Hypothyroidism — DVA SoP factors

Reasonable Hypothesis (RH) — Statement of Principles No. 3 of 2022

At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting hypothyroidism or death from hypothyroidism with the circumstances of a person's relevant service:

1. (1)
   having iodine deficiency within the 6 months before the clinical onset of hypothyroidism;

   Note: iodine deficiency is defined in the Schedule 1 - Dictionary.

2. (2)
   having iodine excess within the 6 months before the clinical onset of hypothyroidism;

   Note: Iodine excess may be due to consuming foods, dietary supplements or medications with a high content of iodine.

   Note: iodine excess is defined in the Schedule 1 - Dictionary.

3. (3)
   being administered an iodine-containing radiographic contrast agent within the 6 months before the clinical onset of hypothyroidism;
4. (4)
   taking a drug from the specified list of drugs within the 6 months before the clinical onset of hypothyroidism;

   Note: specified list of drugs is defined in the Schedule 1 - Dictionary.

5. (5)
   taking minocycline for at least 6 months within the 9 months before the clinical onset of hypothyroidism;
6. (6)
   taking a drug containing at least 10 milligrams of iodine daily for a continuous period of at least 4 weeks within the 6 months before the clinical onset of hypothyroidism;
7. (7)
   taking amiodarone for a continuous period of at least 2 weeks within the 1 year before the clinical onset of hypothyroidism;
8. (8)
   being pregnant or within the 12 months postpartum at the time of the clinical onset of hypothyroidism;
9. (9)
   having a form of thyroiditis from the specified list of forms of thyroiditis at the time of the clinical onset of hypothyroidism;

   Note: specified list of forms of thyroiditis is defined in the Schedule 1 - Dictionary.

10. (10)
    undergoing a course of therapeutic radiation for cancer, where the thyroid gland was in the field of radiation, before the clinical onset of hypothyroidism;
11. (11)
    having received iodine-131 (radioactive iodine) treatment before the clinical onset of hypothyroidism;
12. (12)
    having subtotal or total thyroidectomy, or neck surgery involving the thyroid gland, before the clinical onset of hypothyroidism;
13. (13)
    having a disease involving the thyroid gland from the specified list of diseases at the time of the clinical onset of hypothyroidism;

    Note: specified list of diseases is defined in the Schedule 1 - Dictionary.

14. (14)
    having a primary or secondary malignant neoplasm of the thyroid gland at the time of the clinical onset of hypothyroidism;
15. (15)
    having a type 3 deiodinase-overexpressing neoplasm before the clinical onset of hypothyroidism;
16. (16)
    having hypopituitarism involving deficiency of thyroid-stimulating hormone at the time of the clinical onset of hypothyroidism;
17. (17)
    having chronic kidney disease at the time of the clinical onset of hypothyroidism;

    Note: chronic kidney disease is defined in the Schedule 1 - Dictionary.

18. (18)
    having hepatitis C virus infection at the time of the clinical onset of hypothyroidism;
19. (19)
    being obese for at least 5 years before the clinical onset of hypothyroidism;

    Note: being obese is defined in the Schedule 1 - Dictionary.

20. (20)
    having posttraumatic stress disorder at the time of the clinical onset of hypothyroidism;
21. (21)
    for hypothyroidism first presenting as myxoedema coma only, having an acute precipitating event within the 48 hours before the clinical onset of hypothyroidism;

    Note: acute precipitating event and myxoedema coma are defined in the Schedule 1 - Dictionary.

22. (22)
    having iodine deficiency within the 6 months before the clinical worsening of hypothyroidism;

    Note: iodine deficiency is defined in the Schedule 1 - Dictionary.

23. (23)
    having iodine excess within the 6 months before the clinical worsening of hypothyroidism;

    Note: Iodine excess may be due to consuming foods, dietary supplements or medications with a high content of iodine.

    Note: iodine excess is defined in the Schedule 1 - Dictionary.

24. (24)
    being administered an iodine-containing radiographic contrast agent within the 6 months before the clinical worsening of hypothyroidism;
25. (25)
    taking a drug from the specified list of drugs within the 6 months before the clinical worsening of hypothyroidism;

    Note: specified list of drugs is defined in the Schedule 1 - Dictionary.

26. (26)
    taking minocycline for at least 6 months within the 9 months before the clinical worsening of hypothyroidism;
27. (27)
    taking a drug containing at least 10 milligrams of iodine daily for a continuous period of at least 4 weeks within the 6 months before the clinical worsening of hypothyroidism;
28. (28)
    taking amiodarone for a continuous period of at least 2 weeks within the 1 year before the clinical worsening of hypothyroidism;
29. (29)
    taking a drug that increases the requirement of thyroid hormone replacement therapy at the time of the clinical worsening of hypothyroidism;

    Note: Examples of drugs that may increase the requirement for thyroid hormone replacement therapy include 5-fluorouracil, antiretroviral drugs, clofibrate, raloxifene and tamoxifen.

30. (30)
    being pregnant or within the 12 months postpartum at the time of the clinical worsening of hypothyroidism;
31. (31)
    having a form of thyroiditis from the specified list of forms of thyroiditis at the time of the clinical worsening of hypothyroidism;

    Note: specified list of forms of thyroiditis is defined in the Schedule 1 - Dictionary.

32. (32)
    undergoing a course of therapeutic radiation for cancer, where the thyroid gland was in the field of radiation, before the clinical worsening of hypothyroidism;
33. (33)
    having received iodine-131 (radioactive iodine) treatment before the clinical worsening of hypothyroidism;
34. (34)
    having subtotal or total thyroidectomy, or neck surgery involving the thyroid gland, before the clinical worsening of hypothyroidism;
35. (35)
    having a disease involving the thyroid gland from the specified list of diseases at the time of the clinical worsening of hypothyroidism;

    Note: specified list of diseases is defined in the Schedule 1 - Dictionary.

36. (36)
    having a primary or secondary malignant neoplasm of the thyroid gland at the time of the clinical worsening of hypothyroidism;
37. (37)
    having a type 3 deiodinase-overexpressing neoplasm before the clinical worsening of hypothyroidism;
38. (38)
    having hypopituitarism involving deficiency of thyroid-stimulating hormone at the time of the clinical worsening of hypothyroidism;
39. (39)
    having chronic kidney disease at the time of the clinical worsening of hypothyroidism;

    Note: chronic kidney disease is defined in the Schedule 1 - Dictionary.

40. (40)
    having hepatitis C virus infection at the time of the clinical worsening of hypothyroidism;
41. (41)
    being obese for at least 5 years before the clinical worsening of hypothyroidism;

    Note: being obese is defined in the Schedule 1 - Dictionary.

42. (42)
    having posttraumatic stress disorder at the time of the clinical worsening of hypothyroidism;
43. (43)
    for myxoedema coma only, having an acute precipitating event within the 48 hours before that clinical worsening of hypothyroidism;

    Note: acute precipitating event and myxoedema coma are defined in the Schedule 1 - Dictionary.

44. (44)
    inability to obtain appropriate clinical management for hypothyroidism;

Aggravation-only factors: the factors in subsections 9(22) to 9(44) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.