S. Ertek, R.Ü. Ersoy, C. AnIl, Ö. Demir, M.F. Erdog˘an, S. Güllü, D. Berker, K. Gül, U. Ünlütürk, G. Erdog˘an; Ankara Thyroid Study Group logical characteristics of the nodule and larger pre- operative volume of the thyroid [10]. In our study although we found that patients not on LT4 treat- ment had a larger nodule volume and non-HT patients had an increased number of nodules, regression analysis did not reveal any significant relationship between presence of HT, LT4 use and nodule number or volume of lobes or nodules. Our study is the first clinical study to evaluate nodules and volumes of the remaining lobes among HT and non-HT patients in an iodine deficient area. Studies in similar geographic areas are scarce and have different methodological criteria and/or sur- gical approaches [8-10]. Limitations of our study include the possibility of omitting the TSH fluctua- tions between the two visits due to possible poor compliance of LT4 in patients with drug use, and underestimating the effect of TSH on thyroid and/or nodule volumes. Another limitation is the absence of knowledge on simultaneous urinary iodine lev- els of patients, because some patients have tests before and after iodization in Ankara. Strengths include the fact that the ultrasonographic evalua- tions were all made by endocrinology specialists to provide standardization. An important point is the absence of the definition of increased lobe volume in medical literature, although there are defined cri- teria about increase in nodule volume. For consis- tency, we accepted more than 10% increase in the remaining lobe volume as “increase” for lobe eval- uation. Finally, we cannot extrapolate these results to other partial thyroidectomies, since we only included hemithyroidectomized patients. Similarly, since we excluded patients with a history of multi- ple thyroid surgical interventions, we cannot make inferences on pathologies of recurrent nodules fol- lowing multiple surgical interventions. Meanwhile, despite continuing discussions and studies about benefits of LT4 treatment on nodule and thyroid volume, the dosage should be titrated carefully, considering multiple organ systems [22] and special groups of patients such as pregnant women [23]. In conclusion, our study revealed that starting TSH levels at a given time may have some value for prediction of the risk of hypothyroidism in the future. Caution is however needed with patients not on LT4 treatment for thyroid test abnormalities and in patients without HT diagnosis for the poten- tial of a modest increase in nodule volume and increase in TSH levels. 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