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Clinical Thyroidology

BOOK REVIEW: The 10th Edition of Werner & Ingbar’s Thyroid Is Outstanding

Malika Chowdhry

Clinical Thyroidology

Book Review of: Braverman LE, Cooper D, eds. Werner & Ingbar’s The Thyroid: A Fundamental and Clinical Text, 10th ed. Philadelphia: Lippincott Williams and Wilkins, 2013.

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Werner & Ingbar’s The Thyroid: A Fundamental and Clinical Text is a well-known reference book and can probably be seen on the shelves of most endocrinologists today. In the new 10th edition, the authors and editors have continued the tradition of putting together a comprehensive book with a fresh new look.

The book is divided into two general sections. The first section discusses the thyroid anatomy and development, thyroid hormone synthesis and function, and the thyrotropin receptor and its regulation. This section explores topics in basic science but also incorporates clinical medicine to keep the reader engaged. The next section details the various thyroid diseases in depth, along with the management of these diseases. The book also dedicates a large section to the various aspects of thyroid cancer, including epidemiology, genetics, staging, prognosis, and medical management. This textbook even provides details about thyroid disease during pregnancy and in infants and children.

The figures, graphs, and tables complement the text well and aid the reader in understanding the contents of the chapters. The chapter on thyroid disorders during pregnancy is quite comprehensive and has an excellent summary of the text in tables, which make it easy to use as a reference at a later time. In the chapter about the effects of drugs on TSH secretion, the figure that accompanies the text breaks down the effects of different drugs on TSH inhibition, T4 absorption, synthesis, secretion, transport, and metabolic abnormalities. This not only provides a summary of the drugs but also gives the reader a visual aid to better understand the mechanisms at different levels of the thyroid axis.

The chapter on the molecular genetics of tumors of the thyroid follicular cells is very detailed but is divided well into subsections. The reader who chooses to read only a certain section will be thoroughly educated on that topic without having to read the rest of the chapter, as each section is self-contained. The chapter describes basic oncogenic pathophysiology and ties it in with thyroid cancer, which makes it easy to understand the basic pathophysiology of thyroid cancer.

The thyroid pathology and cytopathology chapter is particularly well written, with excellent descriptions of the various thyroid diseases. However, some of the images fail to complement the description in the text because they are not in color. Color images would better elucidate the descriptions in the text.

Each book is only as good as its authors and the references used by them. The editors have done an outstanding job of recruiting national and international experts in special areas of thyroidology as authors, resulting in content that is extremely thorough. The authors have used a combination of old and new references to ensure that the information in the book is up to date and yet does not overlook seminal articles. The new references incorporate changes in the field of thyroidology over the past few years. Even though the writing styles are different from one chapter to the next, the overall flow of the book is still consistent throughout. The new edition has many new authors. Some of them wrote entirely new chapters and others updated various other chapters. New chapters include surgical management of thyroid cancer and thyroid hormone analogs.

The true test of a reference or book is its utility in answering a query when a clinical question arises. While I was on inpatient medicine, I received a consult about a patient in the ICU with thyroid-function test abnormalities. I was able to go to the nonthyroidal illness chapter in the book and use it as a resource to answer my question. The text was accompanied by very descriptive figures, for visual learners, which made it easy to understand the concepts written in the text. In another instance, I was asked about the causes of congenital hypothyroidism, and I was able to quickly look through the chapter on this topic to answer the question.

As a second year endocrinology fellow, I belong to a generation that grew up reading online journals and articles to obtain most of my medical information. In an era in which online texts and journals are the source of most of our learning and references, books seem a thing of the past. However, it is nice to have a book that is easy to read, yet comprehensive, and can serve as a reliable reference. The text comes with access to the complete contents online and is fully and effectively searchable this way. In most chapters, the text is reiterated in the form of tables or charts that which make the material much easier to recall and reference.

This book is aimed at a large audience, including internists, clinical endocrinologists, and endocrinology fellows. However, I believe it will be most useful to practicing endocrinologists as well as those in training. It is a great resource for endocrinology fellows who are trying to learn about molecular genetics, cytology, and pathophysiology of thyroid diseases along with the management of most thyroid diseases.

Overall, this book is comprehensive without being overbearing or hard to read. As this is an all-inclusive book about the thyroid, there are a few sections that are burdensome to read, but that is true of any book that contains as much detail as this book does. Nonetheless, it provides information that would be useful for every reader, from a general practitioner to a seasoned endocrinologist. It is a well-balanced book that does not focus on either pathophysiology or medical management but has a good balance of both. I highly recommend this new edition for endocrinologists, especially endocrinology fellows, because even though there are many endocrinology texts available to us, no other thyroid book is as comprehensive as Werner & Ingbar’s The Thyroid.