Findings from a new trial suggest total thyroidectomy is more effective than medical management for Hashimoto's disease.
The trial included 150 individuals aged between 18 and 79 years attending a secondary care hospital in Norway. All individuals had persistent Hashimoto-related symptoms despite euthyroid status while receiving hormone replacement therapy and with serum antithyroid peroxidase (anti-TPO) antibody titres greater than 1,000 IU/mL.
Seventy-three patients underwent total thyroidectomy with standard medical therapy, whereas 74 received standard medical therapy only.
At 18 months follow-up, only patients in the surgical group demonstrated improvement in measures of health-related quality of life and fatigue. Mean general health score increased from 38 to 64 points for a between-group difference of 29 points (95% CI 22-35; P<.001 fatigue score decreased from to points a between-group difference of ci p chronic frequency cent per percentage median serum anti-tpo antibody titres also in the surgical group but not medical therapy group.>
The findings are published in the Annals of Internal Medicine.