[Effectiveness of goiter treatment with L-thyroxine in patients over 40]

We examined the effect of levothyroxine on thyroid size in elderly patients (an age > 40 y) with diffuse or nodular goitres.

76 patients without relevant autonomy were treated with levothyroxine (2 micrograms/kg BW/d) over a period of 6-12 months. The elderly patients with diffuse goitres (group A, n = 33) and nodular goitres (group B, n = 21) were compared to 18-30 year old respective control groups (group C, n = 13, group D, n = 9). Laboratory parameters and ultrasonic determined goitre volumes were documented before levothyroxine treatment and after 6-12 months, respectively. All measured thyroid volume reductions were referred to the total goitre size.

After 6-12 months levothyroxine treatment a significant thyroid reduction was observed in group A (14.8%, p < 0.001), group C (16.0%, p < 0.05) and in group D (19.8%, p < 0.05), whereas in group B thyroid volume was nearly unchanged (4.5%). The result of group B differed from that of group D (p < 0.05).

These results suggest that levothyroxine can reduce diffuse goitres in elderly patients (group A), whereas in nodular goitres of elderly patients (group B) only a further thyroid growth can be provided.