[Indication for thyrotoxine therapy after surgery of non-endemic non-toxic goiter]

Levo-thyroxine has for many years been used after operation for non-toxic goitre to prevent recurrence and postoperative thyroid hypofunction. The philosophy behind prevention was to suppress production of the thyroid stimulating hormone (TSH), which was assumed to be the main growth factor for the thyroid gland. Suppression of the serum-TSH concentration by thyroxine therefore seemed logical. No scientific documentation verifying this assumption has been found in non-endemic goitre areas. Treatment with levo-thyroxine subsequent to goitre surgery is thus only indicated in situations with risk of hypofunction, viz. when only a small thyroid remnant is left.