Post-thyroidectomy chronic asthenia: self-deception or disease?

Area of Science:

• Endocrinology
• Surgical Oncology
• Quality of Life Research

Background:

• Persistent asthenia is a reported symptom in patients following total thyroidectomy (TT).
• The causal link between TT and chronic asthenia syndrome has not been thoroughly investigated.
• Asthenia is a known post-thyroidectomy symptom but often inadequately studied as a surgical consequence.

Purpose of the Study:

• To determine the prevalence of asthenia symptoms in post-total thyroidectomy patients.
• To assess if TT causes or unmasks chronic asthenia syndrome.
• To compare asthenia incidence between total lobectomy (TL) and TT.

Main Methods:

• Observational study comparing 100 patients undergoing TL (Group A) and 100 undergoing TT (Group B).
• Patients with normal thyroid hormone levels were interviewed for asthenia symptoms lasting ≥6 months.
• Asthenia severity was measured using the Brief Fatigue Inventory (BFI).

Main Results:

• Post-operative asthenia incidence was 0% after TL versus 25% after TT.
• The surgical procedure (TT) was the only significant variable identified.
• Asthenia presented with low to moderate intensity, impacting at least 25% of TT patients.

Conclusions:

• Complete thyroid removal (TT) can cause chronic asthenia, a significant sequela affecting quality of life.
• The findings highlight the need to identify the causes of post-thyroidectomy asthenia.
• Indications for TT should be strictly limited to essential cases due to the risk of chronic asthenia.