Suppressive therapy with levothyroxine for solitary thyroid nodules.
OBJECTIVE
To evaluate the effect of treatment with TSH suppressive dose of levothyroxine in patients with benign thyroid nodules.


METHODS
Prospective randomized study. Group A (n = 20) patients received levothyroxine and group B (n = 20) patients did not. The dose of levothyroxine was adjusted to obtain an effective suppression of TSH. A clinical, analytical and morphological (with ultrasound) review was performed every 3 months. The mean +/- SD follow-up period was 10.6 +/- 2.2 months.


METHODS
Forty euthyroid women with solitary thyroid nodule on palpation, cold on scintigraphy and cytologically benign without contraindication participated.


METHODS
At entry: biochemical and hormonal parameters, thyroid scintigraphy and thyroid ultrasonography. Every 3 months additional determinations of thyroid hormones and TSH levels were carried out, if necessary, to verify effective TSH suppression. Every 6 months thyroid ultrasound imaging was performed.


RESULTS
Patients were euthyroid at entry into the study. The mean dose of levothyroxine necessary to obtain TSH suppression was 2.82 +/- 0.6 micrograms/kg/day. No significant modification in the thyroid nodule diameter (mean +/- SD 2.6 +/- 1.2 vs 2.5 +/- 1.2 cm) or in the thyroid nodule volume (10.3 +/- 11.9 vs 10.1 +/- 12.2 ml) were observed in group A. In group B the results were similar (2.8 +/- 0.9 vs 2.7 +/- 1.8 cm and 9.2 +/- 6.4 vs 9.2 +/- 9.5 ml, respectively). No differences were found in either group in the number of nodules that reduced significantly their volume (four and three, respectively).


CONCLUSIONS
The suppressive therapy with levothyroxine was not effective in reducing nodule sizes in patients with solitary benign thyroid nodules.
Reverter
J L
JL
Endocrinology Section, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
Lucas
A
A
Salinas
I
I
Audí
L
L
Foz
M
M
Sanmartí
A
A
D000328:Adult; D003864:Depression, Chemical; D005260:Female; D006801:Humans; D011446:Prospective Studies; D013961:Thyroid Gland / Q000503:physiopathology; D016606:Thyroid Nodule / Q000188:drug therapy* / Q000503:physiopathology; D013972:Thyrotropin / Q000378:metabolism*; D013974:Thyroxine / Q000627:therapeutic use*
D013972:Thyrotropin; D013974:Thyroxine