medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2019-4-33(408)-48-53medalphabet-1393Research ArticleСтатьиЗаболевания щитовидной железы в пери- и постменопаузе (обзор литературы)Thyroid disease in peri‑ and postmenopause period (literature review)ЗайдиеваЯ. З.ZaidievaYa. Z.

д. м. н., проф., рук. отделения гинекологической эндокринологии

г. Москва

Moscow

ГлазковаА. В.GlazkovaA. V.

м. н. с., отделение гинекологической эндокринологии

г. Москва

Moscow

КручининаЕ. В.KruchininaE. V.

н. с., отделение гинекологической эндокринологии 

г. Москва

Moscow

ГБУЗ МО «Московский областной научно-исследовательский институт акушерства и гинекологии»РоссияMoscow Regional Research Institute for Obstetrics and GynecologyRussian Federation201923012020433Современная гинекология4853Copyright © Зайдиева Я.З., Глазкова А.В., Кручинина Е.В., 20202020Зайдиева Я.З., Глазкова А.В., Кручинина Е.В.Zaidieva Y.Z., Glazkova A.V., Kruchinina E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/1393

Во время пери‑ и постменопаузы результаты исследований функции щитовидной железы должны интерпретироваться очень внимательно в связи с физиологическими изменениями секреции и метаболизма тиреотропного гормона и гормонов щитовидной железы. У женщин в постменопаузе увеличивается частота заболеваний щитовидной железы. Нет единого мнения в отношении обследования женщин в постменопаузе, хотя имеются данные о влиянии тиреоидного статуса на когнитивные функции, сердечно‑сосудистый риск, метаболизм костной ткани и продолжительность жизни. Постановка диагноза при любом заболевании щитовидной железы является сложной задачей у пожилых пациенток, так как симптомы схожи с менопаузальными. Лечение требует большего внимания в этой популяции, чем у молодых пациенток, так как высокие дозы L‑тироксина могут приводить к сердечно‑сосудистым осложнениям и увеличению скорости костного ремоделирования. Кроме того, радиоактивный йод является предпочтительным в лечении гипертиреоза у пожилых пациентов. В этой группе повышен риск развития узловых заболеваний и рака щитовидной железы. Риск оперативного лечения выше, а прогноз заболеваний хуже. Решение о необходимости применения менопаузальной гормональной терапии должно быть принято индивидуально независимо от наличия заболеваний щитовидной железы.

The interpretation of thyroid function tests should be cautiously made during the perimenopause and postmenopause period bearing in mind that physiologic changes do exist in this group of women in terms of secretion and metabolism of thyrotropin and thyroid hormones. Moreover the incidence of thyroid disorders increases in postmenopausal and elderly women. There is no consensus for screening postmenopausal women even though there is well‑known evidence about the effect of thyroid status on cognitive function, cardiovascular risk, bone turnover, and longevity. The diagnosis of any thyroid disorder is challenging in these patients because the symptoms are more subtle and attributed to menopausal symptoms. Management requires more attention in this population than that of younger groups, because high doses of L‑thyroxine can lead to cardiac complications and increased bone turnover. Furthermore radio‑iodine is preferred in treatment of hyperthyroidism in older patients. The risk of nodular thyroid disease and thyroid cancers increases in this group. Although the diagnostic approach is the same as for young patients, the risk of surgery is high and disease prognosis is worse. Decision for menopausal hormonal therapy should be individualized regardless of the concomitant presence of thyroid disorders.

