Goiter%20nontoxic%20(simple)--%20diffuse%20-and-%20multinodular Treatment
Pharmacotherapy
Radioactive Iodine
- An alternative to surgery especially in the elderly, patients unfit for surgery or with TSH suppression or patients wanting to avoid surgery
- Reduces goiter size and reduces obstructive signs and symptoms (eg dyspnea and dysphagia)
- May be an alternative to surgery and radioactive iodine therapy
- More suitable for patients without thyroid-stimulating hormone (TSH) suppression or with high serum TSH levels
- Has been used to prevent recurrences after surgery
- Suppresses TSH production causing goiter shrinkage
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Prolonged treatment with T4 is required to maintain goiter size reduction and prevent recurrences
- Prolonged TSH suppression by T4 may also increase risk of bone loss and atrial fibrillation
- Not recommended for treatment of nontoxic multinodular goiter due to its low efficacy and risk of thyrotoxicosis