Clinical Resources

2018 European Thyroid Association (ETA) and Thyroid Federation International (TFI) Joint Position Statement: Interchangeability of Levothyroxine Products in EU Countries

2018 European Thyroid Association Guideline: Diagnosis and Management of Central Hypothyroidism

2018 European Thyroid Association Guideline: Management of Graves’ Hyperthyroidism

The Krakow Declaration on Iodine: Tasks and Responsibilities for Prevention Programs Targeting Iodine Deficiency Disorders

2018 European Thyroid Association Guideline: Management of Amiodarone-Associated Thyroid Dysfunction

2017

2017 American Thyroid Association Guidelines: Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum

2017 European Thyroid Association Guideline: Ultrasound Malignancy Risk Stratification of Thyroid Nodules in Adults: The EU-TIRADS

2017 European Thyroid Association Guideline: Thyroid Nodule Molecular Fine-Needle Aspiration Cytology Diagnostics

2016

2016 European Thyroid Association and European Group on Graves’ Orbitopathy Guideline: Management of Graves’ Orbitopathy

2016 American Thyroid Association Guideline: Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis

2015

Perros et al, 2015: The Management of Patients with Graves’ Orbitopathy

2011

2011 Royal College of Physicians: The Diagnosis and Management of Primary Hypothyroidism

Other International Guidelines

American Thyroid Association: ATA Guidelines

American Association of Clinical Endocrinologists: AACE Guidelines

The Endocrine Society: Clinical Practice Guidelines

2006 British Fluoridation Statement: Thyroid Disorders and Fluoride

Specialists and Research

Current Studies

Rabbit Trial

Radiofrequency ABlation of Benign Intrathyroidal Tumours. A pragmatic multicentre, randomised trial to examine the efficacy and cost-effectiveness of radiofrequency ablation versus hemithyroidectomy in the treatment of benign symptomatic thyroid nodules, funded by NIHR/HTA.

Chief Investigators: Prof Neil Sharma and Prof Kristien Boelaert, University of Birmingham.

Status: Open for recruitment

HOT trial

Hemithyroidectomy or Total-Thyroidectomy in ‘low-risk’ thyroid cancers. This is a multi-centre, randomised, non-inferiority, phase III surgical trial in patients with low risk differentiated thyroid cancer (DTC), funded by NIHR/HTA and sponsored by UCL.

Chief Investigator: Prof Dae Kim, Royal Marsden

Status: Active recruitment

EGRET study

wEight chanGes, caRdio-mEtabolic risks and mortality in patients with hyperthyroidism. Study encompassing an emulated trial design using routinely collected clinical data from Clinical Practice Research Datalink (CPRD, Gold and Aurum) linked to Hospital Episode Statistics (HES) and the Office of National Statistics (ONS) registry to compare treatment outcomes in a large cohort of patients (>50,000) with newly diagnosed hyperthyroidism receiving either a prolonged course of antithyroid drugs, radioactive iodine or surgery. Funded by NIHR/RfPB.

RAIN Study

RAdioiodine therapy and thyroid INflammation. Does persisting thyroid inflammation explain poor quality of life after radioiodine therapy? Patients diagnosed with Graves’ disease who are planning to have radioiodine therapy or thyroid surgery are invited to participate in this study. This study will investigate whether radiation to the thyroid can cause long-term inflammation that could explain the poor quality of life reported in some patients with Graves’ disease treated with radioiodine therapy.

This research study is co-ordinated by Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University and funded by The British Thyroid Foundation. A request for further information and referrals to participate can be sent to Dr. Earn Gan, consultant endocrinologist earn.gan1@ncl.ac.uk.

ASPIC Study

Antigen-SPecific Immune Cells in thyroid disease This study is recruiting patients with autoimmune thyroid conditions: Graves’ disease and Hashimoto’s thyroiditis. A third of people with Graves’ disease will develop thyroid eye disease because of the effect of circulating antibodies on the orbit. This study aims to characterise the immune cells producing these culprit antibodies and find out more about how they work, helping to guide the development of treatment for affected patients.

This study is sponsored and funded by the Newcastle upon Tyne Hospitals NHS Foundation Trust. Please contact Professor Simon Pearce, Professor of Endocrinology, for further information, by calling Tel: 01912824636.

TRIuMPH Study

TRIal of Mycophenolate for Persistent symptoms of Hypothyroidism This upcoming clinical study for patients with hypothyroidism on treatment with levothyroxine will release more information shortly.

T3-HF

A trial of oral T3 (liothyronine) treatment in patients with moderate to severe heart failure and low serum T3 levels, assessing exercise tolerance.

