Treatment of iodine deficiency goiter with iodine, levothyroxine or a combination of both.
During recent years several studies have been published comparing different ways of pharmacological treatment of a goiter due to iodine deficiency. These studies usually were performed with 300 to 500 micrograms of iodine, 100 to 150 micrograms levothyroxine, or a combination of in most cases 100 micrograms levothyroxine and 100 micrograms iodine. The largest data have been accumulated in 166 patients with in most cases diffuse goiter. Group A (n = 61) received 150 micrograms levothyroxine per day, group B (n = 50) 400 micrograms iodine per day and group C (n = 55) a combination of 75 micrograms levothyroxine and 200 micrograms iodine per day. During the eight months of therapy, in all three groups a significant and comparable mean decrease in goiter size was documented (-32.1% in group A, -37.3% in group B and -38.7% in group C [n.s. between the three groups]). Striking differences between the three groups are evident in the changes of basal and thyrotropin releasing hormone (TRH) stimulated thyrotropin (TSH). In group A, after eight months a sharp and significant decrease of TSH occurred (from 1.2 mU/l to 0.4 mU/l; mean; p < 0.05), while in group B TSH showed only a minor decrease (from 1.3 mU/l to 0.9 mU/l) and remained significantly higher compared to both, group A and C (p < 0.01). Similar changes were documented when the TSH after TRH administration was calculated. It is concluded, that all three therapeutic approaches are effective for goiter reduction.(ABSTRACT TRUNCATED AT 250 WORDS)
Hintze
G
G
Department of Medicine Ferdinand-Sauerbruch-Hospital Wuppertal, Germany.
Köbberling
J
J
D000328:Adult; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D006042:Goiter / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D006801:Humans; D007455:Iodine / Q000008:administration & dosage / Q000172:deficiency* / Q000627:therapeutic use*; D013961:Thyroid Gland / Q000473:pathology; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000008:administration & dosage / Q000627:therapeutic use*
D013972:Thyrotropin; D007455:Iodine; D013974:Thyroxine