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Hypothyroidism II: Pathophysiology

Hypothyroidism II: Pathophysiology

Hypothyroidism is a disorder characterized by insufficient production of thyroid hormones, which regulate metabolism, energy balance, and multiple organ systems.TypesHypothyroidism is classified based on the level of dysfunction. Primary hypothyroidism results from intrinsic thyroid gland dysfunction, causing reduced hormone production despite normal or increased stimulation. Secondary hypothyroidism arises from inadequate thyroid-stimulating hormone (TSH) secretion by the pituitary. Tertiary...

Hyperthyroidism I: Introduction

Hyperthyroidism I: Introduction

Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...

Hyperthyroidism II: Pathophysiology

Hyperthyroidism II: Pathophysiology

Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH receptors...

Graves Disease II: Pathophysiology

Graves Disease II: Pathophysiology

Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor, and heat...

Graves' Disease I: Introduction

Graves' Disease I: Introduction

Graves' disease is an autoimmune disorder that causes hyperthyroidism, or overactivity of the thyroid gland. It results from autoantibodies called thyroid-stimulating immunoglobulins (TSIs), which bind to thyroid-stimulating hormone (TSH) receptors, leading to overstimulation of hormone production and a hypermetabolic state.EtiologyAlthough considered idiopathic, Graves’ disease has well-established contributing factors. There is a strong genetic component, with increased prevalence in...

Synthesis and Regulation of Thyroid Hormones

Synthesis and Regulation of Thyroid Hormones

Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The iodine is then...

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Hypothyroidism following partial thyroidectomy.

Michael Vaiman¹, Andrey Nagibin, Philippe Hagag

¹Department of Otorhinolaryngology-Head and Neck Surgery, Assaf Harofeh Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Israel. vaimed@yahoo.com

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|January 1, 2008

Summary

This summary is machine-generated.

Hemithyroidectomy resulted in a 28% rate of permanent hypothyroidism, significantly lower than near-total or subtotal thyroidectomy for multinodular goiter. Partial thyroidectomy offers no clear benefit over total thyroidectomy regarding hormone therapy needs.

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Mixed Reality Assisted Radical Endoscopic Thyroidectomy

Mixed Reality Assisted Radical Endoscopic Thyroidectomy

Published on: January 31, 2025

Area of Science:

Endocrinology
Surgical Oncology
Thyroid Surgery

Background:

Multinodular goiter is a common thyroid condition requiring surgical intervention.
Partial thyroidectomy aims to preserve thyroid function while removing diseased tissue.
The incidence of hypothyroidism post-partial thyroidectomy varies by surgical technique.

Purpose of the Study:

To compare the rates of hypothyroidism following three distinct types of partial thyroidectomy: hemithyroidectomy, near-total thyroidectomy, and subtotal thyroidectomy.
To evaluate the long-term need for hormone replacement therapy after these procedures for multinodular goiter.

Main Methods:

Retrospective study of 3470 partial thyroidectomy cases (hemithyroidectomy, near-total, subtotal) from 1990-2006.
Involved two medical centers in Israel and Russia.
Postoperative follow-up ranged from 2 to 15 years to assess hypothyroidism incidence.

Main Results:

Hemithyroidectomy had a 28% rate of permanent hypothyroidism versus 100% for near-total and 87% for subtotal thyroidectomy.
Temporary hypothyroidism affected 46% of hemithyroidectomy patients, compared to 100% for near-total and 93% for subtotal thyroidectomy.
Near-total and subtotal thyroidectomies resulted in hypothyroidism rates approaching those of total thyroidectomy.

Conclusions:

Hemithyroidectomy is associated with a substantially lower risk of permanent hypothyroidism compared to near-total and subtotal thyroidectomy for multinodular goiter.
Partial thyroidectomy techniques do not offer a definitive advantage over total thyroidectomy concerning the need for supplemental hormone therapy.
The choice of partial thyroidectomy technique significantly impacts the likelihood of developing hypothyroidism.