J. Feldkamp et al., TREATMENT OF ENDEMIC GOITER WITH IODINE O R LEVOTHYROXINE IN THE MIDDLE-AGED AND ELDERLY PERSON, Deutsche Medizinische Wochenschrift, 121(51-52), 1996, pp. 1587-1591
Objective: To compare the efficacy of iodide (300 mu g daily) with tha
t of levothyroxine (1.5 mu g/kg daily) in the treatment of endemic goi
tre in middle-aged and elderly persons. The possible occurrence of ant
ibodies against thyroid peroxidase and thyroglobulin was also tested.
Patients and methods: 67 patients (54 women, 13 men; aged over 40 year
s, average 53.5 years) with endemic goitre, excluding toxic goitre, we
re randomly treated with either iodine or thyroxine. Every 3 months fo
r one year their thyroid volume was obtained by ultrasound and the act
ivities of thyroid hormone (TH) and thyroid stimulating hormone (TSH)
and the concentration of antibodies against peroxidase and thyroglobul
in were measured. Results: In patients on levothyroxine the thyroid vo
lume had already markedly decreased after 3 months (P < 0.0001), dimin
ishing by 15.4% at 12 months. Volume reduction in the group on iodine
was 16.2% at one year. There was no significant difference between the
two medications and no case of antibody production in the iodine grou
p. Conclusions: Treatment of endemic goitre with iodine alone is effic
acious even in middle-aged or elderly patients, toxic goitre having be
en excluded. There was no evidence of antibody production against thyr
oid antigens at the stated iodine dosage.