Imperial College London Diabetes Centre (ICLDC), in partnership with Mubadala Health, recently hosted the highly anticipated fifth edition of its Thyroid Masterclass. This virtual event brought together esteemed specialists from the United Kingdom, cultivating an environment of stimulating discussions while showcasing the most current trends and advancements in the field. The event commenced with opening remarks from Professor Amir Sam of Imperial College School of Medicine, UK.
With each presentation being followed by a question-and-answer session, the Thyroid Masterclass was open to all physicians, including general practitioners and specialists interested in enhancing their understanding of thyroid disorders and exploring the latest advancements in thyroid clinical practice. Participants left the event equipped with valuable insights to enhance their professional development, as well as a thorough understanding of improved patient care strategies. The masterclass was a Continuous Medical Education (CME) event, accredited by the Department of Health – Abu Dhabi, where attending healthcare professionals earned two CME hours.
“At Imperial College London Diabetes Centre, we are always focused on providing the caregiver community with opportunities to learn and hear from pioneering medical experts. This is a key priority for our organization, as we believe in the value of continued education, especially for the healthcare community which needs to stay on top of the latest medical research and breakthroughs,” said Dr Mai Ahmed Al Jaber, Acting Executive Director at ICLDC.
“Over the past few years, we have curated several CME-accredited events on subjects ranging from the latest in diabetes management to specific complications associated with the condition. Having acknowledged the importance of such events, and the positive feedback received from attendees, we continue to partner with various global institutions to bring experts from the top of their fields to deliver talks on pressing subjects that have the potential to transform the delivery of care. This has been our purpose with medical education, and we hope to continue offering exceptional sessions from great minds that will further transform the healthcare industry,” she continued.
Triiodothyronine and levothyroxine
The first topic discussed was on helping patients taking triiodothyronine (T3), or desiccated thyroid extract, to switch to the evidence-based medication, levothyroxine. Professor Karim Meeran, a Professor of Endocrinology at Imperial College London, explained that the challenge lies in patients’ fluctuating well-being, which can lead to false perceptions about the efficacy of different treatments. He cautioned against relying on trials of liothyronine and other complementary remedies, highlighting the influence of the placebo effect and the absence of substantial evidence for their actual benefits.
Prof. Meeran emphasised the need for a slow and cautious approach when weaning patients off T3, reassuring them that their own T3 production is sufficient. He also advised against relying on supplements like turmeric and ashwagandha. He emphasized the significance of accurate hypothyroidism diagnosis, urging against initiating treatment with a trial of thyroxine. On this note, he also iterated the importance of ensuring patient protection from potentially harmful and expensive placebos.
Thyroid nodules and thyroid cancer
Aimee Di Marco, a consultant endocrine surgeon from Imperial College Healthcare NHS Trust, UK, proceeded to discuss thyroid nodules and thyroid cancer. Although thyroid nodules are very common, thyroid cancer represents only about one percent of all malignancies worldwide. However, the incidence of thyroid cancer has increased by nearly 200 percent in the past three decades. When evaluating a patient with an indeterminate nodule, it is important to have clear questions in mind. The primary question is whether the nodule is malignant, and the secondary question is whether there is another reason to offer therapy. This requires a comprehensive evaluation of the patient’s overall condition. Di Marco presented various case studies to the audience, proposing scenarios and asking what their course of action would be. She also mentioned that molecular testing is not a definitive solution for diagnosis and emphasized the need for individual assessment using a ‘triple assessment’ approach.
Medullary thyroid carcinoma
Dr Florian Wernig, a consultant endocrinologist from Imperial College Healthcare NHS Trust, UK, discussed the follow-up of medullary thyroid carcinoma (MTC) in the second to last session of the day. He said that medullary thyroid cancer represents around four percent of all thyroid cancer cases. Of those cases, about one to seven percent of patients have hereditary MTC. When dealing with advanced disease, it is important to strike a balance between the relatively slow rate of tumour progression and the limited efficacy and potential side effects of local and systemic therapies.
Thyrotoxicosis in pregnancy
During the last session, Dr Rochan Agha-Jaffar, a consultant endocrinologist from Imperial College Healthcare NHS Trust, UK, addressed the topic of thyrotoxicosis in pregnancy and the importance of balancing the associated risks. She spoke on how the most common form of thyrotoxicosis, also known as Graves’ disease, can potentially affect fertility and increase the risk of miscarriage. She stressed that the choice of thioamide therapy is crucial in managing this condition and so is pre-conception planning, as there is often concern about taking certain medications during pregnancy. The discussion touched upon the definitive treatment options and highlighted the principles of managing Graves’ disease during pregnancy.
