Endocrine Abstracts

Purpose: Preoperative iodine therapy due to toxic nodular goiter (TNG) is discouraged as iodine may cause an aggravation of hyperthyroidism. We aimed to examine the effects of a short course of Lugol’s solution on thyroid hormones and quality of life in TNG patients.

Methods: 20 patients with TNG and subclinical to mild hyperthyroidism (free T4 <30 pmol/l) without complicating illness were included in this pre-post intervention study. All participants received Lugol’s solution 5 %, Three oral drops thrice daily for ten days. Heart rate, TSH, free T4, and free T3 concentrations were collected before (day 0) and after treatment (day 10). Thyroid hormones measurements were repeated at two time points during the intervention to discover any exacerbations of hyperthyroidism. ThyPRO39, a thyroid specific quality-of-life questionnaire was filled out day 0 and repeated at day 10. Differences in heart rate, thyroid hormone concentrations, and quality-of-life before and after treatment were compared.

Results: Median age was 63.5 years with a female to male ratio 19:1. Free T4 and freeT3 concentrations decreased and TSH concentration increased after 10 days of treatment. There was no difference in heart rate. No exacerbations of hormone levels were noticed in any of the participants during the intervention. Three of the 14 scales in ThyPRO39 were improved, including hyperthyroid symptoms. The remaining scales were unchanged.

Conclusion: In this pre-post intervention study on toxic nodular thyroid disease, we found that a short course of Lugol’s solution improved thyroid hormone concentrations and reduced hyperthyroid symptoms. This indicates that Lugol’s solution might be used as preoperative treatment in toxic nodular goiter.