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Aleck Hercbergs, MD; Paul Davis, MD

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Nelson et al¹ report that the development of hypothyroidism in patients with advanced head and neck cancer may be associated with improved survival and highlight the issue of L-thyroxine supplementation in patients diagnosed as having chemical hypothyroidism. Because thyroid hormone supplementation is invariably prescribed for chemical but clinically asymptomatic hypothyroidism, as was the case in the patients in Nelson and colleagues' retrospective study, it is of note that the American Thyroid Association² consensus statement advises that thyroid hormone replacement therapy may not be indicated in subclinical hypothyroidism, ie, in asymptomatic individuals with a serum thyroid-stimulating hormone (TSH) concentration that is mildly elevated (up to 10.0 mIU/L). This consensus position may be especially relevant for individuals with a prior or current cancer diagnosis in view of the growing body of evidence that supports a permissive role for thyroid hormone (L-thyroxine, thyroxine, and . . . [Full Text of this Article]

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RELATED LETTER

Association Between Development of Hypothyroidism and Improved Survival in Patients With Head and Neck Cancer
Marc Nelson, Aleck Hercbergs, Lisa Rybicki, and Marshall Strome
Arch Otolaryngol Head Neck Surg. 2006;132(10):1041-1046.
ABSTRACT | FULL TEXT