гипотиреозгипертиреозрак щитовидной железыменопаузаhypothyroidismhyperthyroidismthyroidcancermenopauseReferencesdel Ghianda S, Tonacchera M, Vitti P. Thyroid and menopause. Climacteric 2014; 17: 225–34.del Ghianda S, Tonacchera M, Vitti P. Thyroid and menopause. Climacteric 2014; 17: 225–34.Santin AP, Furlanetto TW. Role of estrogen in thyroid function and growth regulation. J Thyroid Res 2011; 2011: 1.Santin AP, Furlanetto TW. Role of estrogen in thyroid function and growth regulation. J Thyroid Res 2011; 2011: 1.Arafah BM. Increased need for thyroxine in women with hypothyroidism during estrogen therapy. N Engl J Med 2001; 344: 1743–9.Arafah BM. Increased need for thyroxine in women with hypothyroidism during estrogen therapy. N Engl J Med 2001; 344: 1743–9.Hollowell JG, Staehling NW, Flanders WD, et al. Serum TSH, T, and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab 2002; 87: 489–99.Hollowell JG, Staehling NW, Flanders WD, et al. Serum TSH, T, and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab 2002; 87: 489–99.Papaleontiou M, Haymart MR. Approach to and treatment of thyroid disorders in the elderly. Med Clin North Am 2012; 96: 297–310.Papaleontiou M, Haymart MR. Approach to and treatment of thyroid disorders in the elderly. Med Clin North Am 2012; 96: 297–310.Volzke H, Alte D, Kohlmann T, Reference intervals of serum thyroid function tests in a previously iodine-deficient area. Thyroid 2005; 15: 279–85.Volzke H, Alte D, Kohlmann T, Reference intervals of serum thyroid function tests in a previously iodine-deficient area. Thyroid 2005; 15: 279–85.Surks MI, Hollowell JG. Age-specific distribution of serum thyrotropin and antithyroid antibodies in the US population: implications for the prevalence of subclinical hypothyroidism. J Clin Endocrinol Metab 2007; 92: 4575–82.Surks MI, Hollowell JG. Age-specific distribution of serum thyrotropin and antithyroid antibodies in the US population: implications for the prevalence of subclinical hypothyroidism. J Clin Endocrinol Metab 2007; 92: 4575–82.Boucai L, Hollowell JG, Surks MI. An approach for development of age-, gender-, and ethnicity-specific thyrotropin reference limits.Thyroid 2011; 21: 5–11.Boucai L, Hollowell JG, Surks MI. An approach for development of age-, gender-, and ethnicity-specific thyrotropin reference limits.Thyroid 2011; 21: 5–11.Wong ET, Bradley SG, Schultz AL. Elevations of thyroid-stimulating hormone during acute nonthyroidal illness. Arch Intern Med 1981; 141: 873–5.Wong ET, Bradley SG, Schultz AL. Elevations of thyroid-stimulating hormone during acute nonthyroidal illness. Arch Intern Med 1981; 141: 873–5.Peeters RP, Wouters PJ, Kaptein E, et al. Reduced activation and increased inactivation of thyroid hormone in tissues of critically ill patients. J Clin Endocrinol Metab 2003; 88: 3202–11.Peeters RP, Wouters PJ, Kaptein E, et al. Reduced activation and increased inactivation of thyroid hormone in tissues of critically ill patients. J Clin Endocrinol Metab 2003; 88: 3202–11.Abdullatif HD, Ashraf AP. Reversible subclinical hypothyroidism in the presence of adrenal insufficiency. Endocr Pract 2006; 12: 572.Abdullatif HD, Ashraf AP. Reversible subclinical hypothyroidism in the presence of adrenal insufficiency. Endocr Pract 2006; 12: 572.Caufriez A, Leproult R, L’Hermite-Bal_eriaux M. Progesterone prevents sleep disturbances and modulates GH, TSH, and melatonin secretion in postmenopausal women. J Clin Endocrinol Metab 2011; 96: E 614–23.Caufriez A, Leproult R, L’Hermite-Bal_eriaux M. Progesterone prevents sleep disturbances and modulates GH, TSH, and melatonin secretion in postmenopausal women. J Clin Endocrinol Metab 2011; 