Thyroidectomy as Primary Treatment Optimizes Body Mass Index in Patients with Hyperthyroidism

Abstract

Objective The purpose of this study was to determine how the timing of thyroidectomy influenced postoperative weight change. Methods We conducted a two institution study, identifying patients treated with total thyroidectomy for hyperthyroidism. Patients were classified as “early” if they were referred for surgery as the first treatment option or “delayed” if they were previously treated with radioactive iodine. Groups were compared with the student's t-test or Chi-squared test where appropriate. Results There were 204 patients undergoing thyroidectomy for hyperthyroidsim. 171 patients were classified as early and 33 were delayed. Overall, patients gained 6.0% ± 0.8 of their preoperative body weight at last follow-up. Preoperative BMIs were similar between groups (p= 0.98), and the median follow-up time was 388 days (range 15 – 1,584 days). Both groups gained weight until they achieved a normal TSH postoperatively. After achieving a normal TSH, the early group stabilized or lost weight (-0.2 lbs/day) while the delayed group continued to gain weight (0.02 lbs/day, p = 0.61). At last follow-up, there were significantly more patients in the delayed group who increased their BMI category compared to the early group (42.4% vs. 21.6%, p = 0.01). Twice as many patients in the delayed group moved up or into an unhealthy BMI category (overweight or obese) compared to the early group (39.4% vs. 19.3%, p = 0.01). Conclusions Compared to patients initially treated with radioactive iodine, patients with hyperthyroidism who underwent surgery as the first treatment were less likely to become overweight or obese postoperatively.

Frequency of Malignant Thyroid Pathology in Thyroidectomized Patients With Diagnosis of Multinodular Bocio

“…La mayoría de los trabajos que publican sobre tiroidectomías son series de bastantes pacientes, una de las series con mayor número de pacientes fue realizado por la de Miccoli 998 pacientes, Bauer con 683 pacientes, Gervasio 253 pacientes, Schneider con 216 pacientes, nuestra serie de 296 casos (1,4,5) .…”

“…Entre los diferenciados se citan al carcinoma papilar, folicular y de células de Hurthle. Los indiferenciados son el medular y el anaplásico (5) .…”

Change in BMI after radioactive iodine ablation for graves disease

“…Most patients treated with ATDs were not seen at our institution at their initial presentation with GD, and thus their pre-treatment BMIs were not available. However, previous research has suggested that the use of sequential treatment modalities in adults can result in continued weight gain compared with definitive treatment as a first line approach [ 8 ]. This question would be interesting to investigate in pediatric patients as well.…”

“…While TTE was negatively correlated with ∆BMI SDS in our subanalysis, the weakness of this association suggests that other factors should also be considered. Though some studies in adults show differences in BMI outcome by treatment modality [ 8 , 9 ], this has not been demonstrated consistently, and it is unknown whether these expectations can be extended to children. We found similar outcomes in our population when compared to reports from other centers [ 5 ].…”

Weight change in patients with differentiated thyroid carcinoma after total thyroidectomy versus lobectomy

“…Even though weight gain with increasing age is well known, prevention of any undesired weight gain could be important for the maintenance of well-being in most patients. Several studies have addressed this issue with a focus on outcomes of thyroidectomy in patients with hyperthyroidism [2,4,5]. Other studies compared outcomes of thyroidectomy in thyroid cancer patients compared to those with benign nodules [6][7][8].…”