Public knowledge of thyroid disorders in the West Bank, Palestine: pregnancy and medication-related safety gaps in a cross-sectional study

Background: Thyroid disorders are common and often under-recognized. Evidence on public thyroid health literacy in Palestine is limited. This study assessed public knowledge of thyroid disorders among adults in the West Bank, Palestine. Methods: A cross-sectional online survey was conducted from May 1 to August 1, 2025, among adults (≥18 years) residing in the West Bank. Participants with current or prior health-professional training or employment in healthcare were excluded. Non-probability convenience sampling was used through social media distribution (Facebook, WhatsApp, Telegram). Knowledge was assessed using a 17-item multiple-choice instrument covering risk factors (7 items), clinical manifestations (7 items), and preventive behaviors (3 items). Correct responses were scored as 1 and incorrect/"I don't know" as 0; knowledge levels were categorized as low (<50%), moderate (50-75%), and high (>75%). Data were analyzed using descriptive statistics, chi-square tests, and ordinal logistic regression. Results: A total of 1,119 participants were included (71.3% women, 75.0% university-educated). Mean knowledge score was 8.60/17 (50.6%); 56.7% had low knowledge, 26.3% moderate, and 17.1% high. Risk-factor knowledge was lowest (mean 2.97/7; 42.4%), while prevention-related knowledge was comparatively higher (mean 2.03/3; 67.7%). Notable gaps were observed for medication-related risks (amiodarone 9.7%; lithium 11.0%) and pregnancy/postpartum risk (41.7%). In adjusted analyses, higher knowledge was associated with age >50 years (aOR 1.71), while lower knowledge was associated with male sex (aOR 0.70) and no formal education versus university education (aOR 0.26). Conclusion: Public knowledge of thyroid disorders in the West Bank was generally low, with the most pronounced deficits related to pregnancy and the postpartum period and to medication associated thyroid dysfunction. These findings support targeted, low cost health education integrated into routine primary care, maternal and reproductive health services, and community pharmacy counseling, with future studies needed to evaluate effects on timely care seeking and safer medication practices.