96: E 614–23.Gonzalez-Rodriguez LA, Felici-Giovanini ME, Haddock L. Thyroid dysfunction in an adult female population: a population-based study of Latin American Vertebral Osteoporosis Study (LAVOS) — Puerto Rico site. P R Health Sci J 2013; 32: 57–62.Gonzalez-Rodriguez LA, Felici-Giovanini ME, Haddock L. Thyroid dysfunction in an adult female population: a population-based study of Latin American Vertebral Osteoporosis Study (LAVOS) — Puerto Rico site. P R Health Sci J 2013; 32: 57–62.De Carvalho GA, Bahls SC, Boeving A, Graf H. Effects of selective serotonin reuptake inhibitors on thyroid function in depressed patients with primary hypothyroidism or normal thyroid function. Thyroid 2009; 19: 691–7.De Carvalho GA, Bahls SC, Boeving A, Graf H. Effects of selective serotonin reuptake inhibitors on thyroid function in depressed patients with primary hypothyroidism or normal thyroid function. Thyroid 2009; 19: 691–7.Gitlin M, Altshuler LL, Frye MA, et al. Peripheral thyroid hormones and response to selective serotonin reuptake inhibitors.J Psychiatry Neurosci 2004; 29: 383–6.Gitlin M, Altshuler LL, Frye MA, et al. Peripheral thyroid hormones and response to selective serotonin reuptake inhibitors.J Psychiatry Neurosci 2004; 29: 383–6.Clonidine and Hypothyroidism — from FDA reports. July 30, 2018. Available from: www.ehealthme.com/ds/clonidine/hypothyroidism.Clonidine and Hypothyroidism — from FDA reports. July 30, 2018. Available from: www.ehealthme.com/ds/clonidine/hypothyroidism.Helfand M, Redfern C. C. Screening for thyroid disease: an update. Ann Intern Med 1998; 129: 144–58.Helfand M, Redfern C. C. Screening for thyroid disease: an update. Ann Intern Med 1998; 129: 144–58.American Academy of Family Physicians: Summary of policy recommendations for periodic health examinations, Leawood, KS, 2002, American Academy of Family Physicians.American Academy of Family Physicians: Summary of policy recommendations for periodic health examinations, Leawood, KS, 2002, American Academy of Family Physicians.Garber JR, Cobin RH, Gharib H. Clinical practice guidelines for hypothyroidism in adults. Endocr Pract 2012; 18: 988–1028.Garber JR, Cobin RH, Gharib H. Clinical practice guidelines for hypothyroidism in adults. Endocr Pract 2012; 18: 988–1028.Rugge JB, Bougatsos C, Chou R. Screening and treatment of thyroid dysfunction: an evidence review for the U. S. Preventive Services Task Force. Ann Intern Med 2015; 162: 35–45.Rugge JB, Bougatsos C, Chou R. Screening and treatment of thyroid dysfunction: an evidence review for the U. S. Preventive Services Task Force. Ann Intern Med 2015; 162: 35–45.Stone MB, Wallace RB, Institute of Medicine (U.S.) Committee on Medicare Coverage of Routine Thyroid Screening: Medicare coverage of routine screening for thyroid dysfunction, Washington, DC: National Academies Press 2003.Stone MB, Wallace RB, Institute of Medicine (U.S.) Committee on Medicare Coverage of Routine Thyroid Screening: Medicare coverage of routine screening for thyroid dysfunction, Washington, DC: National Academies Press 2003.Canaris GJ, Manowitz NR, Mayor G, Ridgway EC. The Colorado Thyroid Disease Prevalence Study. Arch Intern Med 2000; 160: 526–34.Canaris GJ, Manowitz NR, Mayor G, Ridgway EC. The Colorado Thyroid Disease Prevalence Study. Arch Intern Med 2000; 160: 526–34.Cooper DS, Biondi B. Subclinical thyroid disease. Lancet 2012; 379: 1142–54.Cooper DS, Biondi B. Subclinical thyroid disease. Lancet 2012; 379: 1142–54.Andersson M, de Benoist B, Delange F, Zupan J. Prevention and control of iodine deficiency in pregnant and lactating women andin children less than 2-years-old: conclusions and recommendations of