Post-Radioiodine Graves' Management: The Pragma-Study

Perros, Petros; Dayan, Colin; Vaidya, Bijay; Williams, Graham R.; Lazarus, John; Hickey, Janis; Willis, Debbie; Archer, Natasha M.; Franklyn, Jayne A.; Basu, Ansu

doi:10.1530/endoabs.44.oc3.3

Cited by 1 publication

(3 citation statements)

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“…Significant weight gain was observed with treatment, and male gender, black or Hispanic ethnicity and T3 levels at diagnosis were found to be independent predictors of weight rise, whereas age, cause of hyperthyroidism, post‐treatment TSH, compliance and insurance status were not . The PRAGMA study, a multi‐centre, retrospective UK study which included 812 patients who underwent RAI for Graves' disease showed that hypothyroidism developed in two‐thirds of the patients during the first 1 year, with 11% still found to be biochemically hypothyroid at 12 months . Frequent weight gain was reported, affecting about two‐thirds of patients, but with the risk being attenuated in those patients who were commenced on ATDs together with L‐T4 post‐therapy .…”

Section: Weight Changes Due To Hyperthyroidismmentioning

confidence: 99%

“…64 The PRAGMA study, a multi-centre, retrospective UK study which included 812 patients who underwent RAI for Graves' disease showed that hypothyroidism developed in two-thirds of the patients during the first 1 year, with 11% still found to be biochemically hypothyroid at 12 months. 65 Frequent weight gain was reported, affecting about two-thirds of patients, but with the risk being attenuated in those patients who were commenced on ATDs together with L-T4 post-therapy. 65 Another recurring theme that is evident from these studies is that the development of hypothyroidism is likely to be at least partly to blame for the weight gain observed with hyperthyroidism treatment modalities.…”

Section: Risk Factors For Excessive Weight Gain With Hyperthyroidismentioning

confidence: 99%

“…65 Frequent weight gain was reported, affecting about two-thirds of patients, but with the risk being attenuated in those patients who were commenced on ATDs together with L-T4 post-therapy. 65 Another recurring theme that is evident from these studies is that the development of hypothyroidism is likely to be at least partly to blame for the weight gain observed with hyperthyroidism treatment modalities. 57,58,62 Nevertheless, not all the studies are congruent with this conclusion and there is marked heterogeneity among the studies in their design, definitions and timing of thyroid function assessment and indeed there with no consistent reporting of the thyroid function (Table 3).…”

Section: Risk Factors For Excessive Weight Gain With Hyperthyroidismentioning

confidence: 99%

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Weight gain following treatment of hyperthyroidism—A forgotten tale

Kyriacou

Makris

et al. 2019

Clinical Obesity

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Summary Hyperthyroidism causes weight loss in the majority, but its effect is variable and 10% of patients gain weight. Its treatment usually leads to weight gain and some studies have reported an excess weight regain. However, there is considerable inter‐individual variability and a differential effect on body weight by different treatments, with some studies reporting more weight increase with radioiodine, and perhaps surgery, compared with anti‐thyroid drugs. The excess weight regain may relate to treatment‐induced hypothyroidism. Furthermore, the transition from hyperthyroidism to euthyroidism may unmask, or exacerbate, the predisposition that some patients have towards obesity. Other risk factors commonly implicated for such weight increase include the severity of thyrotoxicosis at presentation and underlying Graves' disease. Conflicting data exist whether lean body mass or fat mass or both are increased post‐therapy and whether such increments occur concurrently or in a sequential manner; this merits clarification. In any case, clinicians need to counsel their patients regarding this issue at presentation. Limited data on the effect of dietary interventions on weight changes with treatment of hyperthyroidism are encouraging in that they cause significantly lesser weight gain compared to standard care. More research is indicated on the impact of the treatment of hyperthyroidism on various anthropometric indices and the predisposing factors for any excessive weight gain. Regarding the impact of dietary management or other weight loss interventions, there is a need for well‐designed and, ideally, controlled intervention studies.

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Section: Weight Changes Due To Hyperthyroidismmentioning

confidence: 99%