ECEESPE2025 Poster Presentations Thyroid (141 abstracts)
Natural course of subclinical hyperthyroidism in primary care in the netherlands
Stan Ursem 1 , Wendy den Elzen 2 , Jesse van den Berg 3 , Anita Boelen 1 , Petra Elders 4 , Raymond Noordam 5 & Annemieke C Heijboer 1
1Amsterdam UMC, Endocrine Laboratory, Laboratory Medicine, Amsterdam, Netherlands; 2Amsterdam UMC, Laboratory of Specialized Diagnostics & Research, Laboratory Medicine, Amsterdam, Netherlands; 3Pharmo Institute, Utrecht, Netherlands; 4Amsterdam UMC, General Practice, Amsterdam, Netherlands; 5Leiden University Medical Center, Internal Medicine, Section Gerontology and Geriatrics, Leiden, Netherlands
JOINT773
Background: Subclinical hyperthyroidism (SHT) is characterized by a suppressed thyroid-stimulating hormone (TSH) concentration with normal free thyroxine (FT4) levels. While SHT has potential health implications, the epidemiology and contributing factors for its natural course and guideline adherence in primary care remain unclear.
Objectives: To investigate the incidence and natural course of SHT in primary care and assess guideline adherence to follow-up recommendations within Dutch primary care.
Methods: Using a retrospective cohort design, we analyzed data from the PHARMO General Practitioner database in the Netherlands (2012 to 2021). Patients with biochemically confirmed SHT were followed to assess progression to hyperthyroidism, recovery, or persistence. Adherence to the Dutch primary care guideline on SHT management was evaluated.
Results: The annual incidence of SHT was approximately 200 cases per 100,000 person-years, with a temporary increase in 2016-2017 coinciding with a national thyroid medication shortage. Among the 11,163 patients with SHT, 47% recovered, 11% persisted, and 8% progressed to overt hyperthyroidism over a median follow-up of five years. Female sex and baseline TSH <0.1 mU/l were associated with higher progression rates (1,69 (CI 1,32 - 2,17) and 2,36 (CI 1,97 - 2,83), respectively). Guideline adherence evaluation showed 33% received follow-up TSH measurement within six months, and 4% underwent TSH receptor antibody testing.
Conclusion: This study highlights that a small subset of SHT patients progresses to overt hyperthyroidism. Significant contributing factors of progression included lower TSH at baseline and female sex. In addition, our findings indicate a need for improved guideline adherence in follow-up and diagnostic testing.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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