the Technical Consultation. Phn 2007; 10: 1606–11.Andersson M, de Benoist B, Delange F, Zupan J. Prevention and control of iodine deficiency in pregnant and lactating women andin children less than 2-years-old: conclusions and recommendations of the Technical Consultation. Phn 2007; 10: 1606–11.Kappers MH, van Esch JH, Smedts FM, de Krijger RR, et al. Sunitinib-induced hypothyroidism is due to induction of type 3 deiodinase activity and thyroidal capillary regression. J Clin Endocrinol Metab 2011; 96: 3087–94.Kappers MH, van Esch JH, Smedts FM, de Krijger RR, et al. Sunitinib-induced hypothyroidism is due to induction of type 3 deiodinase activity and thyroidal capillary regression. J Clin Endocrinol Metab 2011; 96: 3087–94.Huang SA, Fish SA, Dorfman DM, et al. A 21-year-old woman with consumptive hypothyroidism due to a vascular tumor expressing type 3 iodothyronine deiodinase. J Clin Endocrinol Metab 2002; 87: 4457–61.Huang SA, Fish SA, Dorfman DM, et al. A 21-year-old woman with consumptive hypothyroidism due to a vascular tumor expressing type 3 iodothyronine deiodinase. J Clin Endocrinol Metab 2002; 87: 4457–61.Mouat F, Evans HM, Cutfield WS, Hofman PL, Jefferies C. Massive hepatic hemangioendothelioma and consumptive hypothyroidism. J Pediatr Endocrinol Metab 2008; 21: 701–3.Mouat F, Evans HM, Cutfield WS, Hofman PL, Jefferies C. Massive hepatic hemangioendothelioma and consumptive hypothyroidism. J Pediatr Endocrinol Metab 2008; 21: 701–3.Razvi S, Weaver J, Butler T, Pearce S. (Levothyroxine treatment of subclinical hypothyroidism, fatal and nonfatal cardiovascular events, and mortality. Arch Intern Med 2012; 172: 811–7.Razvi S, Weaver J, Butler T, Pearce S. (Levothyroxine treatment of subclinical hypothyroidism, fatal and nonfatal cardiovascular events, and mortality. Arch Intern Med 2012; 172: 811–7.Gussekloo J, van Exel E, de Craen AJ, et al. Thyroid status, disability and cognitive function, and survival in old age. JAMA 2004; 292: 2591–9.Gussekloo J, van Exel E, de Craen AJ, et al. Thyroid status, disability and cognitive function, and survival in old age. JAMA 2004; 292: 2591–9.Rozing MP, Houwing-Duistermaat JJ, Slagboom PE, et al. Familial longevity is associated with decreased thyroid function. J Clin Endocrinol Metab 2010; 95: 4979–84.Rozing MP, Houwing-Duistermaat JJ, Slagboom PE, et al. Familial longevity is associated with decreased thyroid function. J Clin Endocrinol Metab 2010; 95: 4979–84.Pearce SH, Brabant G, Duntas LH, et al. 2013 ETA Guideline: management of subclinical hypothyroidism. Eur Thyroid J 2013; 2: 215–28.Pearce SH, Brabant G, Duntas LH, et al. 2013 ETA Guideline: management of subclinical hypothyroidism. Eur Thyroid J 2013; 2: 215–28.Brent GA. Clinical practice. Graves’ disease. N Engl J Med 2008; 358: 2594.Brent GA. Clinical practice. Graves’ disease. N Engl J Med 2008; 358: 2594.Garmendia Madariaga A, Santos Palacios S, Guillen-Grima F, Galofre JC. The incidence and prevalence of thyroid dysfunction in Europe: a meta-analysis. J Clin Endocrinol Metab 2014; 99: 923–31.Garmendia Madariaga A, Santos Palacios S, Guillen-Grima F, Galofre JC. The incidence and prevalence of thyroid dysfunction in Europe: a meta-analysis. J Clin Endocrinol Metab 2014; 99: 923–31.Schouten BJ, Brownlie BE, Frampton CM, Turner JG. Subclinical thyrotoxicosis in an outpatient population — predictors of outcome. Clin Endocrinol (Oxf) 2011; 74: 257–61.Schouten BJ, Brownlie BE, Frampton CM, Turner JG. Subclinical thyrotoxicosis in an outpatient population — predictors of outcome. Clin Endocrinol (Oxf) 2011; 74: 257–61.Vadiveloo T, Donnan PT, Cochrane L, Leese GP. The Thyroid Epidemiology, Audit, and