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 19 Issue 1
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Clinical Thyroidology for the Public Volume 19 Issue 1 (PDF file, 2.33 MB)
TABLE OF CONTENTS – Web Format
HYPERTHYROIDISM
Long-term safety of treatment options for hyperthyroidism: which is the best?
There are 3 treatment options for hyperthyroidism – antithyroid drugs, radioactive iodine therapy and thyroid surgery. There are various factors that go into deciding which treatment option to consider, including the underlying cause for hyperthyroidism, side effects of treatment and patient preferences. This study aimed to assess the long-term safety of each of the three options of treatment for hyperthyroidism.
Chiung-Hui Peng C et al. Mortality risks associated with antithyroid drugs, radioactive iodine, and surgery for hyperthyroidism: a systematic review and network meta-analysis. Thyroid. 2025 Sep 1; doi: 10.1177/10507256251372193. PMID: 40891035.
GRAVES’ DISEASE
Is low-dose block-and-replace therapy as effective as high-dose block-and-replace therapy for treatment of Graves’ disease?
In the 1990s, block-and-replace therapy had gained some popularity in the treatment of Graves’ disease. However, this strategy was not shown to be quicker in resolving Gaves’ disease than ATDs alone and resulted in more side effects, so it is not routinely used. Recent studies have suggested that blockand- replace therapy using lower ATD doses may be able to be effective with less side effects. This study compared high-dose and low-dose block-and-replace therapy in patients with first episodes of Graves’ disease determine whether this would be as effective with possibly less side effects.
Smolders A et al High-dose versus low-dose block-and-replace treatment for a first episode of Graves’ disease. Eur Thyroid J 2025;14:e250039; doi: 10.1530/ETJ-25-0039. PMID: 40172327.
THYROID CANCER
Less is more: is removing only the thyroid isthmus enough for some thyroid cancers?
In recent years, there has been a growing emphasis on reducing the extent of surgery for low-risk thyroid cancer, since the outcomes are similar while the complication rates are lower. Recent studies suggest that removing only the isthmus (isthmusectomy) may be an alternative for some patients when the cancer is limited to the isthmus. Researchers designed this study to look at which option works best for a single thyroid cancer located only in the isthmus.
Lee S et al. Comparative study of clinical outcomes for total thyroidectomy/lobectomy and isthmusectomy in patients with isthmic papillary thyroid carcinoma. Thyroid 2025;35:1322- 1330; PMID: 41020703.
THYROID CANCER
A new blood test strategy may help find a medullary thyroid cancer earlier
Medullary thyroid cancer is a rare type of thyroid cancer that arises from the C-cells of the thyroid. Measuring levels of calcitonin, the hormone that C-cells make, can help diagnose medullary thyroid cancer, but results in the middle range are often unclear and may worry patients unnecessarily. The goal of this study was to see if using calcitonin along with procalcitonin together could improve the accuracy of diagnosing medullary thyroid cancer.
Schonebaum LE, et al. Progastrin-releasing peptide and procalcitonin as additional markers in the diagnostic workup for medullary thyroid carcinoma. Thyroid 2025;35(9):1030- 1038; doi: 10.1089/thy.2024.0293. PMID: 40576708.
THYROID SURGERY
Protocol to decrease the risk of low calcium levels after total thyroidectomy
One of the complications of thyroidectomy is the development of low calcium levels after surgery due to damage/bruising of the parathyroid glands during surgery. Treatment of low calcium levels after surgery can include calcium pills and/or calcitriol. This study was done to evaluate a protocol that grouped patients according to their parathyroid hormone level after surgery to help predict which patients would benefit from supplemental calcium and calcitriol.
Chindris AM, et al. Hypocalcemia post total thyroidectomy: a ten-year, single institution experience with a parathyroid hormone- guided calcium and calcitriol supplementation protocol. Endocr Pract 2025;31(11):1399-1406; doi: 10.1016/j. eprac.2025.07.003. PMID: 40633692.
THYROID CANCER
From rare exceptions to common findings: implications for managing hereditary thyroid cancer risk
A small proportion of thyroid cancers are part of rare hereditary syndromes caused by distinct gene mutations. At present, thyroid cancer patients do not undergo genetic evaluation unless other relatives are diagnosed with these rare hereditary syndromes. The goal of this study is to evaluate mutations that cause thyroid cancer- associated hereditary syndromes by using two large, public, population-scale databases; the All of Us database from the US and the UK Biobank.
White SL et al. Population prevalence of the major thyroid cancer–associated syndromes. J Clin Endocrinol Metab. Epub 2025 Apr 15:dgaf236; doi: 10.1210/clinem/dgaf236. PMID: 40231587.
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