Surgery May Be Best Treatment for Hashimoto's Disease

Patients diagnosed with Hashimoto's disease who underwent a complete thyroidectomy saw significant improvement in chronic fatigue symptoms, according to a new study.

Researchers at Telemark Central Hospital (Porsgrunn, Norway) and University Hospital Stavanger (Norway) conducted a randomized pilot study involving 97 consecutive Hashimoto patients who underwent complete thyroidectomy between 2004 and 2009. The researchers monitored anti-thyroidperoxidase (anti-TPO) levels preoperatively and up to 96 months after surgery, thyroxin supplement, and typical symptoms not ameliorated by thyroxin. They also registered symptoms by phone survey, with patients being asked to estimate changes in the severity of the autoimmune symptoms before and after surgery.

The results showed that post-procedure, anti-TPO levels normalized in a majority of patients, with serious exhaustion, pain, and stiffness in musculature and joints correlated to titers of anti-TPO. The percentage of those reporting severe fatigue was reduced from 84% at baseline to 34% at 18 months, with symptoms improved in more than 75% of patients after 36 months. The study was presented as a poster session at the International Thyroid Congress, held during October 2015 in Orlando (FL, USA).

“Eighteen months after randomization, the surgical group reports significant improvement in health-related quality of life and chronic fatigue, almost comparable to the background population,” said lead author and study presenter Ivar Guldvog, MD, PhD, of Telemark Central Hospital. “The results stimulate the hypothesis that Hashimoto is a surgical condition; there is no other treatment alternative. We have now included all 150 patients planned for the randomized study, and we are in the middle of the follow up time observing that the antibodies are falling in all patients.”

Hashimoto's disease, also known as chronic lymphocytic thyroiditis, is an autoimmune condition in which the immune system attacks the thyroid gland, a part of the endocrine hormonal system. The resulting inflammation often leads to an underactive thyroid gland (hypothyroidism). Hashimoto's disease is the most common cause of hypothyroidism in the United States, primarily affecting middle-aged women, but also can occur in men and women of any age, as well as children.

Related Links:
Telemark Central Hospital
University Hospital Stavanger