This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Brenta, G. Articles by Pisarev, M. A. Search for Related Content PubMed PubMed Citation Articles by Brenta, G. Articles by Pisarev, M. A.

Comparative Efficacy and Side Effects of the Treatment of Euthyroid Goiter with Levo-Thyroxine or Triiodothyroacetic Acid

Department of Endocrinology and Metabolism (G.B., M.S., O.F., E.F., M.G., S.D., N.P., A.B., M.A.P.), French Hospital; Laboratory of Molecular Diagnosis-Biosidus; and Department of Radiobiology (E.G.), National Atomic Energy Commission and Department of Biochemistry (M.A.P.), University of Buenos Aires School of Medicine, Buenos Aires 1429, Argentina

Address all correspondence and requests for reprints to: Mario A. Pisarev, Department of Radiobiology, Comisión Nacional de Energía Atómica, Av del Libertador 8250, Buenos Aires 1429, Argentina. E-mail: pisarev{at}cnea.gov.ar.

Euthyroid goiter is usually treated with TSH-inhibitory doses of levo-T₄ (L-T₄). Because triiodothyroacetic acid (TRIAC) decreases TSH levels, the following study was perfomed: 36 euthyroid goitrous female patients (no cancer or chronic thyroiditis) were randomized to TRIAC (19.6 µg/kg) (n = 19) or L-T4 (1.7 µg/kg) (n = 17) treatment during 11 months. Goiter volume; lumbar and femoral bone mineral density; serum osteocalcin; deoxypyridinoline; TSH; free T₄; total, high-density lipoprotein, and low-density lipoprotein cholesterol; and triglycerides were measured before and after the study period. Student’s t test and ² analysis were performed. TSH values (microunits per milliliter) in the TRIAC and L-T₄ groups were: 1.91 ± 0.6 (basal) and 0.180 ± 0.1 (after) and 2.1 ± 2.5 (basal) and 0.180 ± 0.3 (after), respectively. Thyroid volume decreased 37.9 ± 35.4% in the TRIAC patients and 14.5 ± 39.5% in the L-T₄ group (P = 0.069). Forty-two percent of the goiters with TRIAC reduced more than 50% their initial volume vs. 17.7% with L-T₄ (P = 0.15). With TRIAC, patients experienced fewer side effects. No differences in the changes of bone mineral density, serum deoxypyridinoline, osteocalcin, or the lipid profile were observed between both groups. The present results show that TRIAC is more effective than L-T₄ in the reduction of goiter size, with comparable effects on peripheral parameters.

This work was supported in part by a grant from the Secretary of State of Science and Technology and the University of Buenos Aires. M.A.P. is an established researcher of the National Research Council of Argentina.

Abbreviations: Apo A, Apoprotein A₁; Apo B, apoprotein B; BMD, bone mineral density; FNA, fine needle aspiration; HDL, high-density lipoprotein; LDL, low-density lipoprotein; Tg, thyroglobulin; TPO, thyroperoxidase; TRIAC, triiodothyroacetic acid; US, ultrasonography.