THE EFFECT OF THYROXINE SUPPRESSIVE THERAPY IN ENDEMIC BENIGN NODULAR GOITER: SHOULD THYROXINE BE USED ROUTINELY?

Abstract

We retrospectively evaluated the effect of thyrotropin suppressive therapy with thyroxine on the volume of benign-solitary single nodule and dominant nodule of multinodular goiter in a relatively low iodine intake area. In this study 119 euthyroid patients with a benign,predominantly solid, single nodule (n=18) or multinodular goiter (n=101), who received 100 microg of thyroxine daily, were evaluated. Patients were admitted to the study after evaluation of thyroid biochemical parameters (FT3, FT4, TSH), ultrasound examination, and fine needle aspiration biopsy. First and last evaluations were compared. At the end of the study, mean follow-up was 12.83 ± 6.16 (3-25). Five of 18 (27.7 %) patients with single solid nodule had 50 % or more regression of the nodular volume (responders). Seventeen of 101 (16.8 %) patients had 50% or more regression of the dominant nodule volumes. On the other hand, treatment was not evaluated as successful in 11 of 18 (61%) patients in group 1 and 69 of 101 (68.3%) patients in group 2. We concluded that thyroxine suppressive therapy might be partially effective in arresting the growth or reducing the volume of small endemic euthyroid goiter, thus requiring a more careful evaluation in routine usefulness.