DOI: http://dx.doi.org/10.18203/2349-2902.isj20213600

Role of thyroxine in reducing the size of benign thyroid swellings and pre-treatment thyroid stimulating hormone as a predictor of response to therapy

Jasira Padinhare Madathil, Rajesh T. R., P. J. Babu

Abstract


Background: Conservative management for benign thyroid swellings which do not require surgery is a matter of controversy. There has been studies and trials on the role TSH suppression in reducing thyroid volume, but low dose thyroxine was never been properly studied. Being such a common disorder, more studies have to be undertaken to have an idea on managing the goitres conservatively.

Methods: Patients with benign thyroid goitres without indications for surgery and who were on 50-100 µg of thyroxine per day was included in the study. Their initial thyroid hormone levels, volume on ultrasonogram, and fine needle aspiration cytology were collected along with biodata. They were reassessed after 6 months and 1 year for change in volume of thyroid.

Results: Majority of patients showed a decreasing trend in volume of thyroid after 1 year of thyroxine therapy, even though the amount of reduction was not statistically significant. Rate of decrease in thyroid volume was significantly higher in patients with higher TSH values.

Conclusions: Thyroxine therapy has got a role in reducing and arresting further growth of benign thyroid swellings which doesn’t require surgical management. Pre-treatment TSH can be used a predictor of response to thyroxine therapy.


Keywords


Benign thyroid swellings, Conservative management, Thyroxine therapy, Initial TSH levels

Full Text:

PDF

References


American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer, Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19(11):1167-214.

Rienhoff, WF. Microscopic changes induced in thyroid gland by oral administration of desiccated thyroid. Arch Surg. 1940;41:487.

Studer H, Peter HJ, Gerber H. Natural heterogeneity of thyroid cells: the basis for understanding thyroid function and nodular goiter growth. Endocr Rev. 1989;10(2):125-35.

Astwood EB, Cassidy CE, Aurbach GD. Treatment of goiter and thyroid nodules with thyroid. JAMA. 1960;174:459-64.

Wémeau JL, Caron P, Schvartz C, Schlienger JL, Orgiazzi J, Cousty C, et al. Effects of thyroid-stimulating hormone suppression with levothyroxine in reducing the volume of solitary thyroid nodules and improving extranodular nonpalpable changes: a randomized, double-blind, placebo-controlled trial by the French Thyroid Research Group. J Clin Endocrinol Metab. 2002;87(11):4928-34.

Lima N, Knobel M, Cavaliere H, Sztejnsznajd C, Tomimori E, Neto G. Levothyroxine suppressive therapy is partially effective in treating patients with benign, solid thyroid nodules and multinodular goiters. Thyroid. 1997;7(5):691-7.