Hypothyroidism is the most common hormone deficiency among the general population and is predominantly managed in the primary care (PC) setting1. Large epidemiological studies have shown that the approximate prevalence of hypothyroidism in the general population ranges from 2% to 10%, that it is more common in women and that its incidence increases with age2, 3. A recent Spanish study using PC registries found that 4.2% of men and 13.3% of women had hypothyroidism and that these percentages increased to 5.6–8.8% and 12.5–14.2%, respectively, in men and women over the age of 60 years4.

Hypothyroidism is generally considered easy to manage, and levothyroxine is well tolerated5. However, even though the benefits of hormone replacement therapy for hypothyroidism are irrefutable, poor disease control, whether due to deficient or excess levothyroxine, is a common clinical issue6. Overtreatment with levothyroxine, which manifests as a fall in serum thyroid-stimulating hormone (TSH) levels, increases the risk of cardiovascular disease and fractures7. In contrast, undertreatment, which manifests as elevated TSH levels, is associated with a greater risk of dyslipidaemia and ischaemic heart disease8. Both scenarios result in more medical appointments and complementary tests and, therefore, greater healthcare costs.

Even though most hypothyroid patients are diagnosed and treated by their GPs, information about the management of hypothyroidism in the Spanish PC setting is very scarce. In fact, clinical guidelines of this hormone deficiency in family medicine journals are rare9 and, to date, only one survey on the management of hypothyroidism by primary care doctors has been published10. The aims of this study were: 1) to find what primary care doctors think about hypothyroidism as a health problem; and 2) to analyse their educational and research needs in this medical field.