Remission of Persistent Hypothyroidism Following Subacute Thyroiditis After Discontinuation of Thyroxine - A 9-Year Retrospective Study

Sep 30, 2026

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Long-term outcomes are evaluated for patients with persistent hypothyroidism after subacute thyroiditis when thyroxine replacement is discontinued. This extended follow-up tracks participants from a prednisone-treated subacute thyroiditis clinical trial, assessing thyroid-stimulating hormone, free triiodothyronine, and free thyroxine at 9 years. Of 48 eligible patients, most remained euthyroid, while a small subset showed persistent or subclinical hypothyroidism. Findings indicate thyroid function stability after careful dose reduction and discontinuation, supporting individualized management decisions.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Introduction

Materials and Methods

Study Design and Participants

Results

Conclusion

Wiley International Journal of Endocrinology Volume 2026, Article ID 8820514, 7 pages [https://doi.org/10.1155/ije/8820514](https://doi.org/10.1155/ije/8820514) Research Article Remission of Persistent Hypothyroidism Following Subacute Thyroiditis After Discontinuation of Thyroxine: A 9-Year Retrospective Study Lei Yang , 1 Min Mao ,2 and Lian Duan 3 1 Department of Breast and Tyroid Surgery, Te Tird Afliated Hospital of Chongqing Medical University, Chongqing, China 2 Department of Hematology, Te First Afliated Hospital of Chongqing Medical University, Chongqing, China 3 Department of Endocrinology, Te Tird Afliated Hospital of Chongqing Medical University, Chongqing, China Correspondence should be addressed to Lian Duan; [jasonmao2005@163.com](jasonmao2005@163.com) Received 6 May 2025; Revised 12 November 2025; Accepted 4 December 2025 Academic Editor: Suraiya Saleem Copyright © 2026 Lei Yang et al. International Journal of Endocrinology published by John Wiley & Sons Ltd. Tis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. Objective: Te long-term outcomes of discontinuing thyroxine replacement therapy in patients with persistent hypothyroidism following subacute thyroiditis are unknown. Tis study involved an extended follow-up of a cohort of patients who participated ina clinical trial of prednisone for the treatment of subacute thyroiditis. Methods: Tis retrospective cohort study included 52 patients with moderate to severe scores who were hospitalized between August 2013 and December 2014. Patients previously received prednisone for 1 week, followed by nonsteroidal anti-infammatory drugs for 1 week, and prednisone was administered for 6 weeks, after which the patients completed follow-up to Week 24 . Tyroid-stimulating hormone, free triiodothyronine, and free thyroxine levels of the participants were measured 9 years after enrollment. Results: Of the 52 participants randomly assigned to receive prednisone for 1 or 6 weeks, 50 completed the core trial, and 48 were eligible for extended follow-up, with a median duration of 8.61 years (IQR 8.29−8.77). Tirty participants were assessed at 9 years, 15 could not be contacted, and three refused follow-up tests. Among the 30 participants, 28 were euthyroid and 2 had subclinical hypothyroidism at 9 years. Te median TSH level was 3.46 mIU/L (IQR 2.12–5.15) at 24 weeks and 2.17 mIU/L (IQR 1.83–3.77) at 9 years (p 􀂈 0.001) . Te median FT4 level was 14.27 pmol/L (IQR 12.15–15.72) at 24 weeks and 15.28 pmol/L (IQR 12.53–16.22) at 9 years (p 􀂈 0.959) . Among the three participants diagnosed with persistent hypothyroidism at 24 weeks, one participant was diagnosed with subclinical hypothyroidism without thyroxine replacement therapy at 9 years, and two participants were diagnosed with subclinical hypothyroidism and euthyroidism after gradually withdrawing from thyroxine. Conclusion: Tyroid function remains stable in patients with persistent hypothyroidism following subacute thyroiditis after careful dose reduction and discontinuation of thyroxine replacement therapy. Tis fnding may have implications for the individualized management of hypothyroidism. Keywords: cohort study; hypothyroidism; prognosis; subacute thyroiditis; withdrawal 1. Introduction Patients with hypothyroidism generally receive lifelong thyroxine therapy [1] . Discontinuing unnecessary thyroxine replacement therapy could avoid side efects such as increased risk of arrhythmias, angina, osteoporosis, and fractures [2–4] . Among patients with idiopathic or autoimmune hypothyroidism, 37.2% of those who discontinued thyroxine remained euthyroid; unfortunately, 65.8% needed to restart thyroid hormone therapy during the subsequent follow-up [5] . It is difcult to predict which patients can successfully discontinue thyroxine therapy; therefore

FAQs

What is the main objective of this 9-year retrospective study?

To determine whether patients with persistent hypothyroidism following subacute thyroiditis remain euthyroid or need to restart thyroxine after discontinuation.

How were patients treated and followed up after subacute thyroiditis?

Patients received prednisone for 1 week, then nonsteroidal anti-inflammatory drugs for 1 week, followed by prednisone for 6 weeks; thyroid parameters were measured during extended follow-up up to 9 years.

What were the study findings at 9 years regarding thyroid function?

Most participants were euthyroid at 9 years, with a small number showing subclinical hypothyroidism; overall thyroid function remained stable after careful dose reduction and discontinuation.

Sep 30, 2026

Uploaded by Riley