JMIR Publications

ABSTRACT

Background:

Hypothyroidism affects approximately 5% of the global population. While YouTube has emerged as a dominant health information platform, the specific network dynamics and information flow regarding chronic thyroid disease remain largely unexplored in digital health research.

Objective:

The objective of this study was to conduct a comprehensive infodemiological analysis of hypothyroidism content on YouTube, evaluating temporal trends, network structures, and audience sentiment across different creator categories.

Methods:

We identified 331 hypothyroidism-related YouTube videos (2015-2025). For creator-type comparisons, we excluded 18 videos from channels with unknown creator classification, yielding a filtered dataset of 313 videos (medical n=251; influencer n=62). Descriptive analyses used the full dataset (N=331), whereas inferential comparisons used the filtered dataset (n=313).The methodology integrated engagement analytics, The Valence Aware Dictionary and sEntiment Reasoner(VADER) sentiment analysis (validated via manual coding, κ=0.87), and social network analysis using NetworkX to construct bipartite graphs of the information ecosystem. Statistical comparisons were performed using Mann-Whitney U tests and Cohen d effect sizes.

Results:

Medical channels dominated content production (80.2%). Despite numerical differences in raw metrics, medical and influencer content demonstrated equivalent engagement rates (2.24% vs 2.36%; P=.31; d=-0.091), suggesting that engagement quality is independent of creator credentials. The COVID-19 pandemic catalyzed a 234% increase in content volume, resulting in a sustained elevation of post-pandemic engagement (2.47% vs 1.70% pre-pandemic). Network analysis revealed distinct structural models: medical networks followed a distributed expertise model (density=0.0151), whereas influencer networks utilized hub-centric approaches (density=0.0368). Sentiment analyses included 40,260 comments in the full dataset; creator-type stratified analyses included 38,495 comments after excluding unknown channels. Overall sentiment was predominantly positive (47.3%), though mean sentiment scores significantly declined from pre-pandemic optimism (0.270) to post-pandemic skepticism (0.183). Key information hubs identified included Dr. Westin Childs (medical centrality=0.189) and Fit Tuber (8.1M subscribers).

Conclusions:

This study demonstrates that engagement quality in thyroid health communication transcends traditional creator credentials. The pandemic has permanently transformed digital health consumption patterns, establishing YouTube as a resilient resource for chronic disease information while challenging prevailing assumptions regarding the dominance of health misinformation.