Nodular thyroid disease medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Medical Therapy
- Radioiodine (I-131) is as effective as surgery for the treatment of toxic multinodular goiter, however has a more prolonged reversal of hyperthyroidism after therapy. It has also been used for the treatment of non-toxic multinodular goiter.
- Antithyroid drugs, such as propylthiouracil (PTU) or methimazole are not 1st line agents in treating nodular thyroid disease when overt hyperthyroidism is present. This is primarily due to the fact that this treatment would be lifelong. These drugs are mainly used prior to surgery, as they have been shown to lower the operative risk. Additionally, when given prior to radioiodine therapy, they have been shown to achieve a state of euthyroidism more rapidly, and decrease the exacerbations of hyperthyroidism.
- Recent studies, however, report no significant difference between thyroxine and placebo for the treatment of benign nodules.
- If a nodule grows, with or without replacement, surgery is indicated.
References