Furthermore, we aimed to identify risk factors for postoperative hypothyroidism. Although older age was reported to be a significant risk factor in four studies (46, 55, 73, 74), these findings could not be replicated in eight other studies (3, 54, 61, 62, 64, 65, 67, 68). For all proportions, exact confidence intervals (CI) were calculated. Let us know your question(s) and we will forward it to our surgeons Google Scholar search provided two more relevant articles to include in this meta-analysis (46, 47), and one additional article was included after citation tracking of included articles (48). To make sure that your thyroid hormone levels in your blood are at the right level for you! Suppress the growth of thyroid National Library of Medicine Finally, 31 publications were included in the present meta-analysis (3, 10, 4674). Hypothyroidism after partial thyroidectomy. For meta-analysis of proportions, the exact likelihood approach based on a binomial distribution has advantages compared with a standard random effects model that is based on a normal distribution (13). Collection Instructions: Centrifuge and aliquot serum into a plastic vial. Thyroglobulin (Tg) is a thyroid-specific glycoprotein (approximately 660 KDa) that serves as the source for thyroxine (T4) and triiodothyronine (T3) production within the lumen of thyroid follicles. Solitary indeterminate follicular thyroid nodule, In all patients, thyroid function testing (TSH, fT, Dominant thyroid nodule (enlarging/suspicious nodule, 118 cases; compression symptoms, 10 cases; cosmetic concerns, 3 cases), Biochemical, based on elevated TSH level; cutoff level not reported, TSH measurement, not reported which time period after surgery, Most hypothyroid cases (84.5%) were detected at 1 or 6 months after surgery, Toxic multinodular goiter, nontoxic multinodular goiter, single nodule, Graves' disease, At least the incidence of hypothyroidism was determined within the first year after surgery, Solitary cold nodule in 33 cases, autonomous solitary nodule in 5 cases, and nontoxic goiter with compression in 7 cases, Biochemical, supranormal TSH levels (no reference range reported), FNA consistent with follicular/Hrthle cell neoplasm, 37 cases; progressive nodule growth +- compressive symptoms, 13 cases; persistently nondiagnostic FNA, 10 cases; exclusion of malignancy, 6 cases; incidental nodule, 4 cases; suppurative thyroiditis, 1 case, In all but two patients, hypothyroidism was diagnosed within 8 wk after surgery; two other patients were diagnosed 6 and 7 yr later, due to inadequate follow-up in one, In all patients at least 5 wk after surgery, a TSH measurement, More than 75% hypothyroid cases developed within 9 months; mean, 6.6 months, In all patients 8 to 10 wk after surgery, TSH measurement; subsequently every 34 months, TSH measurement, Incidence, 35/98 (35.7%); prevalence, 37/101 (36.6%), More than 75% of hypothyroid cases within 9 months, At least 2 months after surgery TSH measurement; thereafter every 23 months, for 1 yr in all patients, Benign nodular thyroid disease (progressive increase in nodule size; substernal extension; development of compressive symptoms; radiographic evidence of tracheal, esophageal, or vessel impingement; cosmetic concerns; thyrotoxicosis), Most likely biochemical, based on elevated TSH levels, 70% of patients initial TSH drawn first 3 months, 12% within 46 months, 12% within 712 months; 6% not in the first year, TSH >10 mIU/ml single measurement or 510 mIU/ml two consecutive measurements (interval, 68 wk), Majority (66%) diagnosed in the first year of follow-up, After surgery at 6 months interval TSH measurement, All but one of the 14 hypothyroid patients had been diagnosed so within 2 months, At least one TSH measurement drawn within 6 wk after surgery in all patients; furthermore, measurements were variable in all patients, Lobectomy for various indications including, goiter, follicular neoplasm, TSH >4.82 mIU/ml measured at least 6 wk after surgery, Malignant FNA, 1 case; recurrent cyst, 10 cases; solitary nodule, 145 cases; multinodular goiter, 138 cases, All 247 patients had preoperative TSH levels of 0.54.0 mIU/liter, 68% of hypothyroid cases were diagnosed by 6 months, 90% by 15 months, More than 90% hypothyroid cases within 6 months; 56/233 needed T, TSH measurement at least 46 wk after surgery; subsequently every 36 months for at least 3 yr, Serum TSH >6.0 mIU/liter