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
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Clinical Thyroidology for the Public Volume 14 Issue 5 (PDF file, 6.42 MB)
TABLE OF CONTENTS – Web Format
THYROID FUNCTION TESTS
COVID-19 and the thyroid
The last year has seen the emergence of COVID-19 infection caused by the SARS-Cov-2 virus worldwide. Some reports suggest that the thyroid may be affected by COVID 19. This study was done to look for the frequency of abnormal thyroid function in patients with COVID 19.
Khoo B et al 2021 Thyroid function before, during, and after COVID-19. J Clin Endocrinol Metab 106: e803–e811. PMID: 33180932.
Less use of radioactive iodine in low risk thyroid cancer is safe, though it may take longer to be certain about the response to treatment.
There have been significant changes in how we treat low risk thyroid cancer in the last 10-15 years. Most importantly, less extensive surgery and less radioactive iodine therapy are being administered for low risk cancers. This study was done to determine the safety and treatment response of patients with low risk thyroid cancer who did not receive radioactive iodine therapy compared to those who did.
Grani G et al. 2020 Selective use of radioactive iodine therapy for papillary thyroid cancers with low or lower-intermediate recurrence risk. J Clin Endocrinol Metab. Epub 2020 Dec 30. PMID: 33377969.
Older age and other medical conditions are important considerations when deciding surgical management for thyroid cancer patients
The risk of developing thyroid nodules increases with age and if thyroid cancer is detected in older adults, it has a higher likelihood of being high-risk. Even though surgery to remove the thyroid is considered the standard of care for the initial management of patients with thyroid cancer, prior studies have shown that differences exist in their surgical care. This study aimed to identify factors that influence decisions regarding surgery in older adults with thyroid cancer.
Sutton W et al 2021 Understanding surgical decisionmaking in older adults with differentiated thyroid cancer: A discrete choice experiment. Surgery 169:14–21. PMID: 32475718.
The proportion of in-range TSH values does not differ in users of desiccated thyroid extract compared to levothyroxine
Current guidelines recommend the use of levothyroxine as the recommended form of thyroid hormone replacement. However, some patients and practitioners prefer desiccated thyroid extract (DTE) to treat hypothyroidism as a more “natural” option for treatment. This study was done to understand whether the level of TSH varies significantly over time in patients being treated with DTE as compared to TSH levels in patients taking levothyroxine.
Kuye R et al 2020 Thyroid Stimulating Hormone Stability in Patients Prescribed Synthetic or Desiccated Thyroid Products: A Retrospective Study. Ann Fam Med 18:452–454.
Thyroid function has no impact on physical activity in individuals aged 46-89 years
One question of interest has been the connection between the level of thyroid hormones and the rate of physical activity. However, most of the previous research in this topic has been done in athletes and military personnel, both of whom are physically fit. The aim of this study is to investigate the connection between the thyroid function and physical activity over time in general population.
Dueñas OHRD et al. 2020 Thyroid function and physical activity: A population-based cohort study. Thyroid. Epub 2020 Dec 23. PMID: 33198599.
Low vitamin D levels increase chances of developing low parathyroid hormone levels after thyroid surgery
One problem that can happen after thyroid surgery is development of low calcium levels due to damage to the parathyroid glands. Their job is to make a single hormone (parathyroid hormone), which works with vitamin D in the body to control a person’s calcium levels. The research described here studied people who had surgery to remove all, or part, of their thyroid to learn if low vitamin D levels before thyroid surgery increases the risk of low parathyroid hormone levels after surgery.
Vaitsi K et al 2021 Pre-operative vitamin D deficiency is a risk factor for post-thyroidectomy hypoparathyroidism: A systematic review and meta-analysis of observational studies. J Clin Endocrinol Metab. Epub 2021 Jan 23:dgab039. PMID: 33484571.