Wang Karina, Gulec Seza A
Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL 33328, USA.
Miami Cancer Research Center, Miami, FL 33181, USA.
J Clin Med. 2024 Dec 8;13(23):7465. doi: 10.3390/jcm13237465.
Thyroidectomy has been post-operatively managed by hormone replacement therapy in order to satisfy the reference ranges of thyroid stimulating hormone (TSH) and thyroxine (T4) levels. While medication and standardized reference ranges have proven to be effective, many patients continue to report unintentional weight gain despite adequate amounts of treatment and levels of TSH and T4. Physicians, over the years, have become complacent to these "normal" ranges, and have ignored the metabolic consequences that are affecting thyroidectomy patients. This paper aims to redefine the approach to post-thyroidectomy clinical care by challenging the current standardized hormonal range values, exploring the gaps in thyroid hormone conversion, investigating the metabolic pathways of T3, considering the influence of inflammatory markers, and proposing the future for patient-centered management.
甲状腺切除术后一直通过激素替代疗法进行管理，以满足促甲状腺激素（TSH）和甲状腺素（T4）水平的参考范围。虽然药物治疗和标准化参考范围已被证明是有效的，但许多患者尽管接受了足够的治疗且TSH和T4水平正常，仍继续报告出现意外体重增加。多年来，医生们对这些“正常”范围变得自满，忽视了影响甲状腺切除患者的代谢后果。本文旨在通过挑战当前标准化的激素范围值、探索甲状腺激素转化中的差距、研究T3的代谢途径、考虑炎症标志物的影响以及提出以患者为中心的管理未来，重新定义甲状腺切除术后临床护理的方法。
