Preventive effect of levothyroxine in patients operated for non‐toxic goitre: a randomized trial of one hundred patients with nine years follow‐up

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Abstract
Summary: OBJECTIVE Earlier reports have shown different effects of levothyroxine in the prevention of recurrence of non‐toxic goitre after operation. These studies have been either retrospective or of short‐term follow‐up. This study was designed to evaluate the efficacy of long‐term Eitroxin treatment (levothyroxine 0.1 mg daily) In the prevention of post‐operative recurrence of non‐toxic goitre.DESIGN Randomized prospective non‐placebo controlled study with 9 years follow‐up. Group A (n = 40) received levothyroxine and group B (n = 60) did not.PATIENTS One hundred patients consecutively operated for non‐toxic goitre. All clinically and biochemically euthyroid and none taking any thyroid and/or antithyroid medication.MEASUREMENTS T3, T4, TSH, thyroid antibodies (microsomal/thyroglobulin), weight and neck circumference were measured and thyroid palpation were done preoperatively, 3 and 12 months after surgery and thereafter yearly up to 9 years.RESULTS Sixty‐nine patients completed 9 years follow‐up. Incidence of recurrence in group A vs group B was 14.5 vs 21.8% (P < 0.05) irrespective of type of operation, pathoanatomical diagnosis, removed amount or remnant size of the thyroid gland and level of TSH.CONCLUSION No preventive effect on incidence of recurrence of goitre by Eltroxin 0.1 mg daily in patients operated for non‐toxic sporadic goitre was observed.