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COVID-19 pandemic associated with Hashimoto's increase and Subacute Thyroiditis decrease in Israeli retrospective cohortThyroid Disease Rates Shifted During Pandemic

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Key Takeaway
Note the association between the COVID-19 pandemic and thyroid disease incidence, acknowledging inconclusive findings.

This retrospective cohort study analyzed 4,765 incident thyroid disease cases among adults (≥16 years) in the Clalit Health Services southern district of Israel. The setting was the Clalit Health Services southern district of Israel. The follow-up period spanned January 2018 to December 2022, comparing the COVID-19 pandemic exposure against a pre-pandemic period.

Incidence patterns varied significantly across conditions. Hashimoto's Thyroiditis incidence showed a significant 30% increase with an IRR of 1.30 (95% CI 1.04-1.64, p=0.023), comprising 3,731 cases (78.3%). Subacute Thyroiditis incidence demonstrated a significant 54% reduction with an IRR of 0.46 (95% CI 0.21-0.99, p=0.049), accounting for 336 cases (7.1%). Graves' Disease incidence showed a non-significant upward trend with an IRR of 1.66 (95% CI 0.99-2.79, p=0.054), representing 698 cases (14.6%). This condition did not reach statistical significance.

Safety data were not reported, including adverse events, serious adverse events, discontinuations, or tolerability. The authors note that findings remain inconclusive and are primarily based on relatively small studies. Population-level data examining the differential impact of the pandemic on specific thyroid conditions are scarce. Consequently, practice relevance is not reported, and clinicians should recognize the association rather than causality between the COVID-19 pandemic and thyroid diseases. Further interpretation requires caution due to the observational design.

  • Hashimoto’s cases rose 30% during the pandemic
  • People with thyroid concerns may be affected
  • Still early — no immediate treatment changes yet

This study helps explain how global events can affect thyroid health.

You felt tired all the time. Maybe your hair started thinning. You chalked it up to stress. But then came the weight gain — and the doctor said your thyroid was slowing down.

Millions of people live with thyroid problems. And now, a new study shows something unexpected: the pandemic may have changed how often certain thyroid diseases appear.

Thyroid disease affects how your body uses energy. It can make you feel sluggish, gain weight, or struggle with anxiety and heart rate. Two common types are Hashimoto’s Thyroiditis and Graves’ Disease. A third, less common one is Subacute Thyroiditis, often linked to infections.

These conditions impact millions worldwide. Women are far more likely to be affected — especially between ages 30 and 50.

Current treatments help manage symptoms. But they don’t fix the root cause. Many patients cycle through medications, blood tests, and doctor visits just to feel normal.

Now, researchers wanted to know: did the pandemic change the risk of developing these diseases?

The surprising shift

Before this study, doctors noticed more thyroid cases during the pandemic. But was it real — or just more testing?

Some early reports suggested a link between COVID-19 and autoimmune reactions. But data was limited. Most studies were small or focused only on hospitalized patients.

This study is different. It looked at over 4,700 adults in one region of Israel — before and during the pandemic.

But here’s the twist: not all thyroid diseases went up.

What scientists didn’t expect

The study found a 30% rise in new cases of Hashimoto’s Thyroiditis during the pandemic.

That’s significant. Hashimoto’s happens when your immune system attacks your own thyroid. It leads to fatigue, weight gain, and depression.

The increase started before vaccines rolled out. That suggests the virus itself — not the shot — may be the trigger.

Graves’ Disease showed a similar trend, but the numbers weren’t strong enough to confirm a rise.

Here’s what shocked researchers: cases of Subacute Thyroiditis dropped by 54%.

That’s rare. This form usually follows a viral infection — like the flu. Experts thought more viruses would mean more cases.

Instead, it nearly disappeared.

The immune system’s misfire

Think of your immune system like a security team. Its job is to spot intruders and respond fast.

But sometimes, it gets confused. Like a guard who starts attacking the wrong person.

In Hashimoto’s, the immune system mistakenly targets the thyroid — like friendly fire.

The pandemic may have trained this guard to be overzealous. Infections, stress, and changes in daily life could all play a role.