Chief Investigator: Dr Salman Razvi

OPAL

Examining the impact of the deprescribing of levothyroxine in primary care. Over 100 patients were recruited to this study and the results are pending.

RiGD-2

This research study is recruiting young people with newly-diagnosed Graves’ disease and assessing if treatment with rituximab, alongside antithyroid drugs, increases the remission rate of the condition.

Chief Investigator: Dr Claire Wood

Studies in Thyroid eye Disease

The regional TED clinic have been recruiting to a number of national and international studies investigating novel immunotherapy treatment for patients with thyroid eye disease. Immunovant is currently recruiting patients with recent onset, active thyroid eye disease to assess the impact of treatment with batoclimab. Further studies are expected to open for recruitment during 2025.

University of Birmingham

Professor Kristien Boelaert

UoB Profile: Prof Kristien Boelaert

Kristien Boelaert is Professor of Endocrinology in the Department of Applied Health at the University of Birmingham and President of the British Thyroid Association. Her clinical research aims to improve our knowledge of the prevalence, management and long-term outcomes of hyperthyroidism, managing thyroid disorders during pregnancy, and diagnosis and management of thyroid nodules and cancer. She has been actively involved and led several large multi-centre clinical trials to evaluate the management of thyroid autoimmunity in fertility as well as the diagnosis and management of thyroid nodules. She continues to provide input into the molecular research relating to thyroid cancer pathogenesis with her colleagues at the University of Birmingham.

Professor Chris McCabe

UoB Profile: Prof Chris McCabe

Professor Chris McCabe is Professor of Molecular Endocrinology at the University of Birmingham and Chief Operating Officer and Secretary of the American Thyroid Association. The McCabe group at the University of Birmingham focusses on mechanisms and aetiologies of thyroid and other endocrine tumours. They have a special interest in improving radioiodine therapy for patients via new understanding of how iodide is transported into human cells, as well as pioneering new druggable approaches to enhancing thyroid tumour and metastatic ablation.

Dr Vicki Smith

UoB Profile: Dr Vicki Smith

Vicki Smith is an Associate Professor in Molecular Endocrinology at the Department of Metabolism and Systems Science (MSS) at the University of Birmingham.

Her research is focussed on understanding the molecular pathogenesis of thyroid disease and endocrine cancers, with a particular interest in dysregulated cell signalling and trafficking events.

She is currently investigating new regulatory mechanisms in cell signalling and motility that contribute to thyroid cancer invasion and metastasis, and is developing a thyroid hormone profiling method as a diagnostic and research tool to better understand thyroid dysfunction.

Professor Nadia Schoenmakers

UoB Profile: Prof Nadia Schoenmakers

Nadia Schoenmakers is Professor of Endocrinology in the Department of Metabolism and Systems Science (MSS) at the University of Birmingham. She is a clinician-scientist who investigates the causes and consequences of a broad range of thyroid disorders with particular focus on rare thyroid disease including congenital hypothyroidism (CH), for which she aims to delineate the genetic basis, and to determine the associated phenotypes. In the laboratory, she seeks to understand the role of known and novel genes in thyroid development and hormone synthesis and the consequences of specific gene dysfunction. More recent work has also focussed on evaluating potential environmental contributors to CH.

Clinical/Translational Research at the University of Birmingham

The clinical thyroid research group in Birmingham is running a variety of studies in management of hyperthyroidism and thyroid nodules and cancer.

The Queen Elizabeth Hospital runs large specialist services for patients with thyroid disorders including a multi-disciplinary thyroid clinic as well as regional thyroid oncology, thyroid eye disease obstetric clinics for patients with thyroid conditions.

Our Thyroid Surgeons in Birmingham perform the 3rd largest volume of thyroid surgery in the UK, operating on adult and paediatric patients with benign thyroid disease and thyroid cancer.

University of Cambridge

Professor Krishna Chatterjee

IMC Profile: Prof Krishna Chatterjee

Through a national/international service for the diagnosis and management of rare thyroid disorders (see below), we have assembled cohorts of patients with Resistance to Thyroid Hormone due to defective thyroid hormone receptor beta or alpha. We investigate the pathogenesis and variable phenotype of these disorders and are developing technologies (genetic, biochemical), biomarkers and trialling therapies (e.g. thyroid hormone analogues) to improve their diagnosis and management.

