Clinical Thyroidology for the Public Volume 10 Issue 7

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 10 Issue 7

Graves' Disease Awareness Month

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Clinical Thyroidology for the Public Volume 10 Issue 7 (PDF file, 1.38 MB)


Editor’s Comments

HYPOTHYROIDISM Does bariatric surgery decrease levothyroxine requirements among hypothyroid patients?
Bariatric surgery for weight loss is becoming very common in the US. Obesity and hypothyroidism often occur in the same patient and ~18% of bariatric surgery patients require thyroid hormone therapy. This study examines the levothyroxine dose requirements after bariatric surgery in a population that received mainly gastric sleeve surgery.
Zendel A et al. The impact of bariatric surgery on thyroid function and medication use in patients with hypothyroidism. Obes Surg. March 2, 2017 [Epub ahead of print].
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HYPOTHYROIDISM IN OLDER ADULTS Sequential TSH determinations may help in assessing the adequacy of treatment for overt hypothyroidism in older patients
It is known that there is an increased risk of death associated with an underactive thyroid. However, the target level TSH in the blood is not clearly established in older patients. This study evaluated the association between a series of TSH and free T4 levels and risk of death in older patients with hypothyroidism treated with thyroid hormone.
Akirov A et al. Elevated TSH in adults treated for hypothyroidism is associated with increased mortality. Eur J Endocrinol 2017;176:57-66. Epub October 19, 2016.
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THYROID SURGERY Many patients who become hypothyroid after lobectomy will recover normal thyroid function
Currently, thyroid lobectomy is an option in patients with low risk thyroid cancers and has advantages in decreasing surgical complications and potentially avoiding the need for lifelong thyroid hormone therapy. This study examined the frequency and risk factors for hypothyroidism after lobectomy for papillary thyroid cancer.
Park S et al. Clinical features of early and late postoperative hypothyroidism after lobectomy. J Clin Endocrinol Metab 2017;102:1317-24.
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THYROID CANCER Thyroglobulin measurements and neck ultrasound findings in patients with thyroid cancer after total thyroidectomy
After thyroid cancer surgery, patients are divided into low, intermediate and high risk groups. Most of the time, patients in the low risk group are simply monitored by ultrasound. Patients in the intermediate and high risk groups are usually selected to be treated with radioactive iodine. In this study, the authors evaluated the relationship between thyroglobulin levels, neck ultrasound and whole body radioactive iodine scan to determine who would benefit the most from radioactive iodine therapy.
Matrone A et al. Postoperative thyroglobulin and neck ultrasound in the risk re-stratification and decision to perform 131I ablation. J Clin Endocrinol Metab 2016;Dec 8:jc20162860 [Epub ahead of print].
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THYROID CANCER Recurrence rates in patients with intermediate-risk thyroid cancer are similar after low-dose and high-dose radioactive iodine therapy
Standard treatment for intermediate and high risk thyroid cancer includes surgery, usually a total thyroidectomy, followed by radioactive iodine therapy and thyroid hormone therapy. The best radioactive iodine dose is still controversial. The goal of this study was to evaluate the response to low-dose and high-dose radioactive iodine therapy, including the recurrence rate during long-term follow-up in patients with intermediate risk thyroid
Jeong et al. Clinical outcomes of low-dose and high-dose postoperative radioiodine therapy in patients with intermediate-risk differentiated thyroid cancer. Nucl Med Commun. 2017 Mar;38(3):228-233.
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THYROID CANCER Surgery for neck recurrence of thyroid cancer can achieve complete remission in a majority of patients
The most common site of thyroid cancer recurrence is in the lymph nodes in the neck. Frequently, surgery is the best treatment for cancer recurrence and offers many patients a chance for cure. The author’s goals were to evaluate how good the initial operation was to prevent recurrence/persistence of cancer, to determine prognostic factors for who would have a cancer recurrence, and to look at the long-term outcomes of reoperation at a single institution in France.
Lamartina L et al Surgery for neck recurrence of differentiated thyroid cancer: outcomes and risk factors. J Clin Endocrinol Metab 2017;102:1020-31.
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