Non-toxic goiter treatment with 1-triiodothyronine and 1-thyroxine

Twenty-one patients with goiters-four diffuse and 17 nodular-were treated with I-triiodothyronine and I-thyroxine in doses to tolerance. The four diffuse goiters were barely palpable at the end of the treatment. The average dose of I-triiodothyronine required was 100 mcg. per day. The average dose of I-thyroxine was 0.3 mg. per day. Of the 17 multinodular goiters, 11 showed at least a 50 per cent reduction in size. The average dose of I-triiodothyronine used was 125 mcg. In six cases the gland did not change in size; in three of the six the lesion was diagnosed, at operation, as microfollicular and macrofollicular colloid goiter. Hypermetabolic symptoms may occur when doses of 100 mcg. or more of I-triiodothyronine are used. Results indicated that suppressive therapy with thyroid hormone to tolerance is effective in diffuse goiters. It is only partially effective in the treatment of multinodular goiters. In the cases in which operation was done, no change in the basic histological goiter structure was observed.