TUESDAY, March 12, 2019 (HealthDay News) -- For patients with Hashimoto thyroiditis with persistent symptoms despite normal thyroid gland function, total thyroidectomy, but not medical management, improves health-related quality of life and fatigue, according to a study published online March 12 in the Annals of Internal Medicine.
Ivar Guldvog, M.D., Ph.D., from Telemark Hospital in Skien, Norway, and colleagues examined symptom improvement in 150 patients aged 18 to 79 years with persistent Hashimoto-related symptoms despite euthyroid status while receiving hormone replacement therapy and with serum antithyroid peroxidase (anti-TPO) antibody titers >1,000 IU/mL. Patients were randomly assigned to total thyroidectomy or medical management with hormone substitution.
The researchers found that only the surgical group demonstrated improvement during follow-up. There was an increase in the mean general health score from 38 to 64 points (between-group difference, 29 points) at 18 months. A decrease from 23 to 14 points was observed in the fatigue score (between-group difference, 9.3 points). A decrease was also seen in chronic fatigue frequency, from 82 to 35 percent (between-group difference, 39 percent). A decrease was seen in median serum anti-TPO antibody titers, from 2,232 to 152 IU/mL (between-group difference, 1,148 IU/mL).
"We believe that this is the first randomized controlled trial to demonstrate improvement in health-related quality of life and fatigue and normalization of serum anti-TPO antibody titer levels after complete removal of the diseased thyroid gland," the authors write.