at 6 months and more after surgery, Exclusion of malignancy and relief of compressive symptoms for unilateral thyroid mass, Clinical, 5.4 months (range, 36); subclinical, 12 months (612), TSH measurement once between 3 and 6 months after surgery, at 12 months, thereafter annually; T. In case of disagreement, a third reviewer was consulted. Roughly 5% of people may have temporary symptoms of a low calcium level, known as hypocalcemia , for at least a few weeks after thyroid surgery. Cooper DS , Doherty GM , Haugen BR , Hauger BR , Kloos RT , Lee SL , Mandel SJ , Mazzaferri EL , McIver B , Pacini F , Schlumberger M , Sherman SI , Steward DL , Tuttle RM, Traugott AL , Dehdashti F , Trinkaus K , Cohen M , Fialkowski E , Quayle F , Hussain H , Davila R , Ylagan L , Moley JF, Stoll SJ , Pitt SC , Liu J , Schaefer S , Sippel RS , Chen H, Biondi B , Fazio S , Cuocolo A , Sabatini D , Nicolai E , Lombardi G , Salvatore M , Sacc L, Heemstra KA , Hamdy NA , Romijn JA , Smit JW, Sawin CT , Geller A , Wolf PA , Belanger AJ , Baker E , Bacharach P , Wilson PW , Benjamin EJ , D'Agostino RB, Schlote B , Nowotny B , Schaaf L , Kleinbhl D , Schmidt R , Teuber J , Paschke R , Vardarli I , Kaumeier S , Usadel KH, Saravanan P , Chau WF , Roberts N , Vedhara K , Greenwood R , Dayan CM, Berglund J , Aspelin P , Bondeson AG , Bondeson L , Christensen SB , Ekberg O , Nilsson P, Johner A , Griffith OL , Walker B , Wood L , Piper H , Wilkins G , Baliski C , Jones SJ , Wiseman SM, Hamza TH , van Houwelingen HC , Stijnen T, Berglund J , Bondesson L , Christensen SB , Larsson AS , Tibblin S, Eckert H , Green M , Kilpatrick R , Wilson GM, Tweedle D , Colling A , Schardt W , Green EM , Evered DC , Dickinson PH , Johnston ID, Andker L , Johansson K , Smeds S , Lennquist S, Griffiths NJ , Murley RS , Gulin R , Simpson RD , Woods TF , Burnett D, Keogh JC , Grace PA , Brown HJ , Browne HJ, Wahl RA , Hufner M , Joseph K , Roher HD, Campion L , Gallou G , Ruelland A , Cloarec L , Allannic H, Lehwald N , Cupisti K , Willenberg HS , Schott M , Krausch M , Raffel A , Wolf A , Brinkmann K , Eisenberger CF , Knoefel WT, Marchesi M , Biffoni M , Faloci C , Biancari F , Campana FP, Rodier JF , Strasser C , Janser JC , Navarrete E , Pusel J , Methlin G , Rodier D, Bellantone R , Lombardi CP , Boscherini M , Raffaelli M , Tondolo V , Alesina PF , Corsello SM , Fintini D , Bossola M, Rosato L , Avenia N , Bernante P , De Palma M , Gulino G , Nasi PG , Pelizzo MR , Pezzullo L, Asari R , Niederle BE , Scheuba C , Riss P , Koperek O , Kaserer K , Niederle B, Niepomniszcze H , Garcia A , Faure E , Castellanos A , del Carmen Zalazar M , Bur G , Elsner B, Korun N , Aci C , Yilmazlar T , Duman H , Zorluoglu A , Tuncel E , Ertrk E , Yerci O, Bourguignat E , Barrault S , Mayaux MJ , Koubbi G , Fombeur JP, Heberling HJ , Heintze M , Kuhlmann E , Lohmann D , Hartig W , Mttig H, Matte R , Ste-Marie LG , Comtois R , D'Amour P , Lacroix A , Chartrand R , Poisson R , Bastomsky CH, Verhaert N , Vander Poorten V , Delaere P , Bex M , Debruyne F, Prichard RS , Easwarahingham N , Suliburk J , Sidhu SB , Sywak MS , Delbridge LW, Beisa V , Kazanavicius D , Skrebunas A , Simutis G , Sileikis A , Strupas K, Lankarani M , Mahmoodzadeh H , Poorpezeshk N , Soleimanpour B , Haghpanah V , Heshmat R , Aghakhani S , Shooshtarizadeh P, Dobrinja C , Trevisan G , Piscopello L , Fava M , Liguori G, Lombardi G , Panza N , Lupoli G , Leonello D , Carlino M , Minozzi M, Lee JK , Wu CW , Tai FT , Lin HD , Ching KN, Berglund J , Bondeson L , Christensen SB , Tibblin S, Lindblom P , Valdemarsson S , Lindergrd B , Westerdahl J , Bergenfelz A, Guberti A , Sianesi M , Del Rio P , Bertocchi A , Dazzi D , Guareschi C , Robuschi G, Farkas EA , King TA , Bolton JS , Fuhrman GM, Piper HG , Bugis SP , Wilkins GE , Walker BA , Wiseman S , Baliski CR, Rosrio PW , Pereira LF , Borges MA , Alves MF , Purisch S, Miller FR , Paulson D , Prihoda TJ , Otto RA, Seiberling KA , Dutra JC , Bajaramovic S, Wormald R , Sheahan P , Rowley S , Rizkalla H , Toner M , Timon C, De Carlucci D , Tavares MR , Obara MT , Martins LA , Hojaij FC , Cernea CR, Moon HG , Jung EJ , Park ST , Jung TS , Jeong CY , Ju YT , Lee YJ , Hong SC , Choi SK , Ha WS, Vaiman M , Nagibin A , Hagag P , Kessler A , Gavriel H, Koh YW , Lee SW , Choi EC , Lee JD , Mok JO , Kim HK , Koh ES , Lee JY , Kim SC, Phitayakorn R , Narendra D , Bell S , McHenry CR, Barczyski M , Konturek A , Gokowski F , Hubalewska-Dydejczyk