Diagnosis and Characterization of Thyroid Dysfunction in Patients Evaluated in Primary Care in a Rural Zone of Honduras.

BACKGROUND: Thyroid disorders are prevalent and frequently underdiagnosed in primary care, particularly in resource-limited rural areas. Their nonspecific symptoms complicate early recognition and treatment. This study aimed to determine the prevalence of thyroid dysfunction and describe the clinical reasoning, diagnostic strategies, and laboratory findings among adults evaluated with TSH testing in rural Honduras. METHODS: A retrospective, descriptive, cross-sectional study was conducted at Hospital Loma de Luz in Balfate, Honduras. Adult patients aged ≥18 years who underwent diagnostic TSH testing between January 1, 2022, and January 31, 2023, were included. Patients with prior thyroid diagnoses or current pregnancy were excluded. Data on demographics, symptoms, comorbidities, and labs were collected from electronic records and analyzed using SPSS v26. RESULTS: Of 310 patients initially screened for suspected thyroid dysfunction, 185 met inclusion criteria. Thyroid dysfunction was present in 16.8 % of patients: 11.3 % had hypothyroidism and 5.4 % had hyperthyroidism. The majority of cases were women (83.9 %) aged 18-59. Common symptoms included fatigue (61.3 %), palpitations (48.4 %), and neck enlargement (25.8 %). Comorbidities included hypertension (32.3 %), diabetes (22.6 %), autoimmune diseases (12.9 %), and depression (9.7 %). Only 3.2 % had complete thyroid panels (TSH, T4L, and T3T). CONCLUSION: Thyroid dysfunction was found in nearly one in six adults evaluated with TSH in rural primary care. Female sex, vague symptoms, and autoimmune disease were frequently associated. Reflex T4L testing could improve diagnostic efficiency and facilitate earlier treatment.