title: Treatment of endemic goitre due to iodine deficiency with iodine, levothyroxine or both: results of a multicentre trial.
abstract: Preliminary clinical studies and recent in vitro investigations suggest that iodine administration may be an effective alternative in the treatment of the diffuse euthyroid goitre of iodine deficiency. Therefore a 12-month multicentre study was initiated in which 166 patients were randomly assigned to take either 150 micrograms levothyroxine day-1 (group A, n = 61), 400 micrograms iodine day-1 (group B, n = 50), or a combination of 75 micrograms levothyroxine and 200 micrograms iodine day-1 (group C, n = 55) for 8 months with follow-up examinations at 4 and 8 months as well as 4 months after cessation of treatment. Initially, thyroid volume, as determined by ultrasound, was not significantly different in the three groups. In all three groups, during treatment a significant and comparable mean decrease in goitre size was documented (-32.1% in group A, -37.3% in group B, -38.7% in group C). After cessation of treatment in group A mean thyroid volume again increased to near the baseline value (-12.0% compared to the initial investigation), while the therapeutic effect was sustained in group B (-32.5%). In group C, only a slight rebound effect was observed (-26.3% vs baseline volume). Total thyroxine (T4) increased sharply and significantly in group A from 7.8 +/- 1.9 to 10.9 +/- 2.8 micrograms dl-1 after 8 months (P less than 0.001), but only slightly, although significantly in group B (from 7.8 +/- 1.5 micrograms dl-1 to 8.9 +/- 1.6 micrograms dl-1; P less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Medicine, Ferdinand-Sauerbruch-Hospital, Wuppertal, FRG.
authors.forename: G
authors.initials: G
authors.lastname: Hintze
authors.forename: D
authors.initials: D
authors.lastname: Emrich
authors.forename: J
authors.initials: J
authors.lastname: Köbberling
mesh_terms: D000293:Adolescent; D000328:Adult; D004359:Drug Therapy, Combination; D005260:Female; D006043:Goiter, Endemic / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007455:Iodine / Q000008:administration & dosage / Q000172:deficiency / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D010352:Patient Dropouts; D011897:Random Allocation; D013961:Thyroid Gland / Q000473:pathology; D013963:Thyroid Hormones / Q000097:blood; D013974:Thyroxine / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D013963:Thyroid Hormones; D007455:Iodine; D013974:Thyroxine