A , Cicho S , Nowak W, Yetkin G , Uludag M , Onceken O , Citgez B , Isgor A , Akgun I, Spanheimer PM , Sugg SL , Lal G , Howe JR , Weigel RJ, Tomoda C , Ito Y , Kobayashi K , Miya A , Miyauchi A, Gussekloo J , van Exel E , de Craen AJ , Meinders AE , Frlich M , Westendorp RG, Razvi S , Shakoor A , Vanderpump M , Weaver JU , Pearce SH, Andersson M , Takkouche B , Egli I , Allen HE , de Benoist B, Oxford University Press is a department of the University of Oxford. Thyroid auto-antibodies, lymphocytic infiltration and the development of post-operative hypothyroidism following hemithyroidectomy for non-toxic nodular goitre. Hypothyroidism following hemithyroidectomy: incidence, risk factors, and management. With the exception of postoperative hypothyroidism, most complications are rare. Most patients will have a relatively low risk of recurrence and will thereafter only require unstimulated Tg measurement. This variation may be caused by different definitions of hypothyroidism, differences in patient characteristics between studied populations, follow-up duration, timing of thyroid hormone supplementation, and probably also surgical techniques. Levothyroxine replacement therapy after thyroid surgery. Determined in a larger population, used as a surrogate for the actual hemithyroidectomized population included in this meta-analysis. Because Tg is thyroid-specific, serum Tg concentrations should be undetectable, or very low, after the thyroid gland is removed during treatment for thyroid cancer. Introduction and aim: Exp Rev Endocrinol Metab. Hypothyroidism was defined as an increased TSH level with or without subnormal thyroid hormone levels in 24 studies (75%). The risk for hypothyroidism was higher (49%; 95% CI, 3463) in patients with a high degree of inflammation than in patients with no inflammation or a low degree (10%; 95% CI, 326; P = 0.006). This is the safest hospital for you! Similarly, we calculated the risk for hypothyroidism in patients with no inflammation or a low degree (grade 02) compared with patients with a high degree of inflammation (grade 34) in the resected lobe. These 31 publications reported on 32 cohorts. Albeit, later occurrences of hypothyroidism were possible (74). Hedman et al. Corona Virus Update: Monday May 1, 2023. Although most advantages and disadvantages of the performance of hemithyroidectomy can be disentangled before surgery, the risk of hypothyroidism after hemithyroidectomy is an important element in decision-making for the individual patient, the health care provider, as well as the policy makers. All identified articles were screened independently for eligibility by two reviewers (H.V. Results: In patients with persistent disease, the serum TSH should be maintained below 0.1mU=L indefinitely in the absence of specific contraindications. Prognosis of thyroid function after hemithyroidectomy. Studies reporting on partial thyroidectomies were not included because that intervention can be more or less extended than hemithyroidectomy; including those studies could bias the estimated risk of hypothyroidism after hemithyroidectomy. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide, This PDF is available to Subscribers Only. After a partial thyroidectomy, your Tg should fall within the reference range for the test and remain relatively stable. In two studies, it was possible to extract data for preoperatively euthyroid patients (55, 68). Normalization of thyroid function after a thyroid lobectomy may take a relatively long time period (49, 51, 59). What factors will influence the risk of hypothyroidism after hemithyroidectomy? In case it was unclear whether patients had hypothyroidism before the operation, the reported proportion was regarded to be a prevalence. Also, the inclusion of only euthyroid patients did not affect the risk of hypothyroidism (P = 0.78). When the patient is felt to be free of tumor on this basis, the ATA and ETA guidelines suggest maintaining the blood TSH in the low normal level, which is particularly important in children. After complete thyroidectomy, calcium levels frequently decline. Overt and 'subclinical' hypothyroidism in women. Disclosure Summary: All the authors (H.V., M.L., J.W.S., J.K., J.W.A.S., and O.M.D.) Results: Of the patients who were preoperatively euthyroid, 45% with total thyroidectomy, 42% with subtotal thyroidectomy, and 17% with hemithyroidectomy required L-T4 dose