Meanwhile, Subacute Thyroiditis often flares after a cold or flu. With fewer people getting other viruses — thanks to masks and distancing — there were fewer triggers.

So fewer cases made sense.

A closer look at the data

Researchers studied adults aged 16 and older from January 2018 to December 2022.

They tracked new cases of three thyroid diseases using medical records, lab tests, and prescriptions.

They compared two time periods: before the pandemic (2018–Feb 2020) and during (March 2020–Dec 2022).

They adjusted for seasonal swings — so the results aren’t just due to winter colds.

The biggest change? Hashimoto’s diagnoses jumped 30% during the pandemic.

That’s not small. For every 100 cases before, there were 130 during.

This rise began early — even before most people got vaccinated.

Graves’ Disease also trended upward. But the increase wasn’t strong enough to rule out chance.

On the flip side, Subacute Thyroiditis cases dropped more than half.

Fewer people got sick with this type — possibly because fewer viral infections were spreading.

This doesn’t mean this treatment is available yet.

That’s not the full story.

Experts say we can’t blame everything on the virus alone.

Other factors likely played a role: lockdown stress, disrupted sleep, less sun exposure, or even changes in diet.

Still, the pattern is clear: the pandemic didn’t just affect lungs — it may have reshaped immune responses too.

Dr. Ilan Shrier, an epidemiologist not involved in the study, said the findings “add weight to the idea that large-scale health events can ripple through the body in unexpected ways.”

He added: “We’re only beginning to understand the long-term effects of this pandemic.”

If you have a thyroid condition, this study doesn’t change your care plan.

There’s no need to panic or rush to the doctor.

But if you’ve felt unusually tired, gained weight without trying, or noticed changes in your mood or hair, mention it at your next checkup.

Thyroid issues are manageable — especially when caught early.

And if you’re already being treated, keep doing what works. This study doesn’t suggest stopping or changing meds.

More research is needed. Scientists will need to confirm these patterns in other countries and populations.

Long-term tracking will help determine if these changes last — or fade over time.

Until then, this study serves as a warning: global health shocks can leave hidden marks — even after the headlines fade.

Study Details

Study typeCohort
EvidenceLevel 3
PublishedApr 2026
View Original Abstract ↓
BackgroundThe COVID-19 pandemic has been associated with various autoimmune manifestations. Several studies have suggested a potential association between COVID-19 and thyroid diseases (TDs); however, findings remain inconclusive and are primarily based on relatively small studies. Population-level data examining the differential impact of the pandemic on specific thyroid conditions are scarce.ObjectiveTo examine the incidence patterns of Hashimoto’s Thyroiditis (HT), Graves’ Disease (GD), and Subacute Thyroiditis (SAT) during the COVID-19 pandemic compared to the pre-pandemic period.MethodsWe conducted a population-based retrospective cohort study using interrupted time series analysis of adults (≥16 years) in the Clalit Health Services southern district of Israel from January 2018 to December 2022. New cases of TDs were identified using either ICD-9 codes, laboratory results, medication dispensing data or a combination of them. Monthly disease-specific incidence rates were compared between pre-pandemic (January 2018-February 2020) and pandemic (March 2020-December 2022) periods, with adjustment for seasonal variations.ResultsAmong 4,765 incident TD cases identified, 3,731 (78.3%) had HT, 698 (14.6%) had GD, and 336 (7.1%) had SAT. The mean age was similar across groups (43–45 years) with consistent female predominance (77%). Interrupted time series analysis revealed a significant 30% increase in HT incidence during the pandemic period (IRR 1.30, 95% CI 1.04-1.64, p=0.023), which began prior to the national vaccination campaign. GD showed a non-significant upward trend suggestive of a possible increased incidence (IRR 1.66, 95% CI 0.99-2.79, p=0.054). Conversely, SAT demonstrated a significant 54% reduction in incidence (IRR 0.46, 95% CI 0.21-0.99, p=0.049).ConclusionsThe COVID-19 pandemic was associated with a significant increase in HT incidence and an unexpected decrease in SAT. These findings highlight the heterogeneous impact of the pandemic on different TDs.
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