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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.
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The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
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Hormones intricately bind to receptors on the surface or within target cells, initiating a cascade of cellular responses.
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Updated: Dec 2, 2025

Mixed Reality Assisted Radical Endoscopic Thyroidectomy
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Hormonal Outcomes Following Hemithyroidectomy.

Lauren Anne Buehler1, Nabil Zuhayr Madhun1, James Bena2

  • 1Endocrinology and Metabolism Institute, Cleveland Clinic, Cleveland, Ohio, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|November 3, 2020
PubMed
Summary

Most patients remain euthyroid after hemithyroidectomy (HT). Immediate thyroid hormone (TH) replacement can suppress TSH levels. Observation may be preferable to TH therapy post-HT.

Keywords:
hemithyroidectomyhormonal outcomeshormone replacement

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Area of Science:

  • Endocrinology
  • Surgical Oncology

Background:

  • Hemithyroidectomy (HT) is a common surgical procedure.
  • Assessing hormonal outcomes and the need for thyroid hormone (TH) replacement post-HT is crucial for patient management.

Purpose of the Study:

  • To evaluate hormonal status and the efficacy of thyroid hormone (TH) replacement following hemithyroidectomy (HT).
  • To compare outcomes in patients with overt hypothyroidism (OH), subclinical hypothyroidism (SH), and euthyroidism (EU) after HT.
  • To determine optimal TH dosage to prevent TSH suppression in patients requiring immediate TH therapy.

Main Methods:

  • Retrospective chart review of 335 patients undergoing HT between 2000 and 2010.
  • Categorization of patients into OH, SH, and EU based on thyroid-stimulating hormone (TSH) levels and TH use.
  • Analysis of TSH normalization in SH patients and TSH suppression in those receiving immediate TH therapy.

Main Results:

  • Of patients not immediately started on TH, 54.3% remained euthyroid (EU), 32.4% had overt hypothyroidism (OH), and 13.3% had subclinical hypothyroidism (SH).
  • 58.3% of patients with SH normalized their TSH levels over time.
  • Immediate TH initiation led to TSH suppression in 45% of patients, with doses >1.05 mcg/kg/d of levothyroxine (LT4) being predictive of suppression.

Conclusions:

  • The majority of patients maintain euthyroidism after hemithyroidectomy without immediate thyroid hormone replacement.
  • Early thyroid hormone therapy post-HT can result in TSH suppression.
  • Observation is a viable strategy, and thyroid hormone replacement may not be necessary for all patients after hemithyroidectomy.