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 18 Issue 2
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Clinical Thyroidology for the Public Volume 18 Issue 2 (PDF file, 2.60 MB)
TABLE OF CONTENTS – Web Format
HYPOTHYROIDISM
Is levothyroxine enough during menopause in hypothyroid women?
Some hypothyroid patients treated with levothyroxine report persistent cognitive symptoms such as “brain fog” and difficulty concentrating despite normal TSH blood levels. Similar cognitive symptoms can be seen during menopause. This study aimed to investigate whether levothyroxine-treated hypothyroidism is associated with a more significant decline in cognitive function in women during the menopausal transition.
Ettleson MD et al. The association between hypothyroidism and cognitive function change in women across the menopause transition: the study of women’s health across the nation. Thyroid 2024;34(10):1205-1213; doi: 10.1089/ thy.2024.0358. PMID: 39225158.
HYPOTHYROIDISM
Treatment preferences in patients with hypothyroidism
The standard of care for the treatment of hypothyroidism is L-T4 administered at doses to normalize TSH levels. The goal of this study was to review and analyze the results of clinical trials that evaluated patient preference in adults with hypothyroidism comparing treatments using L-T4 monotherapy with those using T4 and T3 in the form of either T4/T3 combination therapy or DTE.
de Lima Beltrão FE et al Treatment preferences in patients with hypothyroidism: an analysis of eleven randomized controlled trials. J Clin Endocrinol Metab. Epub 2024 Sep 18:dgae651; doi: 10.1210/clinem/dgae651. PMID: 39290156.
HYPOTHYROIDISM
Thyroid hormone levels change with age
TSH and FT4 tests are commonly ordered to evaluate patients for possible thyroid problems. Currently, laboratories use the same normal range for TSH and FT4 for all adults, regardless of age. However, some research suggests that TSH and FT4 levels may change with age. The goal of this study was to establish agespecific normal reference ranges for TSH and FT4.
Jansen HI et al. Age-specific reference intervals for thyroidstimulating hormones and free thyroxine to optimize diagnosis of thyroid disease. Thyroid. Epub 2024 Sep 30
HYPERTHYROIDISM
Cancer risks of patients with Graves’ disease who received antithyroid drugs as initial treatment
Some studies have shown that patients with hyperthyroidism have an increase chance to develop several types of cancer. Other studies looking at the link between hyperthyroidism and cancer only looked at those patients who were treated with radioactive iodine therapy, since radiation is a risk factor for cancer. The goal of this study is to shed some light about the risk of cancer in patients with Graves’ disease who are treated with ATDs.
Lee JY, et al. Cancer risks of patients with Graves’ disease who received antithyroid drugs as initial treatment: a nationwide population-based analysis. Thyroid 2024;34(10):1271-1279; doi: 10.1089/thy.2024.0178. PMID: 39228052.
THYROID NODULES
Are thyroid nodules in the isthmus different from nodules in the thyroid lobes?
Some studies suggest that isthmus nodules, while less frequent than nodules within the thyroid lobes, may carry a higher risk of cancer than nodules in either thyroid lobe. A recent study suggested potential differences in gene mutations found in thyroid cancer between the isthmus and the lobes. This study examines the cytologic and molecular marker differences between nodules and papillary thyroid cancer based on whether the cancer is in the isthmus or the thyroid lobes.
Jasim S, et al. Cytologic and molecular assessment of isthmus thyroid nodules and carcinomas. Thyroid. Epub 2024 Nov 11; doi: 10.1089/thy.2024.0254. PMID: 39527399.
THYROID CANCER
Effect of thyroidectomy on survival outcomes for medullary thyroid cancer with distant metastasis at diagnosis
Medullary thyroid cancer (MTC) is a more aggressive thyroid cancer and is more likely to spread outside the thyroid into the neck. As such, there is limited data regarding the potential benefit of thyroidectomy on survival in patients with spread of the MTC outside of the neck when the cancer is diagnosed. This study 1) evaluates the prognosis based on the presence of what organs and how many contain MTC cells, 2) evaluates whether thyroidectomy is beneficial in these patients, and (3) identifies the best candidates for thyroidectomy in patients with metastatic MTC at diagnosis.
Liu C-Q, et al. Survival outcome and optimal candidates of primary tumor resection for patients with metastatic medullary thyroid cancer. J Clin Endocrinol Metab 2024;109(11):2979-2985; doi: 10.1210/clinem/dgae214. PMID: 38570918.
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