Clinical Presentation of Hypothyroidism in a Primary Care Cohort: An Exploratory Analysis of Gender Differences

Objective: To describe patient-reported symptoms of hypothyroidism in a primary care cohort and perform an exploratory assessment of potential gender differences. Methods: This retrospective observational study included 1000 patients with confirmed hypothyroidism treated at the Public Institution Health Care Centre Visoko between January and October 2024. Data were extracted from electronic medical records. Collected variables included age, gender, comorbidities, family history, pregnancy status, and reported symptoms. Descriptive statistics were performed for the entire cohort. Exploratory logistic regression analyses were used to assess potential gender differences in reported symptoms. Results: The cohort comprised 921 (92.1%) female and 79 (7.9%) male patients, with a mean age of 57±14.6 years. The most commonly reported symptoms were hyperhidrosis (97%), fatigue (96.6%), and heart palpitations (83.5%). Male patients showed a higher likelihood of reporting heart palpitations (OR 2.42, p=0.03) and bowel problems (OR 2.03, p=0.01), and a lower likelihood of reporting neck tightness (OR 0.26, p<0.001) and tearfulness (OR 0.045, p<0.001). Conclusion: In this primary care cohort, the reported symptom burden was largely nonspecific and reflects real-world patient-reported complaints rather than classical manifestations of overt hypothyroidism. Exploratory analyses suggested potential gender-related differences; however, the low number of male patients limits firm conclusions. Larger prospective studies are needed to confirm these observations.