{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T12:25:19Z","timestamp":1792239919502,"version":"4.4.0"},"reference-count":26,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T00:00:00Z","timestamp":1569888000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T00:00:00Z","timestamp":1569888000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Thyroid\u00ae"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Some studies reported that among athyreotic patients on levothyroxine (LT4) after total thyroidectomy, patients with normal serum thyrotropin (TSH) levels had mildly low serum free triiodothyronine (fT3) levels, whereas patients with mildly suppressed serum TSH levels had normal serum fT3 levels. The reduction of the thyroid volume (TV) after radioiodine treatment for Graves' disease is well known; however, a few studies evaluated thyroidal function including serum triiodothyronine (T3) levels of hypothyroid patients on LT4 after radioiodine treatment in detail.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We retrospectively studied 446 patients treated with LT4 for radioiodine-induced hypothyroidism and who had undergone ultrasonography. We compared serum fT4 and fT3 levels in hypothyroid patients on LT4 who presented an atrophic thyroid change after radioiodine treatment, with those in the euthyroid matched control group with intact thyroids. We also stratified patients with normal TSH levels according to TV and evaluated serum thyroid hormone levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In 356 of 446 (80%) patients, TV was lower than the lower limit of the 95% reference range of controls. Excluding 43 patients with high serum TSH levels, we assessed thyroid function test results in 313 patients with atrophic thyroid glands. Of these cases, eight patients with strongly suppressed TSH levels had serum fT3 levels that were significantly higher than those in controls (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Overall, 27 patients with mildly suppressed TSH levels had serum fT3 levels equivalent to those in controls (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.386), whereas 278 patients with normal TSH levels had serum fT3 levels that were significantly lower than those in controls (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). We also assessed fT3 levels relative to TV in 326 patients with normal TSH levels. Of these cases, in 267 patients with TV less than 5\u2009mL and in 46 patients with TV between 5 and 10\u2009mL, serum fT3 levels were significantly lower than those in controls (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). In 13 patients with TV more than 10\u2009mL, serum fT3 levels were equivalent to those in controls (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.844).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Serum thyroid hormone balance in most patients on LT4 after radioiodine treatment for Graves' disease was similar to that in athyreotic patients on LT4. Mild TSH suppression with LT4 is needed to achieve normal fT3 levels in such patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/thy.2019.0135","type":"journal-article","created":{"date-parts":[[2019,8,14]],"date-time":"2019-08-14T07:00:40Z","timestamp":1565766040000},"page":"1364-1370","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":16,"title":["Serum Thyroid Hormone Balance in Levothyroxine Monotherapy-Treated Patients with Atrophic Thyroid After Radioiodine Treatment for Graves' Disease"],"prefix":"10.1177","volume":"29","author":[{"given":"Mitsuru","family":"Ito","sequence":"first","affiliation":[{"name":"Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Motoki","family":"Kawasaki","sequence":"additional","affiliation":[{"name":"Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirosuke","family":"Danno","sequence":"additional","affiliation":[{"name":"Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuyoshi","family":"Kohsaka","sequence":"additional","affiliation":[{"name":"Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiko","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mako","family":"Hisakado","sequence":"additional","affiliation":[{"name":"Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waka","family":"Yoshioka","sequence":"additional","affiliation":[{"name":"Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshihiko","family":"Kasahara","sequence":"additional","affiliation":[{"name":"Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takumi","family":"Kudo","sequence":"additional","affiliation":[{"name":"Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eijun","family":"Nishihara","sequence":"additional","affiliation":[{"name":"Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuji","family":"Fukata","sequence":"additional","affiliation":[{"name":"Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsushige","family":"Nishikawa","sequence":"additional","affiliation":[{"name":"Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirotoshi","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Miyauchi","sequence":"additional","affiliation":[{"name":"Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,10,15]]},"reference":[{"key":"e_1_3_3_2_2","first-page":"715","article-title":"Thyroidal and peripheral production of 3,5,3\u2032-triiodothyronine in humans by multicompartmental analysis","volume":"258","author":"Pilo A","year":"1990","unstructured":"Pilo A, , Iervasi G, , Vitek F, , Ferdeghini M, , Cazzuola F, , Bianchi R. 1990. Thyroidal and peripheral production of 3,5,3\u2032-triiodothyronine in humans by multicompartmental analysis. Am J Physiol, 258:715\u2013726.","journal-title":"Am J Physiol"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-11-1029"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.299.7.769"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0022552"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/cen.12527"},{"key":"e_1_3_3_7_2","first-page":"978","article-title":"Radioiodine-induced hypothyroidism in Graves' disease: factors associated","volume":"23","author":"Cunnien AJ","year":"1982","unstructured":"Cunnien AJ, , Hay ID, , Gorman CA, , Offord KP, , Scanlon PW. 1982. Radioiodine-induced hypothyroidism in Graves' disease: factors associated. 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Third edition. Japan Association of Breast and Thyroid Sonology Tokyo Japan pp 13\u201314."},{"key":"e_1_3_3_13_2","first-page":"3257","article-title":"Changes in thyroid volume in response to radioactive iodine for Graves' hyperthyroidism correlated with activity of thyroid-stimulating antibody and treatment outcome","volume":"81","author":"Murakami Y","year":"1996","unstructured":"Murakami Y, , Takamatsu J, , Sakane S, , Kuma K, , Ohsawa N. 1996. Changes in thyroid volume in response to radioactive iodine for Graves' hyperthyroidism correlated with activity of thyroid-stimulating antibody and treatment outcome. J Clin Endocrinol Metab, 81:3257\u20133260.","journal-title":"J Clin Endocrinol Metab"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-15-0138"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2016.0426"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI25083"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2006-1242"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2007-2237"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-10-0736"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1398616"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI77588"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI118353"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2016-2660"},{"key":"e_1_3_3_24_2","first-page":"4533","article-title":"Systemic thyroid hormone status during levothyroxine therapy in hypothyroidism: a systematic review and meta-analysis","volume":"103","author":"McAninch EA","year":"2018","unstructured":"McAninch EA, , Rajan KB, , Miller CH, , Bianco AC. 2018. Systemic thyroid hormone status during levothyroxine therapy in hypothyroidism: a systematic review and meta-analysis. J Clin Endocrinol Metab, 103:4533\u20134542.","journal-title":"J Clin Endocrinol Metab"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0043-125064"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-15-0130"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2014.0028"}],"container-title":["Thyroid\u00ae"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/thy.2019.0135","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/thy.2019.0135","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/thy.2019.0135","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T22:05:59Z","timestamp":1777586759000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/thy.2019.0135"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10]]},"references-count":26,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2019,10]]}},"alternative-id":["10.1089\/thy.2019.0135"],"URL":"https:\/\/doi.org\/10.1089\/thy.2019.0135","relation":{},"ISSN":["1050-7256","1557-9077"],"issn-type":[{"value":"1050-7256","type":"print"},{"value":"1557-9077","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10]]}}}