TREATMENT OF ENDEMIC GOITER WITH IODINE O R LEVOTHYROXINE IN THE MIDDLE-AGED AND ELDERLY PERSON

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.