Cambridge University Hospitals NHS Foundation Trust

Cambridge Addenbrooke’s Hospital Endocrine Laboratory

We operate a national/international service in the Department of Clinical Biochemistry, investigating samples from patients with discordant or unusual patterns of thyroid function. The service comprises use of diverse laboratory technologies to exclude analytical interference; or knowledge of the clinical context to rule out other causes (e.g. drug therapy, comorbidities) of discordance. Following this, for UK patients, candidate gene testing undertaken by Genomic Laboratory Hub using NHS Genomic Medicine service panels (e.g R182, R145), enables genetic diagnosis of most rare disorders of thyroid gland formation, hormone synthesis and action. Clinicians (Krishna Chatterjee; Mark Gurnell; Carla Moran; Nadia Schoenmakers) can advise on management of such rare disorders.

University of Cardiff

Dr Peter Taylor

UoC Profile: Dr Peter Taylor

The Cardiff Thyroid Research Group has been at forefront of thyroid research for over 25 years with the work of many colleagues including Reg Hall, John Lazarus and Marian Ludgate. Our current focus is on Thyroid Eye Disease (Graves’ Orbitopathy, GO) and the mechanisms underlying this disfiguring and distressing condition including retro-orbital pre-adipocyte function and the effects of the microbiome. We also work closely with ophthalmology colleagues and as part of TEAMeD and the EUGOGO group to conduct clinical studies to improve therapies and implement measures to improve outcomes (www.btf-thyroid.org/projects/teamed/332-teamed-5).

The Thyroid Research Group also conducts large scale epidemiological, genetic and data linkage studies to define the effects of changes in thyroid hormone levels across the population, to study the effects of thyroid hormone replacement and the long-term outcomes of thyroid disease including thyroid disease in pregnancy.

Prof Colin Dayan

UoC Profile: Prof Colin Dayan

Imperial College, London

Imperial College Endocrine Unit

The Imperial College Endocrine Unit is world famous and includes a dedicated team of physicians and surgeons look after patients with common thyroid diseases, thyroid cancers, as well as rare inherited thyroid disorders

Click here for the Imperial Centre for Endocrinology

Department of Thyroid and Endocrine Surgery

The Department of Thyroid and Endocrine Surgery is the first and largest department of its type in the UK with three dedicated specialist surgeons that deal with all aspects of malignant as well as benign thyroid disease.

Imperial College: Thyroid Cancer

Imperial Profile: Fausto-palazzo

Imperial Profile: Aimee-di-Marco

Imperial Profile: Neil Tolley

The Imperial College Healthcare NHS Trust’s Thyroid Multidisciplinary Team treats thyroid cancer patients from the whole of West London and receives national and international referrals. The MDT includes surgeons, endocrinologists, oncologists, radiologists, pathologists and specialist nurses.

Department of Metabolism, Digestion and Reproduction

Imperial College Department of Metabolism, Digestion and Reproduction is a world leader in thyroid hormone action research with a particular focus on the role of thyroid hormones in the developing skeleton, and in the maintenance and repair of adult bones and joints

Imperial Profile: Duncan Bassett

Imperial Profile: Graham Williams

Imperial Profile: Florian Werning

Clinicians are also involved in cutting edge clinical research into the Management of Grave’s Disease and the side effects of anti-thyroid medication.

University of Newcastle and Newcastle Upon Tyne Hospitals

Translational and Clinical Research Institute

The endocrine research group at the Translational and Clinical Research Institute at Newcastle University are running clinical and laboratory studies in Graves’ disease, hypothyroidism and other aspects of thyroid health and immunity.

Newcastle Upon Tyne Hospitals

The Newcastle upon Tyne Hospitals runs specialist services for patients with thyroid conditions, including a large multidisciplinary thyroid clinic, a regional thyroid eye clinic and a dedicated endocrine obstetrics clinic for the management of thyroid conditions in pregnancy.

In the thyroid eye clinic, patients can access a range of immunotherapy treatments for active disease, and we are enrolling patients onto clinical trials of novel treatments for thyroid eye disease.

Our Endocrine Surgeons in Newcastle perform the 4th largest volume of thyroid surgery in the UK, operating on adult and paediatric patients with benign thyroid disease and thyroid cancer.

St Vincent’s University Hospital, Dublin

Dr Carla Moran, Dublin, Ireland

UoD Profile: Dr Carla Moran

Has expertise in diagnosis and management of all forms of Resistance to Thyroid hormone, as well as drug induced thyroid disease and the work up of discordant thyroid function. She is happy to provide advice to clinicians from around the world and conducts research into these conditions.

Rare Thyroid Disease Clinic operates at St Vincent’s University Hospital, Dublin, Ireland. Led by Dr Carla Moran, this clinic provides care to people with rare forms of thyroid disease, or common thyroid diseases with unusual aspects. Referrals (from GPs or consultants) are accepted from all of Ireland.