroiditis affects up to 2% of the general population. [1]About 5% of Caucasians will develop Hashimoto's at some point in their lives. In the U.S., it affects fewer African-Americans, but is linked to greater mortality in the African-American population. It is also less frequent in Asian populations. About 1.0 to 1.5 in 1000 people have this disease at any time.

It occurs between 8 and 15 times more often in women than in men. Some research suggests a connection to the role of the placenta as an explanation for the sex difference. Though it may occur at any age, including in children, it is most often observed in women between 30 and 60 years of age. The highest prevalence from one study was found in the elderly members of the community. [2]

Those that already have an autoimmune disease are at greater risk of developing Hashimoto's as the diseases generally coexist with each other. [1] Common diseases seen coexisting with Hashimoto's include celiac disease, multiple sclerosis, type 1 diabetes, vitiligo, and rheumatoid arthritis.

Congenital hypothyroidism affects 1 in 3500-4000 newborns at birth and is a version of mental retardation that can be treated if caught early, but can be hard to diagnose given that symptoms are minimal at a young age. [2] Congenital hypothyroidism is generally caused by defects of the thyroid gland, but for most cases in Europe, Asia, and Africa, the iodine intake can cause hypothyroidism in newborns.

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Diets consisting of low or high iodine intake determine a population's risk of developing thyroid-related disorders.[3] It is more common in regions of high iodine dietary intake, and among people who are genetically susceptible. Geography plays a large role in which regions have access to diets with low or high iodine. Iodine levels in both water and salt should be heavily monitored in order to protect at-risk populations from developing hypothyroidism.[4]

Geographic trends of hypothyroidism vary across the world as different places have different ways of defining disease and reporting cases. Populations that are spread out or defined poorly may skew data in unexpected ways.[1]

Iodine Deficiency Disorder (IDD) is combated using an increase in iodine in a person's diet. When a dramatic change occurs in a person's diet, they become more at-risk of developing hypothyroidism and other thyroid disorders. Combatting IDD with high salt intakes should be done carefully and cautiously as risk for Hashimoto's may increase.[3] If making modifications to one's diet, it is important to use a clinician's discretion to ensure that the dietary changes are the best option as recommendations can vary person to person.

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The secular trends of hypothyroidism reveal how the disease has changed over the course of time given changes in technology and treatment options. Even though ultrasound technology and treatment options have improved, the incidence of hypothyroidism has increased according to data focused on the US and Europe. Between 1993 and 2001, per 1000 women, the disease was found varying between 3.9 and 4.89. Between 1994 and 2001, per 1000 men, the disease increased from 0.65 to 1.01. [2]

Changes in the definition of hypothyroidism and treatment options modify the incidence and prevalence of the disease overall. Treatment using levothyroxine is individualized, and therefore allows the disease to be more manageable with time but does not work as a cure for the disease.[1]

References

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  1. ^ a b c d Chistiakov, Dimitry A. (2005-03-11). "Immunogenetics of Hashimoto's thyroiditis". Journal of Autoimmune Diseases. 2 (1): 1. doi:10.1186/1740-2557-2-1. ISSN 1740-2557. PMC 555850. PMID 15762980.{{cite journal}}: CS1 maint: PMC format (link) CS1 maint: unflagged free DOI (link) Cite error: The named reference ":2" was defined multiple times with different content (see the help page).
  2. ^ a b c Vanderpump, M. P. J. (2011-09-01). "The epidemiology of thyroid disease". British Medical Bulletin. 99 (1): 39–51. doi:10.1093/bmb/ldr030. ISSN 0007-1420.
  3. ^ a b Khattak, Rehman Mehmood; Ittermann, Till; Nauck, Matthias; Below, Harald; Völzke, Henry (2016-11-08). "Monitoring the prevalence of thyroid disorders in the adult population of Northeast Germany". Population Health Metrics. 14 (1): 39. doi:10.1186/s12963-016-0111-3. ISSN 1478-7954. PMC 5101821. PMID 27833458.{{cite journal}}: CS1 maint: PMC format (link) CS1 maint: unflagged free DOI (link)
  4. ^ Katagiri, Ryoko; Yuan, Xiaoyi; Kobayashi, Satomi; Sasaki, Satoshi (2017-03-10). "Effect of excess iodine intake on thyroid diseases in different populations: A systematic review and meta-analyses including observational studies". PLoS ONE. 12 (3): e0173722. doi:10.1371/journal.pone.0173722. ISSN 1932-6203. PMC 5345857. PMID 28282437.{{cite journal}}: CS1 maint: unflagged free DOI (link)