Research Study (TEARS): the natural history of endogenous subclinical hyperthyroidism. J Clin Endocrinol Metab 2011; 96: E 1–8.Vadiveloo T, Donnan PT, Cochrane L, Leese GP. The Thyroid Epidemiology, Audit, and Research Study (TEARS): the natural history of endogenous subclinical hyperthyroidism. J Clin Endocrinol Metab 2011; 96: E 1–8.Rosario PW. Natural history of subclinical hyperthyroidism in elderly patients with TSH between 0.1 and 0.4 mIU/l: a prospective study. Clin Endocrinol (Oxf) 2010; 72: 685–8.Rosario PW. Natural history of subclinical hyperthyroidism in elderly patients with TSH between 0.1 and 0.4 mIU/l: a prospective study. Clin Endocrinol (Oxf) 2010; 72: 685–8.Das G, Ojewuyi TA, Baglioni P, Geen J, Premawardhana LD, Okosieme OE. Serum thyrotrophin at baseline predicts the natural course of subclinical hyperthyroidism. Clin Endocrinol (Oxf) 2012; 77: 146–51.Das G, Ojewuyi TA, Baglioni P, Geen J, Premawardhana LD, Okosieme OE. Serum thyrotrophin at baseline predicts the natural course of subclinical hyperthyroidism. Clin Endocrinol (Oxf) 2012; 77: 146–51.Boelaert K, Torlinska B, Holder RL, Franklyn JA. Older subjects with hyperthyroidism present with a paucity of symptoms and signs: a large cross-sectional study. J Clin Endocrinol Metab 2010; 95: 2715.Boelaert K, Torlinska B, Holder RL, Franklyn JA. Older subjects with hyperthyroidism present with a paucity of symptoms and signs: a large cross-sectional study. J Clin Endocrinol Metab 2010; 95: 2715.Bahn RS, Burch HB, Cooper DS, et al. Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Endocr Pract 2011; 17: 456–520.Bahn RS, Burch HB, Cooper DS, et al. Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Endocr Pract 2011; 17: 456–520.Faggiano A, Del Prete M, Marciello F, et al. Thyroid diseases in elderly. Minerva Endocrinol 2011; 36: 211–31.Faggiano A, Del Prete M, Marciello F, et al. Thyroid diseases in elderly. Minerva Endocrinol 2011; 36: 211–31.Mitrou P, Raptis SA, Dimitriadis G. Thyroid disease in older people. Maturitas 2011; 70: 5–9.Mitrou P, Raptis SA, Dimitriadis G. Thyroid disease in older people. Maturitas 2011; 70: 5–9.Asvold BO, Bjoro T, Platou C, Vatten LJ. Thyroid function and the risk of coronary heart disease: 12-year follow-up of the HUNT study in Norway. Clin Endocrinol (Oxf) 2012; 77: 911–7.Asvold BO, Bjoro T, Platou C, Vatten LJ. Thyroid function and the risk of coronary heart disease: 12-year follow-up of the HUNT study in Norway. Clin Endocrinol (Oxf) 2012; 77: 911–7.Collet TH, Gussekloo J, Bauer DC, et al. Subclinical hyperthyroidism and the risk of coronary heart disease and mortality. Arch Intern Med 2012; 172: 799–809.Collet TH, Gussekloo J, Bauer DC, et al. Subclinical hyperthyroidism and the risk of coronary heart disease and mortality. Arch Intern Med 2012; 172: 799–809.Yang LB, Jiang DQ, Qi WB, et al. Subclinical hyperthyroidism and the risk of cardiovascular events and all-cause mortality: an updated meta-analysis of cohort studies. Eur J Endocrinol 2012; 167: 75–84.Yang LB, Jiang DQ, Qi WB, et al. Subclinical hyperthyroidism and the risk of cardiovascular events and all-cause mortality: an updated meta-analysis of cohort studies. Eur J Endocrinol 2012; 167: 75–84.Gencer B, Collet TH, Virgini V, et al. Subclinical thyroid dysfunction and the risk of heart failure events: an individual participant data analysis from 6 prospective cohorts. Circulation 2012; 126: 1040–9.Gencer B, Collet TH, Virgini V, et al. Subclinical thyroid dysfunction and the risk of heart failure events: an individual participant data analysis from 6 prospective cohorts. Circulation 2012; 126: 1040–9.Selmer C, Olesen JB, Hansen ML, et al. The