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 16 Issue 10 (PDF file, 2.79MB)
TABLE OF CONTENTS – Web Format
Dealing with indeterminate thyroid nodules in real life
Thyroid nodule biopsy results are reported using the Bethesda System which helps to determine the likelihood of cancer in the biopsied thyroid nodule. Bethesda III results are called indeterminate, meaning that the cells are not entirely normal but not entirely abnormal. This study was done by a survey of patients, clinicians, and healthy patients with the goal to evaluate their preferences when addressing with Bethesda III thyroid nodules.
van Kinschot CMJ et al 2023 Preferences of patients, clinicians, and healthy controls for the management of a Bethesda III thyroid nodule. Head Neck 45:1772–1781. PMID: 37158317.
Effect of the COVID-19 pandemic on surgery for indeterminate thyroid nodules
About 10-15% of thyroid biopsies are called indeterminate. This study aimed to determine to what extent thyroid surgery for indeterminate thyroid nodules was reduced during the COVID-19 pandemic; and to determine whether or not the delay in thyroid surgery was associated with an increased occurrence of more aggressive thyroid cancer.
Medas F et al 2023 Effect of the COVID-19 pandemic on surgery for indeterminate thyroid nodules (THYCOVID): A retrospective, international, multicentre, cross-sectional study. Lancet Diabetes 11:402–413. PMID: 37127041.
Isolated NIFTP is a low-risk thyroid neoplasm
In 2016, an international group of experts suggested that noninvasive encapsulated FVPTC was not a cancer at all changed the name to NIFTP. The long-term outcome of NIFTP is still being investigated. The goal of this study was to analyze a large group of NIFTP patients diagnosed at a single institution since the introduction of this term in 2016 and further stratify and compare the pure NIFTP patients with those who had other co-existing low-risk and high-risk thyroid cancers.
Alzumaili BA 2023 A Comprehensive Study on the Diagnosis and Management of Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features. Thyroid 33:566–577. PMID: 36960710.
Risk of hypothyroidism in babies born by women with active Graves’ disease
Women with active Graves’ disease and hyperthyroidism during pregnancy are often treated with antithyroid medications. Overtreatment with antithyroid medications in the mother can lead to hypothyroidism in the baby. The aim of this study was to determine how common hypothyroidism is in babies born to mothers with Graves’ disease treated with antithyroid medications during pregnancy.
Yoshihara A et al 2023 Incidence of and risk factors for neonatal hypothyroidism among women with Graves’ disease treated with antithyroid drugs until delivery. Thyroid. Epub 2023 Feb 21. PMID: 36680759
THYROID HORMONE REPLACEMENT
Are different batches of levothyroxine consistently treating hypothyroidism?
This study was done to see if TSH levels that are monitored during the treatment of both types of hypothyroidism are significantly changed when switching to/from generic or brand name formulations of levothyroxine hormone replacement therapy. The goal of this study is to look at the frequency of normal TSH values and likelihood of abnormal TSH values when different levothyroxine preparations are taken.
Bianco AC et al Levothyroxine Treatment Adequacy and Formulation Changes in Patients With Hypothyroidism: A Retrospective Study of Real-World Data From the United States Thyroid, 2023, online.
Increase in DTE prescriptions in the United States for the treatment of hypothyroidism
Hypothyroidism is most often treated with levothyroxine. Other thyroid hormone preparations include liothyronine, which is often used along with levothyroxine, and DTE. This study reviewed clinical prescriptions databases regarding prescriptions for levothyroxine and desiccated thyroid extract to understand the frequency of prescriptions of these forms of thyroid hormone replacement.
Ettleson MD et al 2023 Demographic, healthcare access, and dietary factors associated with thyroid hormone treatments for hypothyroidism. J Clin Endocrinol Metab. Epub 2023 Jun 16. PMID: 37327351.