From the Guidelines
Hypothyroidism risk factors include female sex, advancing age, white race, type 1 diabetes, Down syndrome, family history of thyroid disease, goiter, previous hyperthyroidism, and external-beam radiation in the head and neck area, as identified in the most recent and highest quality study 1.
Key Risk Factors
- Female sex: Women are at a higher risk of developing hypothyroidism, with a risk 5-8 times higher than men 1.
- Advancing age: The risk of hypothyroidism increases with age, especially after 60 1.
- White race: White individuals are at a higher risk of developing hypothyroidism compared to other racial groups 1.
- Type 1 diabetes: Individuals with type 1 diabetes are at a higher risk of developing hypothyroidism due to shared autoimmune mechanisms 1.
- Down syndrome: Down syndrome is associated with an increased risk of thyroid dysfunction, including hypothyroidism 1.
- Family history of thyroid disease: Having relatives with thyroid or other autoimmune diseases increases the risk of developing hypothyroidism 1.
- Goiter: A history of goiter is a risk factor for hypothyroidism 1.
- Previous hyperthyroidism: Previous hyperthyroidism, possibly due to ablation therapy, can increase the risk of developing hypothyroidism 1.
- External-beam radiation: External-beam radiation in the head and neck area can damage the thyroid gland and increase the risk of hypothyroidism 1.
Additional Considerations
- Autoimmune disorders: Autoimmune disorders, particularly Hashimoto's thyroiditis, are a common cause of hypothyroidism in developed countries 1.
- Pregnancy: Pregnancy can trigger thyroid problems in susceptible women, particularly in the first year postpartum 1.
- Iodine deficiency or excess: Iodine deficiency or excess can increase the risk of hypothyroidism in certain individuals 1.
- Other autoimmune conditions: Other autoimmune conditions, such as celiac disease and rheumatoid arthritis, are associated with an increased risk of hypothyroidism due to shared autoimmune mechanisms 1.
From the Research
Risk Factors for Hypothyroidism
The risk factors for hypothyroidism include:
- Age: The prevalence of hypothyroidism increases with age 2
- Sex: Hypothyroidism is more common in females than in males 2
- Autoimmune thyroid disease: This is the most common etiology of hypothyroidism in the United States 2
- Family history: A family history of thyroid disease may increase the risk of developing hypothyroidism
- Radiation exposure: Radiation therapy to the head and neck area may increase the risk of developing hypothyroidism
- Certain medications: Such as amiodarone, lithium, and immune checkpoint inhibitors 3
- Thyroid surgery: Surgical removal of part or all of the thyroid gland may increase the risk of developing hypothyroidism 3
- Iodine deficiency: Severe iodine deficiency was historically the most common cause of hypothyroidism, although this is now less common in developed countries 3
Special Considerations
Certain groups of people may be at higher risk of developing hypothyroidism, including:
- Pregnant women: Women with hypothyroidism who become pregnant may need to increase their levothyroxine dosage 4
- Older adults: Patients older than 60 years or with known or suspected ischemic heart disease should start at a lower dosage of levothyroxine 4
- Patients with subclinical hypothyroidism: Those with thyroid-stimulating hormone levels greater than 10 mIU per L or elevated thyroid peroxidase antibody titers may be at greater risk of progressing to clinical disease 4, 2