spectrum of thyroid disease and risk of new onset atrial fibrillation: a large population cohort study. BMJ 2012; 345: e7895.Selmer C, Olesen JB, Hansen ML, et al. The spectrum of thyroid disease and risk of new onset atrial fibrillation: a large population cohort study. BMJ 2012; 345: e7895.Schultz M, Kistorp C, Raymond I, et al. Cardiovascular events in thyroid disease: a population based, prospective study. Horm Metab Res 2011; 43: 653–9.Schultz M, Kistorp C, Raymond I, et al. Cardiovascular events in thyroid disease: a population based, prospective study. Horm Metab Res 2011; 43: 653–9.Chaker L, Baumgartner C, Ikram MA, et al. Subclinical thyroid dysfunction and the risk of stroke: a systematic review and meta-analysis. Eur J Epidemiol 2014; 29: 791–800.Chaker L, Baumgartner C, Ikram MA, et al. Subclinical thyroid dysfunction and the risk of stroke: a systematic review and meta-analysis. Eur J Epidemiol 2014; 29: 791–800.Abrahamsen B, Jorgensen HL, Laulund AS, et al. Low serum thyrotropin level and duration of suppression as a predictor of major osteoporotic fractures — the OPENTHYRO register cohort. J Bone Miner Res 2014; 29: 2040–50.Abrahamsen B, Jorgensen HL, Laulund AS, et al. Low serum thyrotropin level and duration of suppression as a predictor of major osteoporotic fractures — the OPENTHYRO register cohort. J Bone Miner Res 2014; 29: 2040–50.Gan EH, Pearce SH. Clinical review: the thyroid in mind: cognitive function and low thyrotropin in older people. J Clin Endocrinol Metab 2012; 97: 3438–49.Gan EH, Pearce SH. Clinical review: the thyroid in mind: cognitive function and low thyrotropin in older people. J Clin Endocrinol Metab 2012; 97: 3438–49.Wijsman LW, de Craen AJ, Trompet S, et al. Subclinical thyroid dysfunction and cognitive decline in old age. PLoS One 2013; 8: e59199.Wijsman LW, de Craen AJ, Trompet S, et al. Subclinical thyroid dysfunction and cognitive decline in old age. PLoS One 2013; 8: e59199.Formiga F, Ferrer A, Padros G, et al. Thyroid status and functional and cognitive status at baseline and survival after 3 years of follow-up: the OCTABAIX study. Eur J Endocrinol 2014; 170: 69–75.Formiga F, Ferrer A, Padros G, et al. Thyroid status and functional and cognitive status at baseline and survival after 3 years of follow-up: the OCTABAIX study. Eur J Endocrinol 2014; 170: 69–75.Roberts LM, Pattison H, Roalfe A, et al. Is subclinical thyroid dysfunction in the elderly associated with depression or cognitive dysfunction? Ann Intern Med 2006; 145: 573–81.Roberts LM, Pattison H, Roalfe A, et al. Is subclinical thyroid dysfunction in the elderly associated with depression or cognitive dysfunction? Ann Intern Med 2006; 145: 573–81.Almeida OP, Alfonso H, Flicker L, et al. Thyroid hormones and depression: the Health in Men study. Am J Geriatr Psychiatry 2011; 19: 763–70.Almeida OP, Alfonso H, Flicker L, et al. Thyroid hormones and depression: the Health in Men study. Am J Geriatr Psychiatry 2011; 19: 763–70.de Jongh RT, Lips P, van Schoor NM, et al. Endogenous subclinical thyroid disorders, physical and cognitive function, depression, and mortality in older individuals. Eur J Endocrinol 2011; 165: 545–54.de Jongh RT, Lips P, van Schoor NM, et al. Endogenous subclinical thyroid disorders, physical and cognitive function, depression, and mortality in older individuals. Eur J Endocrinol 2011; 165: 545–54.Biondi B, Bartalena L, Cooper DS, et al. The 2015 European Thyroid Association guidelines on diagnosis and treatment of endogenous subclinical hyperthyroidism. Eur Thyroid J 2015; 4: 149–63.Biondi B, Bartalena L, Cooper DS, et al. The 2015 European Thyroid Association guidelines on diagnosis