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Marina Weber Pasa Thyroid Section, Endocrine Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil

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Rafael Selbach Scheffel Thyroid Section, Endocrine Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil

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André Borsatto Zanella Thyroid Section, Endocrine Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil

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Ana Luiza Maia Thyroid Section, Endocrine Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil

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José Miguel Dora Thyroid Section, Endocrine Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil

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highest dose) and LT 3 to 40 μg/day to achieve a euthyroid state during hospitalization. Thyroid ultrasound displayed a topical and homogeneous gland, with regular contours and increased age-related size (total volume of 2.4 mL, RV 0.2–2.7). Thyroid

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Bharath Bachimanchi Department of Endocrinology & Metabolism, Sri Venkateswara Institute of Medical Sciences, Tirupati, India

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Suresh Vaikkakara Department of Endocrinology & Metabolism, Sri Venkateswara Institute of Medical Sciences, Tirupati, India

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Alok Sachan Department of Endocrinology & Metabolism, Sri Venkateswara Institute of Medical Sciences, Tirupati, India

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Ganji Praveen Kumar Department of Endocrinology & Metabolism, Sri Venkateswara Institute of Medical Sciences, Tirupati, India

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Ashok Venkatanarasu Department of Endocrinology & Metabolism, Sri Venkateswara Institute of Medical Sciences, Tirupati, India

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Palaparti Sai Krishna Chaitanya Department of Endocrinology & Metabolism, Sri Venkateswara Institute of Medical Sciences, Tirupati, India

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Bekkem Sreedivya Department of Endocrinology & Metabolism, Sri Venkateswara Institute of Medical Sciences, Tirupati, India

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Ravi Poojari Department of Endocrinology & Metabolism, Sri Venkateswara Institute of Medical Sciences, Tirupati, India

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hormones that were assessed and the methods used are given in Table 1 . The patients were then started on T 4 replacement in doses titrated to achieve a normal TSH of 0.5–5 mIU/L. Two months or more after achieving euthyroid status (reconfirmed by TSH

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Bjarke Borregaard Medici Department of Endocrinology, Herlev University Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Jeppe Lerche la Cour Department of Endocrinology, Herlev University Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Luba Freja Michaelsson Department of Endocrinology, Herlev University Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Jens Oscar Faber Department of Endocrinology, Herlev University Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Birte Nygaard Department of Endocrinology, Herlev University Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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symptoms despite being biochemically euthyroid [ 1 ]. European Thyroid Association (ETA) guidelines [ 2 ] from 2012 suggest that L-T 4 /liothyronine (L-T 3 ) combination therapy could be considered as an experimental approach for compliant patients with

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Earn H. Gan Institute of Genetic Medicine, International Centre for Life, Newcastle upon Tyne, United Kingdom

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Anna L. Mitchell Institute of Genetic Medicine, International Centre for Life, Newcastle upon Tyne, United Kingdom

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Ruth Plummer Institute of Genetic Medicine, International Centre for Life, Newcastle upon Tyne, United Kingdom

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Simon Pearce Institute of Genetic Medicine, International Centre for Life, Newcastle upon Tyne, United Kingdom

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Petros Perros Institute of Genetic Medicine, International Centre for Life, Newcastle upon Tyne, United Kingdom

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biochemically euthyroid, 8 weeks following antithyroid drug treatment. The block and replace therapy for Graves disease was withdrawn after 12 months. He continues to receive 6-monthly tremelimumab treatment to date and has remained biochemically and clinically

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Roberto Negro Division of Endocrinology, ‘V. Fazzi' Hospital, Lecce

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Giacomo Greco Faculty of Medicine, San Raffaele Hospital, Milan, Italy

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oxidative stress is higher in overt hypothyroid patients than in euthyroid or subclinical hypothyroid patients, and the total antioxidant status is lower in overt hypothyroid subjects compared to the other groups [ 15 ]. Selenium (Se) has physiological

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Marko Stojanović Neuroendocrine Department, Diabetes and Metabolic Diseases, Clinical Center of Serbia
Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia

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Sandra Pekić Faculty of Medicine, University of Belgrade
Neuroendocrine Department, Diabetes and Metabolic Diseases, Clinical Center of Serbia
Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia

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Mirjana Doknić Faculty of Medicine, University of Belgrade
Neuroendocrine Department, Diabetes and Metabolic Diseases, Clinical Center of Serbia
Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia

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Dragana Miljić Faculty of Medicine, University of Belgrade
Neuroendocrine Department, Diabetes and Metabolic Diseases, Clinical Center of Serbia
Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia

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Slavica Ćirić Neuroendocrine Department, Diabetes and Metabolic Diseases, Clinical Center of Serbia
Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia

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Aleksandar Diklić Faculty of Medicine, University of Belgrade
Endocrine Surgery Department, Diabetes and Metabolic Diseases, Clinical Center of Serbia
Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia

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Svetislav Tatić Faculty of Medicine, University of Belgrade
Institute of Pathology, Clinical Center of Serbia, Belgrade, Serbia

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Miloje Joksimović Clinic for Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia

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Emilija Manojlović-Gačić Faculty of Medicine, University of Belgrade
Institute of Pathology, Clinical Center of Serbia, Belgrade, Serbia

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Milica Skender-Gazibara Faculty of Medicine, University of Belgrade
Institute of Pathology, Clinical Center of Serbia, Belgrade, Serbia

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Vera Popović Faculty of Medicine, University of Belgrade
Neuroendocrine Department, Diabetes and Metabolic Diseases, Clinical Center of Serbia
Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia

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local lymphadenopathy, was found. Physical examination was otherwise unremarkable. The patient had a long-standing euthyroid multinodular goiter since the age of 20. She reported no compressive symptoms and no past ultrasound (US) reports were available

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Federica D’Aurizio Department of Laboratory Medicine, Institute of Clinical Pathology, University Hospital of Udine, Udine, Italy

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Alessia Biasotto Department of Medicine, University of Udine, Udine, Italy

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Claudia Cipri Endocrinology, Metabolism and Clinical Nutrition Unit, University Hospital of Udine, Udine, Italy

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Franco Grimaldi Endocrinology, Metabolism and Clinical Nutrition Unit, University Hospital of Udine, Udine, Italy

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Jessica Zucco Department of Laboratory Medicine, Institute of Clinical Pathology, University Hospital of Udine, Udine, Italy

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Stefania Marzinotto Department of Laboratory Medicine, Institute of Clinical Pathology, University Hospital of Udine, Udine, Italy

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Francesco Curcio Department of Laboratory Medicine, Institute of Clinical Pathology, University Hospital of Udine, Udine, Italy
Department of Medicine, University of Udine, Udine, Italy

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Salvatore Benvenga Department of Clinical and Experimental Medicine, Endocrinology Section, University of Messina, Messina, Italy

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with both TSH and the clinical status since she continued to be clinically euthyroid. On the same serum sample, thyroid autoantibodies were negative (TPOAb = 52 U/mL; thyroglobulin antibodies, TgAb = 17 U/mL, cut-off = 60 U/mL, Advia Centaur XP, Siemens

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Allan Carlé Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark

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Jens Faber Department of Endocrinology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Rudi Steffensen Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark

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Peter Laurberg Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark

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Birte Nygaard Department of Endocrinology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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with biochemically restored euthyroidism due to L-T4 substitution and found that the group of patients dissatisfied with their treatment had the same serum TSH, T3, and T4 concentrations as the patients having no complaints. A different co

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Naohiro Araki Diagnostic Division, Otsuka Pharmaceutical Co. Ltd., Tokushima, Japan

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Mitsuru Iida Diagnostic Division, Otsuka Pharmaceutical Co. Ltd., Tokushima, Japan

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Nobuyuki Amino Department of Internal Medicine, Kuma Hospital, Kobe, Japan

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Shinji Morita Department of Internal Medicine, Kuma Hospital, Kobe, Japan

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Akane Ide Department of Internal Medicine, Kuma Hospital, Kobe, Japan

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Eijun Nishihara Department of Internal Medicine, Kuma Hospital, Kobe, Japan

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Mitsuru Ito Department of Internal Medicine, Kuma Hospital, Kobe, Japan

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Jun Saito Department of Medicine, Yokohama Rosai Hospital, Yokohama, Japan

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Tetsuo Nishikawa Department of Medicine, Yokohama Rosai Hospital, Yokohama, Japan

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Kiyonori Katsuragi Diagnostic Division, Otsuka Pharmaceutical Co. Ltd., Tokushima, Japan

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Akira Miyauchi Department of Internal Medicine, Kuma Hospital, Kobe, Japan

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; 37 female); 45 with thyrotoxic subacute thyroiditis (mean age 44 years, range 27-79 years; 42 female), 102 with chronic thyroiditis (52 euthyroid; mean age 53 years, range 15-79 years; 48 female); 50 with hypothyroidism (mean age 55 years, range 16

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Birgitta Johansson Department of Clinical Neuroscience, Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden

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Mats Holmberg ANOVA, Karolinska University Hospital, Norra Stationsgatan 69, Stockholm, Sweden
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Wallenberg’s Centre of Molecular and Translational Medicine, Region Västra Götaland, Sweden

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Simon Skau Department of Clinical Neuroscience, Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
Department of Pedagogical, Curricular and Professional Studies, Faculty of Education, University of Gothenburg, Gothenburg, Sweden

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Helge Malmgren Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

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Helena Filipsson Nyström Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Wallenberg’s Centre of Molecular and Translational Medicine, Region Västra Götaland, Sweden
Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden

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Introduction Untreated hyperthyroid patients with Graves’ disease (GD, autoimmune hyperthyroidism) often report fatigue, cognitive problems, and emotional distress. Once the patients are regarded as clinically recovered and euthyroid, the

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