adjustments. Berglund et al. WebThe American Thyroid Association's Guidelines (2009) make several recommendations regarding TSH. Patients whose thyroid glands have been removed will need to be on levothyroxine medication for the rest of their lives. WebHigh levels of TSH 7 years after thyroidectomy. Low serum thyrotropin concentrations as a risk factor for atrial fibrillation in older persons. We investigated the adequacy of our thyroid hormone replacement therapy for three months after total-, subtotal-, and hemithyroidectomy using an upper reference limit of thyrotropin (TSH) of 4.6 mU/L. The medication, which is necessary for maintaining a person's full health, must be taken on an empty stomach. TSH LEVEL <0.005 chrstn299529 Jul 27, 2016 3:54 PM Hi, i just to ask about my thyroid problem, i was diagnose for about a year having an hyperthyroidism, i was just having a tsh <0.005 result and it doesnt change for the begining of my blood test i was taking PTU and Inderal tablets .. Do have any suggestions for this how to make it normal ? Accessibility If your papillary thyroid cancer has been gone for a period of time and comes back, this is called recurrent papillary thyroid cancer. Data extraction from included studies was performed using a predefined extraction sheet, which was updated after a pilot test on five randomly selected relevant studies. 2004 Jun;60(6):750-7. doi: 10.1111/j.1365-2265.2004.02050.x. To serve you better, the Clayman Thyroid Center has moved to the brand new Hospital for Endocrine Surgery. Unable to load your collection due to an error, Unable to load your delegates due to an error. In all studies, the majority of patients were female, with proportions ranging from 5896%. Eligible studies were restricted to the English, Dutch, German, and French languages. For patients who underwent thyroid lobectomy and isthmusectomy and who were not on levothyroxine before surgery, if the serum TSH level was elevated above the normal range at 6 weeks, levothyroxine therapy was initiated for the treatment of postsurgical hypothyroidism. Positive anti-thyroid peroxidase status is a relevant preoperative indicator of hypothyroidism after surgery. In this meta-analysis, studies were performed in countries in which iodine status may vary. Decision levels for thyroid cancer patients who are not completely athyrotic (ie, patient has some remnant normal thyroid tissue) have not been established but are likely to be somewhat higher; remnant normal thyroid tissue contributes to serum Tg concentrations 0.5 to 1.0 ng/mL per gram of remnant tissue, depending on the thyroid-stimulating hormone (TSH) level. J Am Coll Surg. To improve diagnostic accuracy, it is recommended that this measurement be initially obtained after TSH stimulation, either following thyroid hormone withdrawal or after injection of recombinant human TSH. Tg 2.1 to 9.9 ng/mL: Tg levels must be interpreted in the context of TSH levels, serial Tg measurements, and radioiodine ablation status. Siegmund W, Spieker K, Weike AI, Giessmann T, Modess C, Dabers T, Kirsch G, Snger E, Engel G, Hamm AO, Nauck M, Meng W. Clin Endocrinol (Oxf). [Studies on thyroid function by means of TRH tests in simple goiter before and after strumectomy]. You had a papillary thyroid cancer and underwent removal of all of your thyroid gland. It is necessary to check with the pharmacist and physician when new drugs are being prescribed. Higher proportions of included patients with preoperatively known hypothyroidism will falsely increase the postoperative risk estimate. Webtsh 0.01 L 0.01 L 0.01 L t3, free 4.8 H 4.3 H 3.5 H (2.3-4.2) We increased to 112 mcg Synthroid/ and remained on the 20 mcg Cytomel a month after the surgery.. The pooled risk of hypothyroidism after hemithyroidectomy was 22% (95% CI, 1927). Indications for hemithyroidectomy include symptomatic unilateral goiter or toxic adenoma. Thyroid function after unilateral total lobectomy: risk factors for postoperative hypothyroidism. Well evaluate your TSH level (blood test) at six-week intervals to see if this is the correct level. In the remaining five studies, the selection procedure was not clearly reported (49, 51, 52, 57). This will allow accurate detection of Tg, in the presence of TgAb, down to 0.2 ng/mL (risk of residual/recurrent disease <1%-3%). So our beautiful new home is also the safest place in the world to have your thyroid operation. Would you like email