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Use of Levothyroxine in Patients with Subtotal Thyroidectomy: A Systematic Review Levothyroxine After Subtotal Thyroidectomy

Year: 2026
Type: review
Study design: Systematic Review
Abstract: Introduction: Subtotal thyroidectomy preserves glandular tissue intending to maintain hormonal autonomy; however, the viability of the remnant is unpredictable, complicating postoperative pharmacological management. Objective: To analyze available scientific evidence on the indication, dosage regimens, and clinical outcomes of levothyroxine use in patients undergoing subtotal thyroidectomy. Methodology: A systematic review was conducted following the PRISMA 2020 statement. A search in indexed databases (PubMed, Scielo, ScienceDirect, Cochrane) identified 50 relevant studies published in the last 5 years. Results: Evidence indicates that a significant proportion of patients develop late-onset hypothyroidism due to remnant exhaustion or require suppressive therapy to prevent goiter recurrence. Unlike total resection, dosing is complex and empirical, with a high risk of iatrogenic subclinical hyperthyroidism due to overtreatment, impacting cardiovascular and bone health. Conclusions: Levothyroxine therapy is frequently necessary and effective but demands strict TSH monitoring to personalize dosage, balancing recurrence prevention with patient safety.
Language: English
Subfield: Surgery
Field: Medicine
Open Access status: green
OpenAlex ID: W7142039784
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