Diagnosis and Management of Hypothyroidism in Gulf Cooperation Council (GCC) Countries.
Ali S Alzahrani, Mourad Al Mourad, Kevin Hafez, Abdulrahman M Almaghamsy, Fahad Abdulrahman Alamri, Nasser R Al Juhani, Alhussien Sagr Alhazmi, Mohammad Yahya Saeedi, Saud Alsefri, Musa Daif Allah Alzahrani, Nadia Al Ali, Wiam I Hussein, Mohamed Ismail, Ahmed Adel, Hisham El Bahtimy, Eslam Abdelhamid
Author Information
Ali S Alzahrani: King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. aliz@kfshrc.edu.sa.
Mourad Al Mourad: Scientific Committee to the General Directorate for Control of Genetic and Chronic Diseases, Assistant Agency for Preventive Medicine, Ministry of Health, Riyadh, Saudi Arabia.
Kevin Hafez: Dr Soliman Fakeeh Hospital, Jeddah, Saudi Arabia.
Abdulrahman M Almaghamsy: Dr Soliman Fakeeh Hospital, Jeddah, Saudi Arabia.
Fahad Abdulrahman Alamri: Director General for Clinical Health Education and Promotion, Ministry of Health, Riyadh, Saudi Arabia.
Nasser R Al Juhani: Department of Internal Medicine, East Jeddah Hospital, Jeddah, Saudi Arabia.
Alhussien Sagr Alhazmi: Department of Obstetrics, Gynaecology and Infertility, King Saud Medical City, Riyadh, Saudi Arabia.
Mohammad Yahya Saeedi: College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Saud Alsefri: Taif University, Taif, Saudi Arabia.
Musa Daif Allah Alzahrani: Unit of Pediatric Endocrinology and Diabetes, Children's Hospital, King Saud Medical City, Riyadh, Saudi Arabia.
Nadia Al Ali: Unit of Endocrinology and Metabolism, Amiri Hospital, Ministry of Health, Kuwait City, Kuwait.
Wiam I Hussein: Royal Bahrain Hospital, Manama, Bahrain.
Mohamed Ismail: Al Ain Hospital, Al Ain City, United Arab Emirates.
Ahmed Adel: Merck Serono, Jeddah, Saudi Arabia.
Hisham El Bahtimy: Merck Serono Middle East FZ LLC, Dubai, United Arab Emirates.
Eslam Abdelhamid: Merck Serono Middle East FZ LLC, Dubai, United Arab Emirates.
Hypothyroidism is one of the most common chronic endocrine conditions. However, as symptoms of hypothyroidism are non-specific, up to 60% of those with thyroid dysfunction are unaware of their condition. Left untreated, hypothyroidism may contribute to other chronic health conditions. In the Arabian Gulf States, hypothyroidism is thought to be common, but is underdiagnosed, and management approaches vary. An advisory board of leading Saudi endocrinologists and policy advisers was convened to discuss and formulate recommendations for the diagnosis and management of hypothyroidism in Saudi Arabia based on their clinical expertise. The final document was shared with leading endocrinologists from the other Gulf Cooperation Council (GCC) and aconsensus report was generated and summerized in this article. While there is no consensus regarding population screening of hypothyroidism, current recommendations suggest screening patients with risk factors, including those with a history of head or neck irradiation, a family history of thyroid disease or pharmacological treatment that may affect thyroid function. Evidence from a cross-sectional study in Saudi Arabia suggests screening the elderly (> 60 years), at least in the primary care setting. In Saudi Arabia, the incidence of congenital hypothyroidism is approximately 1 in every 3450 newborns. Saudi nationwide population prevalence data are lacking, but a single-centre study estimated that the prevalence of subclinical hypothyroidism in the primary care setting was 10%. Prevalence rates were higher in other cross-sectional studies exclusively in women (13-35%). The recommendations included in this article aim to streamline the diagnosis and clinical management of hypothyroidism in the GCC, especially in the primary care setting, with the intention of improving treatment outcomes. Further study on the incidence, prevalence and risk factors for, and clinical features of, hypothyroidism in the GCC countries is required.
