Incidence of thyroid diseases: Results from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Sgarbi, José Augusto; Janovsky, Carolina Castro Porto Silva; Pittito, Bianca Almeida; Diniz, Maria de Fátima Haueisen Sander; Almeida, Maria da Conceição Chagas de; Alvim, Sheila; Barreto, Sandhi Maria; Giatti, Luana; Duncan, Bruce Bartholow; Schmidt, María Inês; Fonseca, Maria de Jesus Mendes da; Griep, Rosane Härter; Molina, María del Carmen Bisi; Mill, José Geraldo; Goulart, Alessandra Carvalho; Lotufo, Paulo A

doi:10.20945/2359-3997000000348

Cited by 3 publications

(2 citation statements)

References 43 publications

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“…Primary hypothyroidism is a frequent disorder worldwide ( 1 ). According to the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), the yearly incidences of overt and subclinical hypothyroidism in Brazil are about 0.5% and 1%, respectively ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

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Approach to adult patients with primary hypothyroidism in some special situations: a position statement from the Thyroid Department of the Brazilian Society of Endocrinology and Metabolism (SBEM)

Mazeto

Sgarbi

Ramos

et al. 2022

Archives of Endocrinology and Metabolism

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Primary hypothyroidism is a common disorder in clinical practice. The management of most cases of hypothyroidism is usually straightforward, but the best approach in some special situations may raise questions among physicians. This position statement was prepared by experts from the Brazilian Society of Endocrinology and Metabolism to guide the management of three special situations, namely, hypothyroidism in the elderly, subclinical hypothyroidism in patients with heart disease, and difficult-to-control hypothyroidism. The authors prepared the present statement after conducting a search on the databases MEDLINE/PubMed, LILACS, and SciELO and selecting articles with the best evidence quality addressing the selected situations. The statement presents information about the current approach to patients in these special situations.

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Section: Introductionmentioning

confidence: 99%

“…The incidence of hypothyroidism increases with age ( 2 ). This observation is particularly important considering the progressively increasing number and proportion of elderly individuals worldwide and a projected elderly population of about 1.4 billion individuals in 2030 ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

Approach to adult patients with primary hypothyroidism in some special situations: a position statement from the Thyroid Department of the Brazilian Society of Endocrinology and Metabolism (SBEM)

Mazeto

Sgarbi

Ramos

et al. 2022

Archives of Endocrinology and Metabolism

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Use of thyroid hormones in hypothyroid and euthyroid patients: a 2022 THESIS questionnaire survey of members of the Latin American Thyroid Society (LATS)

Cassemiro,

Ilera,

Batalles

et al. 2023

Thyroid Res

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Purpose Inconsistencies in the medical management of hypothyroidism have been reported between endocrinologists in different countries. This study aimed to identify the attitudes of Latin America thyroid specialists towards the use of thyroid hormones. Methods Online survey of members of the Latin America Thyroid Society. Results 81/446 (18.2%) completed the questionnaire. Levothyroxine (LT4) was the initial treatment of choice for all respondents. 56.8% would consider LT4 use in biochemically euthyroid patients: infertile women with elevated anti-thyroid antibodies (46.9%), resistant depression (17.3%) and growing goiter (12%). Most respondents preferred tablets (39.5%) over liquid formulations (21.0%) or soft gel capsules (22.2%) and would not consider switching formulations in patients with persistent symptoms. 39.5% would never use LT4 + liothyronine (LT3) combination therapy in symptomatic euthyroid patients, due to low quality evidence for benefit. 60.5% reported that persistence of symptoms despite normal TSH is rare (below 5% of patients) and its prevalence has been stable over the last five years. Psychosocial factors (84.0%), comorbidities (86.4%) and the patient unrealistic expectation (72.8%) were considered the top three explanations for this phenomenon. Conclusion LT4 tablets is the treatment of choice for hypothyroidism. A significant proportion of respondents would use LT4 in some groups of euthyroid individuals, contrasting the recommendations of the major clinical practice guideline indications. LT4 + LT3 combination treatment in euthyroid symptomatic patients was considered by nearly 50%. Practices based on weak or absent evidence included use of thyroid hormones for euthyroid subjects by 56.8% of respondents and use of LT4 + LT3 treatment by 60.5% of respondents for patients with persistent symptoms. In contrast to many European countries, LATS respondents report a low and unchanged proportion of dissatisfied patients over the last five years.

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Gut microbiota short-chain fatty acids and their impact on the host thyroid function and diseases

Mendoza-León,

Mangalam,

Regaldiz

et al. 2023

Front. Endocrinol.

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Thyroid disorders are clinically characterized by alterations of L-3,5,3’,5’-tetraiodothyronine (T4), L-3,5,3’-triiodothyronine (T3), and/or thyroid-stimulating hormone (TSH) levels in the blood. The most frequent thyroid disorders are hypothyroidism, hyperthyroidism, and hypothyroxinemia. These conditions affect cell differentiation, function, and metabolism. It has been reported that 40% of the world’s population suffers from some type of thyroid disorder and that several factors increase susceptibility to these diseases. Among them are iodine intake, environmental contamination, smoking, certain drugs, and genetic factors. Recently, the intestinal microbiota, composed of more than trillions of microbes, has emerged as a critical player in human health, and dysbiosis has been linked to thyroid diseases. The intestinal microbiota can affect host physiology by producing metabolites derived from dietary fiber, such as short-chain fatty acids (SCFAs). SCFAs have local actions in the intestine and can affect the central nervous system and immune system. Modulation of SCFAs-producing bacteria has also been connected to metabolic diseases, such as obesity and diabetes. In this review, we discuss how alterations in the production of SCFAs due to dysbiosis in patients could be related to thyroid disorders. The studies reviewed here may be of significant interest to endocrinology researchers and medical practitioners.

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Incidence of thyroid diseases: Results from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Cited by 3 publications

References 43 publications

Approach to adult patients with primary hypothyroidism in some special situations: a position statement from the Thyroid Department of the Brazilian Society of Endocrinology and Metabolism (SBEM)

Approach to adult patients with primary hypothyroidism in some special situations: a position statement from the Thyroid Department of the Brazilian Society of Endocrinology and Metabolism (SBEM)

Use of thyroid hormones in hypothyroid and euthyroid patients: a 2022 THESIS questionnaire survey of members of the Latin American Thyroid Society (LATS)

Gut microbiota short-chain fatty acids and their impact on the host thyroid function and diseases

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