updates of new search results? Clinicopathologic predictors for early and late biochemical hypothyroidism after hemithyroidectomy. Grebe SKG: Diagnosis and management of thyroid carcinoma: a focus on serum thyroglobulin. Disagreement on the screening or data extraction process was resolved by consensus after consulting a third reviewer (O.M.D.). Years of publication ranged from 1983 to 2011. If the thyroglobulin level begins to Endocrinological follow-up six weeks after surgery revealed the need for L-T4 dose adjustments, especially in preoperatively hyperthyroid patients. The site is secure. Comparative study between the effects of replacement therapy with liquid and tablet formulations of levothyroxine on mood states, self-perceived psychological well-being and thyroid hormone profile in recently thyroidectomized patients. The intervention performed had to be a hemithyroidectomy with preservation of the contralateral lobe. This goal may change to a normal range of TSH following long term follow-up and no detectable thyroglobulin. We aimed to calculate the incidence of hypothyroidism, defined as the proportion of preoperatively nonhypothyroid patients becoming hypothyroid after the procedure. The normal range of TSH levels in non- pregnant adult women is 0.5 to 5.0 mIU/L. [The thyrotropic function of the hypophysis and peripheral thyroid hormones after removal of bland and autonomous nodular goiters]. Sometimes surgery damages the parathyroid glands, located behind your thyroid. In patients who are clinically and biochemically free of disease but who presented with high risk disease, consideration should be given to maintaining TSH suppressive therapy to achieve serum TSH levels of 0.10.5mU=L for 510 years. Tg levels 2.1 to 9.9 ng/mL in athyrotic individuals on suppressive therapy indicate an increased risk of clinically detectable recurrent papillary/follicular thyroid cancer. This study showed a risk for postoperative hypothyroidism (23%) similar to the overall pooled risk from our meta-analysis. Your parathyroid glands may not work as well as they should after surgery. The normal range of TSH levels in non- pregnant adult women is 0.5 to 5.0 mIU/L. In patients who have not undergone remnant ablation who are clinically free of disease and have undetectable suppressed serum Tg and normal neck ultrasound, the serum TSH may be allowed to rise to the low normal range (0.32mU=L). For example, a 29 What is normal TSH after thyroidectomy? More information about levothyroxine is in the web site section titled "Know Your Pills.". We know there is a lot of information on the site and it can be Tg 10 ng/mL: Tg levels must be interpreted in the context of TSH levels, serial Tg measurements, and radioiodine ablation status. See Supplemental Table 2 for more details. However, these results should be interpreted carefully because patients in whom a near-total lobectomy was pursued were also studied, which is the reason for not including this study in our meta-analysis. Tg 0.1 to 2.0 ng/mL: Tg levels must be interpreted in the context of TSH levels, serial Tg measurements, and radioiodine ablation status. Pacini F, Catagana MG, Brilli L, et al: Thyroid cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Generally, it should not be taken with other drugs, since a large number of drugs interfere with thyroid hormone getting into the blood stream. Papillary thyroid cancer patients, who have completed treatments, the timing of follow-up appointments and the types of studies obtained in the follow up of their papillary thyroid cancer depends upon: Follow-up of papillary thyroid cancer patients is usually accomplished by an endocrinologist every six months for the first year and then annually thereafter if there is no evidence of disease. Of the patients who were preoperatively hyperthyroid, 60% of those with total thyroidectomy and all of those with subtotal thyroidectomy required L-T4 dose adjustments. Here are the results that I've had for the Ultrasensitive Thyroglobulin Antibodies since May 2013 (after my Partial and before the total) was 306 then in July after the Total they dropped to 260 then were 143, 106, 105 and then I had RAI. The number and timing of laboratory measurements varied from only one TSH measurement 48 wk after surgery to monthly, 2-monthly, or 3-monthly regular thyroid hormone measurements for years after the intervention. New insights into subclinical