and treatment of endogenous subclinical hyperthyroidism. Eur Thyroid J 2015; 4: 149–63.Haugen BR, Alexander EK, Bible KC, et al. 2015 American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the american thyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid 2016; 26: 1–133.Haugen BR, Alexander EK, Bible KC, et al. 2015 American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the american thyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid 2016; 26: 1–133.Guth S, Theune U, Aberle J, Galach A, Bamberger CM. Very high prevalence of thyroid nodules detected by high frequency (13 MHz) ultrasound examination. Eur J Clin Invest 2009; 39: 699–706.Guth S, Theune U, Aberle J, Galach A, Bamberger CM. Very high prevalence of thyroid nodules detected by high frequency (13 MHz) ultrasound examination. Eur J Clin Invest 2009; 39: 699–706.Haymart MR, Repplinger DJ, Leverson GE, et al. Higher serum thyroid stimulating hormone level in thyroid nodule patients is associated with greater risks of differentiated thyroid cancer and advanced tumor stage. J Clin Endocrinol Metab 2008; 93: 809–14.Haymart MR, Repplinger DJ, Leverson GE, et al. Higher serum thyroid stimulating hormone level in thyroid nodule patients is associated with greater risks of differentiated thyroid cancer and advanced tumor stage. J Clin Endocrinol Metab 2008; 93: 809–14.Kwak JY, Han KH, Yoon JH, et al. Thyroid imaging reporting and data system for US features of nodules: a step in establishing better stratification of cancer risk. Radiology 2011; 260: 892–9.Kwak JY, Han KH, Yoon JH, et al. Thyroid imaging reporting and data system for US features of nodules: a step in establishing better stratification of cancer risk. Radiology 2011; 260: 892–9.Moon WJ, Jung SL, Lee JH, et al. Benign and malignant thyroid nodules: US differentiation-multicenter retrospective study. Radiology 2008; 247: 762–70.Moon WJ, Jung SL, Lee JH, et al. Benign and malignant thyroid nodules: US differentiation-multicenter retrospective study. Radiology 2008; 247: 762–70.Moon HJ, Kwak JY, Kim MJ, Son EJ, Kim EK. Can vascularity at power Doppler US help predict thyroid malignancy? Radiology 2010; 255: 260–9.Moon HJ, Kwak JY, Kim MJ, Son EJ, Kim EK. Can vascularity at power Doppler US help predict thyroid malignancy? Radiology 2010; 255: 260–9.Salmaslıoglu A, Erbil Y, Dural C, et al. Predictive value of sonographic features in preoperative evaluation of malignant thyroid nodules in a multinodular goiter. World J Surg 2008; 32: 1948–54.Salmaslıoglu A, Erbil Y, Dural C, et al. Predictive value of sonographic features in preoperative evaluation of malignant thyroid nodules in a multinodular goiter. World J Surg 2008; 32: 1948–54.Gul K, Ersoy R, Dirikoc A, et al. Ultrasonographic evaluation of thyroid nodules: comparison of ultrasonographic, cytological, and histopathological findings. Endocrine 2009; 36: 464–72.Gul K, Ersoy R, Dirikoc A, et al. Ultrasonographic evaluation of thyroid nodules: comparison of ultrasonographic, cytological, and histopathological findings. Endocrine 2009; 36: 464–72.Gervasi R, Orlando G, Lerose MA, et al. Thyroid surgery in geriatric patients: a literature review. BMC Surg 2012; 12: S 16–S 518.Gervasi R, Orlando G, Lerose MA, et al. Thyroid surgery in geriatric patients: a literature review. BMC Surg 2012; 12: S 16–S 518.Uygur MM., Yoldemir T., Yavuz DG. Thyroid disease in the perimenopause and postmenopause period Climacteric, 2018; 21: 6: 542–548.Uygur MM., Yoldemir T., Yavuz DG. Thyroid disease in the perimenopause and postmenopause period Climacteric, 2018; 21: 6: 542–548.

The authors declare that there are no conflicts of interest present.