Substitution therapy after surgery for autonomous adenomas

A substitution therapy with L-thyroxine subsequent to surgery on the thyroi d gland due to autonomous dysfunction depends in particular on the extent o f resection. A specific postoperative therapy is not necessary in areas wit h sufficient iodine supply if the remaining part of the thyroid gland guara ntees a euthyroid metabolic state. The radicalness of the intervention is d ependent on the existence of an unifocal, multifocal or disseminated autono my. Surgery due to disseminated autonomy always necessitates a substitutive therapy with thyroid hormones and in most cases surgery due to multifocal autonomies require the same treatment. The therapy is initiated with a dose of 1.5 mu g L-thyroxine per kg body weight. Suppression of the TSH level i s not necessary. Due to the greater risk of recurrence the L-thyroxine admi nistration should be complemented in areas of iodine deficiency with approx imately 100 - 200 mg iodide. After operations with functionally adequate th yroid remnants (8 - 10 mi), an exclusive prophylaxis with 200 mg iodide can be implemented. The result of surgery should be sonographically documented three months after the intervention.