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Levothyroxine suppressive therapy for solitary thyroid nodule
E Mainini1, I Martinelli, G Morandi
1Divisione di Endocrinologia, Ospedale Sant'Antonio Abate, Gallarate, Italy.
Journal of Endocrinological Investigation
|November 1, 1995
Summary
Levothyroxine (LT4) therapy was evaluated for single thyroid nodules. Only a small percentage of patients experienced significant nodule shrinkage, though no new nodules formed in the treated group.
Area of Science:
- Endocrinology
- Thyroidology
Background:
- Single thyroid nodules are common, and TSH suppression is a potential therapeutic strategy.
- Evaluating levothyroxine's efficacy in reducing nodule volume is crucial for patient management.
Purpose of the Study:
- To assess the effectiveness of TSH-suppressive levothyroxine (LT4) therapy in reducing the volume of single, benign thyroid nodules.
Main Methods:
- 55 euthyroid patients with benign, cold, solid thyroid nodules were studied.
- 45 patients received LT4 (mean 1.7 μg/kg/day) for ~21 months; 10 served as controls.
- Nodule volume changes, thyroid function, and clinical/ultrasonographic findings were monitored.
Main Results:
- Significant nodule volume decrease (≥50%) occurred in only 17.8% of LT4-treated patients.
- No significant change in nodule volume was observed in the control group.
- No new nodules developed in the treated group, unlike in two controls (p<0.05).
Conclusions:
- TSH-suppressive therapy with levothyroxine is effective in a small subset of patients with single thyroid nodules.
- No predictive factors for treatment response were identified.
- The therapy was well-tolerated, with transient increases in T4 and FT4, and no observed side effects.