Clinical Thyroidology for the Public summarizes selected research studies discussed in the previous month’s issue of Clinical Thyroidology, an official publication of the American Thyroid Association. Editor-in-chief, Alan Farwell, MD, FACE

Volume 15 Issue 1

January is Thyroid Awareness Month

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Clinical Thyroidology for the Public Volume 15 Issue 1 (PDF file, 2.55 MB)



Can thyroid hormone levels help us recognize which patients with COVID-19 will have more severe disease in the hospital?

COVID-19 mostly affects the respiratory system, but many patients also develop changes in thyroid function tests known as non-thyroidal illness syndrome (NTIS). This study was designed to evaluate thyroid hormone levels and presence of NTIS in patients admitted with COVID-19 and to investigate whether thyroid hormone levels were associated with pro-inflammatory markers and COVID-19 severity and death rate.
Beltrão FEL et al 2021 Thyroid hormone levels during hospital admission inform disease severity and mortality in COVID-19 patients. Thyroid. Epub 2021 Sep 9. PMID: 34314259.

Comparison of levothyroxine, desiccated thyroid extract, and combination levothyroxine + liothyronine for hypothyroidism

Hypothyroidism is usually treated by levothyroxine (L-T4) which usually resolves the thyroid-related symptoms. For patients with continued symptoms on treatment with L-T4 alone, alternative treatment options with desiccated thyroid extract (DTE) or combination therapy (L-T4 with liothyronine, L-T3) have been used with some success. The current study aimed to evaluate the clinical effects of DTE, L-T4, and combination therapy (L-T4 and L-T3) in patients with hypothyroidism.
Shakir MKM et al 2021 Comparative effectiveness of levothyroxine, desiccated thyroid extract, and levothyroxine + liothyronine in hyporthyroidism. J Clin Endocrinol Metab. Epub 2021 Jun 29. PMID: 34185829.

Biotin use can interfere with the management of thyroid diseases, including thyroid cancer

Biotin is a dietary supplement that is taken by some for purposes like improving hair and nail quality. However, biotin can interfere with the measurement of hormone levels in the laboratory, making them inaccurate. This study has been done to compare the effect of biotin intake on hormone levels from 4 different laboratories used in diagnosis of thyroid disorders.
Ylli D et al 2021 Biotin interference in assays for thyroid hormones, thyrotropin and thyroglobulin. Thyroid 31:1160– 1170. PMID: 34042535.

How useful is the Bethesda system for reporting cytology results in children and adolescents with thyroid nodules?

The Bethesda System for Reporting Thyroid Cytopathology is often used in adults to determine the chance a thyroid nodule is cancerous. Little is known about the use of the Bethesda system for thyroid nodules in children and adolescents. This study investigates the use of the Bethesda system in pediatrics.
Vuong HG et al 2021 The use of the Bethesda System for reporting thyroid cytopathology in pediatric thyroid nodules: A meta-analysis. Thyroid 31:1203–1211. PMID: 33504264.

Core needle biopsy for evaluation of thyroid nodules

Thyroid biopsy is usually done with a thin needle (fine needle biopsy) and is a well-tolerated procedure with minimal to no complications and can be done in the office. Core needle biopsy (CNB) uses a large needle and requires an experienced operator with specific training. CNB also has a higher risk of complications than a fine needle biopsy, including injuries to the trachea and carotid artery. This study was performed to compare the use of CNB vs a fine needle biopsy as a first option in the evaluation of thyroid nodules.
Ahn HS et al 2021 Diagnostic performance of core needle biopsy as a first‐line diagnostic tool for thyroid nodules according to ultrasound patterns: Comparison with fineneedle aspiration using propensity score matching analysis. Clin Endocrinol (Oxf) 94:494–503. PMID: 32869866.

The presence of minimal extension of thyroid cancer outside of the thyroid does not predict initial response to treatment but can help determine prognosis

Minimal extrathyroidal extension (ETE) means that a small amount of thyroid cancer is found extending outside of the thyroid gland after examining the cancer under the microscope. This study was done to look at the impact of minimal ETE in predicting initial treatment response in papillary thyroid cancer, with and without treatment with radioactive iodine therapy.
Forleo R et al. 2021 Minimal extrathyroidal extension in predicting 1-year outcomes: A longitudinal multicenter study of low-to-intermediate-risk papillary thyroid carcinoma (ITCO#4). Thyroid. Epub 2021 Sept 19. PMID: 34541894.