Thiyagarajan, Arulmani

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Thiyagarajan, Arulmani
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arulmani.thiyagarajan@gmail.com
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Scopus Author ID
57208205338

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    Item type:Publication,
    Trends in the use of thyroid diagnostics and treatment in Germany: analyses based on the German Pharmacoepidemiological Research Database
    (2026-09-08)
    Thiyagarajan, Arulmani
    ;
    Zeeb, Hajo
    ;
    Riedel, Oliver
    ;
    Haug, Ulrike
    Thyroid disorders are common in Germany due to the low natural occurrence of iodine in the soil. Besides the environmental factor, Germany’s reunification history and the subsequent health-policy changes on the prevention of thyroid disorders have also influenced the prevalence of thyroid disorders. This, in turn, may have impacted on the corresponding use of thyroid diagnostics and treatments. However, data (particularly population-based data) in these areas remain extremely limited. Therefore, using data from the so-called German Pharmacoepidemiological Research Database (GePaRD), which covers approximately 20% of the German population, this dissertation examines the trends in the use of thyroid diagnostics and treatments in Germany. Specifically, it estimates the annual prevalence of thyroid diagnostics and treatments, investigates the regional differences in the use of thyroid-stimulating hormone (TSH) measurement and levothyroxine, and describes the epidemiology of thyroid storm (a rare and life-threatening thyroid disorder) in Germany. Findings from this dissertation suggest a continued decline in the prevalence of clinically significant thyroid disorders in Germany between 2008 and 2019, potentially reflecting the long-term effectiveness of an iodine fortification program that was implemented since 1993. Furthermore, the marked increase and substantial regional variations in TSH measurement and levothyroxine use support the hypothesis of overdiagnosis and overtreatment. These patterns are unlikely to be explained by regional differences in the prevalence of clinically significant thyroid disorders, warranting further investigation.
    doctoral thesis
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