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involving over 18,000 patients found that while general complications were rare and comparable between patients undergoing surgery for autoimmune thyroid disease and those with multinodular goitre, the risk of transient (15.3%) and permanent (1.1%) hypoparathyroidism was significantly higher in HT patients than in those undergoing surgery for multinodular goitre (12.9% and 0.9%, respectively) ( Importantly, a recent cost-effectiveness analysis using a Markov decision model showed that total thyroidectomy may be both more effective and less costly over the long term than continued medical therapy in euthyroid HT patients with disabling symptoms ( 5 Supplements The literature on the clinical management of HT devotes considerable attention to the role of nutritional supplements, particularly selenium and vitamin D, in modulating the autoimmune process and alleviating persistent symptoms (65)

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