Thyroid conditions and life insurance

Usually nothing happens

Of everything in this section, this condition is the most likely to have no effect at all on an application.

Underactive thyroid treated with replacement medication is extremely common. When bloodwork shows the level in range, it routinely results in standard rates. Underwriters see it constantly. It is well understood, and it is well managed.

People with thyroid conditions often worry about disclosing them. They are then surprised at how little happens. This page exists mainly to say so plainly, and to cover the few situations that are different.

Underactive thyroid

Hypothyroidism is the medical name for an underactive thyroid. It includes cases caused by Hashimoto’s thyroiditis. It is managed with daily replacement medication and checked with bloodwork from time to time.

What an underwriter looks for is simply whether it is controlled. TSH stands for thyroid stimulating hormone. It is the standard blood test for thyroid function. A TSH within the expected range, on a stable dose, checked from time to time, describes a managed condition. For most applicants, that is the end of the assessment.

Being on medication is not a negative here, and never has been. It is the treatment working as intended.

Two things attract a little more attention. One is a dose that has needed frequent adjustment, which suggests instability. The other is levels that stay outside range despite treatment.

Hashimoto’s is autoimmune. Where it appears alongside other autoimmune conditions, the underwriter reads the combination rather than the thyroid alone. See lupus, rheumatoid arthritis and IBD.

Overactive thyroid

Hyperthyroidism is the medical name for an overactive thyroid, and it includes Graves’ disease. It gets a closer look than the underactive form. The reason is the heart.

Untreated or poorly controlled hyperthyroidism is linked with heart rhythm problems, atrial fibrillation in particular. It is also linked with effects on bone and general health. Underwriters take an interest in whether any of that has occurred.

Where it has been treated and resolved, the assessment is usually straightforward. That holds whether the treatment was medication, radioactive iodine or surgery. Many people end up hypothyroid after treatment. They are then managed on replacement medication, which puts them back in the ordinary category above.

If hyperthyroidism did cause atrial fibrillation, that is assessed on its own terms. Having a clearly identified and treated cause is usually helpful there. See atrial fibrillation.

Graves’ eye disease, where present, is noted. It is not usually a significant factor in a life insurance assessment.

Nodules

Thyroid nodules are common, and the great majority are benign (not cancerous).

Underwriters want to know whether the nodule was investigated, and what was found. Say a nodule was scanned and biopsied, the result was benign, and it is checked from time to time. That is a small matter.

A nodule that has not been investigated is different, because the underwriter cannot tell what it is. Sometimes a nodule is still being investigated and results are pending. Then a postponement (a request to apply again later) until the results are in is a common and reasonable outcome.

Thyroid cancer

This is assessed as a cancer rather than as a thyroid condition. It is among the more favourably assessed cancers.

The factors are those in life insurance after cancer. They are the type, the stage, the treatment, the time since it ended, and the follow-up since. Many thyroid cancers are found early and treated with success. Waiting periods are often shorter than for other cancers.

Ongoing thyroid hormone suppression therapy after treatment is common. It is usually not a problem in itself.

Disclose it

Yes, even though it will probably change nothing.

Applications ask whether you have been diagnosed with or treated for any condition. They also ask whether you take any medication. A thyroid condition on replacement medication engages both questions.

It also cannot really be left out. Prescription history shows the medication. Bloodwork at a paramedical may show thyroid levels. A gap between the application and the record is a much bigger problem than the condition. The condition itself is likely to be no problem at all. See leaving something off the application.

Applying

Say which condition you have and when it was diagnosed. Say what you take and at what dose. Say roughly when your levels were last checked and whether they were in range. Say whether any nodules have been found and investigated.

That is usually all it takes. For most applicants this is one line in the file and nothing more.

The boundary

This page describes underwriting. It is not information about thyroid conditions, medication or monitoring. Nothing here is a recommendation about your treatment. Your doctor owns that.