Follow‐up evaluation of thyroid function after thyroidectomy for thyrotoxicosis

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Abstract
One hundred fifty‐seven patients with hyperthyroidism treated by subtotal thyroidectomy 2–8 years previously were followed up with serum T3, T4, and TSH determinations. There was some difficulty in distinguishing the various groups of patients by thyroid function tests. However, it was determined that the percentages of patients with hyperthyroidism, euthyroidism, and hypothyroidism, based on T3 values, were 3.2%, 89.7%, and 7.1%, respectively, whereas 5.8%, 41.6%, and 53.1% were hyperthyroid, euthyroid, and hypothyroid by TSH criteria. Subclinical hypothyroidism, that is, increased TSH levels but normal T3 and T4 levels, accounted for the major discrepancy in these results. Subclinical hypothyroidism is more sensitive to disclosure by the TRH stimulation test. However, the incidence and severity of hypothyroidism after thyroidectomy are lower and milder than after131I treatment. The recurrence rate is less than that after the administration of antithyroid drugs, and postoperative complications are rare. Surgical treatment, therefore, plays an important role in the treatment of patients with hyperthyroidism. Those patients with sustained subclinical hypothyroidism after subtotal thyroidectomy should receive supplemental thyroid hormone.