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Very little is known of the effects and side-effects of 131I in
diffuse non-toxic goitre. Only reports on a total of 21 highly selected subjects and 12
months of follow-up are available28,29. These suggest that thyroid volume can be reduced
by 62% within 12 months, leading to a normalization of thyroid volume in 15 of 21 (71%) of
the patients. Additional 131I-therapy allows further reduction of thyroid volume (29).
Side effects were hypothyroidism in 3 patients (14%), two of whom were anti-TPOab positive before treatment and one case of post 131I-therapy Graves’ disease related to appearance of TSHRab (28,29). The place of this therapy is at present not clarified. Much larger series followed for longer periods are needed. Controlled studies comparing L-T4 therapy or surgery with 131I are the next step. Presently, I believe it to be an alternative in patients who have an unsatisfactory effect of L-T4 therapy, who are poor surgical risks or who refuse surgery. |
