POSTOPERATIVE CARE OF THE FUNCTIONAL AUTO NOMOUS GOITER - AN INDIVIDUALIZED THERAPEUTIC CONCEPT

The pathophysiology of intrathyroidal iodine deficiency requires a cha nge of thought in the approach to postoperative care of patients with functionally autonomous sufficient iodine supplement with individually adjusted levothroxine substitution. 73% (= 131) of the patients inves tigated in this study developed thyroidal insufficiency one week posto peratively. Following oral iodine administration (200-300 mug/day) 56% of the patients developed an euthyroid functional level after 6-12 we eks which was maintained for one year. At the same mean thyroidal resi dual volume of 9.68 ml, 44% of the patients had gradually varying hypo thyroidal functional levels. Using iodine prophylaxis, the hypothyroid al spectrum was changed in favour of a lower hormonal deficit. Functio nal recompensation was reached by iodine induced amelioration of the f unctional reserve of the remnant thyroid and low dose levothyroxine of 1.25 mug/kg bodyweight compared to 1.80 mug/kg bodyweight in patients with non-autonomous nodular goiters.