Prevalence of hypothyroidism in the elderly in Germany. A pilot study

In 2579 senior German citizens studied in nursing homes and in- and outpatient clinics overt hypothyroidism was found in only 1%. This figure is clearly lower than that reported for Great Britain, New Zealand and North America (2-3%). Subclinical primary hypothyroidism on the other hand was detected in almost 4% on the basis of an exaggerated TSH response to TRH. Measurement of the basal TSH levels did not significantly increase the diagnostic sensitivity for hypothyroidism, since among the 768 subjects screened by primary TRH test only 16 of the 29 cases classified as subclinical hypothyroidism had a slightly elevated basal TSH. Basal TSH was elevated in only 2.4% of the cases. Again this figure is lower than that found in other countries (6-14%). In view of the low prevalence of subjects with overt hypothyroidism who would benefit from subsequent treatment, a large scale screening program can be recommended only with reserve for the federal republic of Germany.