hypothyroidism and cardiovascular risk. Symptom relief should be all important to you, not just test results. : determined in young group of patients with mean age of 40 yr. Su et al. Preoperative levels of the thyroid hormones free T4 (FT4), T3, and thyroid stimulating hormone (TSH) were retrospectively analyzed in patients who underwent total thyroidectomy for Graves disease. The https:// ensures that you are connecting to the For all studies the proportion of patients lost to follow-up was determined. At our beautiful new hospital you can have one family member with you at all times. There are several different types of thyroid hormone pills and you should discuss this with your endocrinologist to make sure that you are feeling well and your hormone levels are right for you. A small majority of our preoperatively euthyroid patients received adequate therapy. Studies not excluding patients with preoperative hypothyroidism or in which preoperative thyroid status was unknown were included; in a sensitivity analysis, studies with only preoperative euthyroid patients were analyzed. Our great team of doctors, nurses, pathologists, anesthesia services, and diagnostic imaging have made the move with us to continue the exceptional care we provide our patients from around the world. Because patients with subclinical hypothyroidism due to a hemithyroidectomy differ from patients with spontaneous subclinical hypothyroidism, it is difficult to extrapolate the risks derived from studies including hypothyroid patients to operated patient populations. Dr. Robert Uyeda answered. Read our Thyroid Blog! The ATA and ETA guidelines suggest TSH suppression when a patient has active tumor or has a very aggressive tumor that has been treated with surgery and radioactive iodine (I 131). The following databases were searched up to August 17, 2011: PubMed, EMBASE (OVID-version), Web of Science, COCHRANE Library, CINAHL (EbscoHOST-version), Academic Search Premier (EbscoHOST-version), ScienceDirect, Springer Journal web site, Wiley Journal web site, LWW-Journals (OVID-version), HighWire Press, Informahealth Journal web site, and Google Scholar. If the apparent Tg concentration is <1.0 ng/mL, the sample should be remeasured by mass spectrometry. 3) Thyroglobulin: Thyroglobulin is a protein produced by thyroid cells (both follicular thyroid cancer and normal cells). However, the positive predictive value for residual/recurrent disease is modest when Tg is just above this threshold (3%-25%) in athyrotic patients. Patients with higher Tg levels, who have no demonstrable remnant of thyroid tissue, might require additional testing, such as further stimulated Tg measurements, neck ultrasound, or isotope imaging. I believe your PT was November 2019 and you've had rising TSH since. Bethesda, MD 20894, Web Policies Preoperatively euthyroid patients received 150 microg L-T4 daily following total thyroidectomy, 100 microg L-T4 after subtotal thyroidectomy, and 50 microg L-T4 after hemithyroidectomy. The following study characteristics were considered relevant for the assessment of risk of bias for the present meta-analysis: 1) selection of the exposed cohort. : based on total population of 3470 patients who underwent partial thyroidectomy [subtotal thyroidectomy, near-total thyroidectomy, and hemithyroidectomy (n = 1051)]. 2009;4(1):25-43. doi: 10.1586/17446651.4.1.25, 2. Cooper DS, Doherty GM, Haugen BR, et al: Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. The TRHR Gene Is Associated with Hypothalamo-Pituitary Sensitivity to Levothyroxine. Ann Oncol. In studies clearly reporting time to diagnosis since intervention, it was shown that hypothyroidism was usually detected within the first 6 months after hemithyroidectomy (46, 53, 54, 59, 6163, 67, 68, 73, 74). Predictive factors for recurrence after thyroid lobectomy for unilateral non-toxic goiter in an endemic area: results of a multivariate analysis. Meta-analysis of the prevalence of hypothyroidism after hemithyroidectomy. First, the available data did not allow us to assess what proportion of the reported hypothyroidism is transient or permanent. 3 It may last for Br J Surg. MeSH The largest study comprised 1051 patients (66). In six studies, comprising 791 patients, the risk of hypothyroidism in patients with anti-TPO antibodies was compared with the risk in patients without these antibodies.
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