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 15 Issue 10 (PDF file, 2.85 MB)
TABLE OF CONTENTS – Web Format
The asymptomatic patient and thyroid nodule surgery
Thyroid cancer is one of the fastest rising cancers in the world. It is unclear if this increase is because of increased use of imaging studies or represents a true increase in cancer. This study examined the mode of detection for thyroid nodules that subsequently led to thyroid surgery in varying parts of the world to determine whether there was a true increase in papillary thyroid cancer or if this trend is secondary to an increase in nodule detection.
Sajisevi M et al 2022 Evaluating the rising incidence of thyroid cancer and thyroid nodule detection modes: A multinational, multi-institutional analysis. JAMA Otolaryngol Head Neck Surg 148:811–818. PMID: 35834240.
Does inadequate treatment of hypothyroidism during hospitalization lead to worse hospital outcomes?
Hypothyroidism is a common medical condition and occurs in about 11% of the US population. Unfortunately, many patients on thyroid hormone are not adequately treated and TSH levels may remain abnormal despite being on treatment. This study examines whether inadequately treated hypothyroidism may cause any complications for patients admitted to the hospital.
Ettleson MD et al. 2022 Suboptimal thyroid hormone replacement is associated with worse hospital outcomes. J Clin Endocrinol Metab. Epub 2022 Apr 26. PMID: 35472082.
Thyroid hormones enhance the growth of estrogen receptor–positive breast cancers
Some studies have suggested an association between thyroid disorders and breast cancer where thyroid hormone appears to play an important role. Further, up to 30% of patients with breast cancer are on thyroid hormone for treatment of hypothyroidism. This study aimed at investigating the effects of thyroid hormone treatment for hypothyroidism on the outcome of patients with stage I breast cancer.
Wahdan-Alaswad RS et al 2021 Exogenous thyroid hormone is associated with shortened survival and upregulation of high-risk gene expression profiles in steroid receptor-positive breast cancers. Clin Cancer Res 27:585–597. PMID: 33097494.
THYROID AND PREGNANCY
Lower egg quality and quantity were seen in women with infertility and TSH levels in the high-normal ranges.
Overt hyperthyroidism and hypothyroidism have impact on fertility. It is currently not clear whether mildly abnormal thyroid hormone levels cause infertility. This study aimed to assess whether blood TSH levels in the upper half of the normal range are associated with infertility.
Li N et al. 2022 The impact of moderately high preconception thyrotropin levels on ovarian reserve among euthyroid infertile women undergoing assisted reproductive technology. Thyroid 32:841–848. PMID: 35317605.
THYROID HORMONE THERAPY
Preliminary experience of early T3 therapy in patients with an acute heart attack
T3 levels are low in patients admitted with heart attack and after heart surgery. This is known as the low T3 syndrome and has led to studies using T3 therapy in patients acutely sick with heart problems to increase T3 levels back to normal to try to improve outcomes. This study was aimed to evaluate the effect of high-dose liothyronine (LT3) shortly after a heart attack.
Pantos CI et al 2022 Effects of acute triiodothyronine treatament in patients with anterior myocardial infarction undergoing primary angioplasty: Evidence from a pilot randomized clinical trial (ThyRepair Study). Thyroid. Epub 2022 May 5. PMID: 35297659.
AUTOIMMUNE THYROID DISEASE
Role of serum thyroid antibody status in predicting cancer therapy–associated thyroid disease
One of the more effective cancer immunotherapy drugs belong to a class known as immune checkpoint inhibitors (ICI). Since these ICI drugs activate the patient’s immune system, it is not surprising that other autoimmune diseases may develop or flare during the treatment with ICI. The goal of this study was to characterize the association of antithyroid antibodies with the development of ICI-related thyroid disease.
Muir CA et al 2022 Association of antithyroid antibodies in checkpoint inhibitor-associated thyroid immune-related adverse events. J Clin Endocrinol Metab 107(5):e1843– e1849. PMID: 35104870.