Current Practices in Hashimoto’s Thyroiditis: Differences in Attitudes Between Pediatric and Adult Endocrinologists in Türkiye: A National Survey

Objective: This study aimed to assess the clinical practices and attitudes towards Hashimoto’s thyroiditis (HT) among pediatric (PEs) and adult endocrinologists (AEs).

Methods: The members of Turkish Society for Pediatric Endocrinology and Diabetes (n=502) and the Society of Endocrinology and Metabolism of Türkiye (n=910) were invited to participate in an online survey.

Results: Of the respondents (n=168), 72.6% (n=122) were PEs and 27.3% (n=46) were AEs. The response rate was 24% among PEs and only 5% among AEs. Respondents median age was 41 years. The use of “only thyroid peroxidase autoantibodies” was preferred more frequently by AEs (28.3%) than by PEs (4.1%) (p=0.002). The rate of informing patient/parents at the time of diagnosis that HT lasts a lifetime was 91.3% for AEs and 62.3% for PEs (p=0.001). The rate of beginning treatment in euthyroid cases with goiter was significantly higher in PEs (26.2%) compared to AEs (4.3%) (p=0.017). Among AEs, 71.7% stated that they would never stop treatment, while among PEs, 33.6% did (p<0.001). Moreover, 44% of PEs stated that they would attempt treatment discontinuation in euthyroid patients at the end of puberty. The rate of those who were undecided about selenium supplementation was higher amongst PEs (41%) than among AEs (21.7%) (p=0.007). Although none of the PEs recommended gluten restriction, 6.5% of the AEs indicated that they would recommend gluten-free diet even without Celiac disease (p=0.015).

Conclusion: There are significant differences between PEs and AEs encompassing aspects of diagnosis, treatment and nutritional supplementation in HT.