Therapeutic errors associated with thyroid medications in non-healthcare facility settings reported to United States poison centers, 2000–2024

Purpose To investigate the characteristics and trends of therapeutic errors involving thyroid medications in non-healthcare facility settings reported to United States (US) poison centers. Methods National Poison Data System data from 2000 to 2024 were retrospectively analyzed and population-based rates were calculated. Results There were 89,614 reported thyroid medication therapeutic error-related exposures in non-healthcare facility settings from 2000 to 2024, including medications used to treat hypothyroidism ( n = 85,030, 95%) and hyperthyroidism ( n = 4,584, 5%). Most (97%) exposures did not receive healthcare facility treatment. The annual rate per 100,000 US population of therapeutic errors increased by 263% from 0.51 in 2000 to 1.85 in 2024. Females accounted for more than two-thirds of exposures, as did adults 40 years and older. Therapeutic errors involving liothyronine were more likely to be associated with a medical admission (OR: 5.15, 95% CI: 2.80–9.48) or a moderate or major effect (OR: 10.53, 95% CI: 7.27–15.27) than those involving other medications used to treat hypothyroidism. Compared with therapeutic errors involving acute or acute-on-chronic exposures, chronic exposures were more likely to be associated with a medical admission (OR: 6.28, 95% CI: 4.24–9.28) or a moderate or major effect (OR: 15.33, 95% CI: 12.00-19.59) for medications used to treat hypothyroidism, and similarly, a medical admission (OR: 8.84, 95% CI: 1.09–71.71) or a moderate or major effect (OR: 15.37, 95% CI: 4.28–55.21) for medications used to treat hyperthyroidism. Conclusion Therapeutic errors involving thyroid medications have been increasing, although most clinical outcomes are not severe. Increased prevention efforts should be considered for higher-risk subgroups.