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ARTICLE |

Treatment of Goiter and Thyroid Nodules with Thyroid FREE

E. B. Astwood, M.D.; Carl E. Cassidy, M.D.; G. D. Aurbach, M.D.
[+] Author Affiliations

Boston

From the Pratt Clinic—New England Center Hospital and the Department of Medicine, Tufts University School of Medicine. Dr. Aurbach is now at the National Institute of Arthritis and Metabolic Diseases, National Institutes of Health, Bethesda, Md.


JAMA. 1960;174(5):459-464. doi:10.1001/jama.1960.03030050001001
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The effectiveness of orally administered thyroid substance in the treatment of simple goiter was noted 70 years ago, but its justification awaited the modern discovery of the relation of the thyroid to the thyrotropic hormone of the hypophysis. The present analysis of 230 cases of simple goiter demonstrates the value of thyroid U.S.P., which was given in single daily doses, usually of 180 mg. at the outset. This amount caused mild symptoms of overdosage in 16% of the patents and in some cases it had to be increased in order to obtain the desired regression. Thyroid nodules and simple goiter were reduced in size or disappeared in about two-thirds of the cases. This corroborates the older clinical observations as well as the underlying theory and indicates that simple goiter is essentially a benign process.

REFERENCES

Greer, M. A., and Astwood, E. B.:  Treatment of Simple Goiter with Thyroid , J. Clin. Endocrinol. 13:1312-1331 ( (Nov.) ) 1953;.
Burrows, B. A.:  Tracer Studies in Medical Diagnosis , M. Clin. North America 41:1181-1192 ( (Sept.) ) 1957;.
Astwood, E. B.:  Problem of Nodules in Thyroid Gland: Commentary , Pediatrics 18:501-505 ( (Sept.) ) 1956;.
Sokal, J. E.:  Problem of Malignancy in Nodular Goiter —Recapitulation and Challenge , J. A. M. A. 170:405-412 ( (May 23) ) 1959;.
Vertán, E.:  Beneficial Effect of Dried Thyroid Preparation on Goiter , Klin. Wchnschr. 19:250-252 ( (March 16) ) 1940;.
Papper, S., and others:  Effects of L-thyroxine Sodium on Nontoxic Goiter, on Myxedema and on Thyroid Uptake of Radioactive Iodine , New England J. Med. 247: 897-899 ( (Dec. 4) ) 1952;.
Gorzkowski, T.:  Therapeutic Effects of Thyroid Preparations in Simple Goiter , Polski tygodnik lek. 8:1501-1503 ( (Nov. 2) ) 1953;.
Gomez Afanador, J. C.:  Clinical Study of 244 Cases of Goiter: Treatment of Simple Goiter with Thyroid , Rev. Soc. colomb. endocrinol. 1:21-53 ( (Dec.) ) 1955;.
Crile, G., Jr.:  Endocrine Dependency of Certain Thyroid Cancers and Danger That Hypothyroidism May Stimulate Their Growth , Cancer 10:1119-1137 ( (Nov.) -Dec.) 1957;.
Starr, P., and Goodwin, W.:  Use of Triiodothyronine for Reduction of Goiter and Detection of Thyroid Cancer , Metabolism 7:287-292 (July pt. (1) ) 1958;.
Doniach, D.; Hudson, R. V.; Trotter, W. R.; and Waddams, A.:  Effect of Thyroxine, Triiodotyrosine and TRIAC on Metabolic Rate, Blood Lipids and Thyroid Size and Function in Subjects with Nontoxic Goiter , Clin. Sc. 17:519-529 ( (Aug.) ) 1958;.
Lamberg, B. A.; Hernberg, C. A.; and Hakkila, R.:  Treatment of Nontoxic Goitre with Thyroid Preparations , Acta endocrinol. 33:584-592 ( (April) ) 1960;.
Statland, H.; Wasserman, M. M.; and Vickery, A. L.:  Struma Lymphomatosa (Hashimoto's Struma): Review of 51 Cases with Discussion of Endocrinologic Aspects , A. M. A. Arch. Int. Med. 88:659-678 ( (Nov.) ) 1951;.
Furr, W. E., and Crile, G., Jr.:  Struma Lymphomatosa: Clinical Manifestations and Response to Treatment , J. Clin. Endocrinol. 14:79-86 ( (Jan.) ) 1954;.
Gribetz, D.; Talbot, N. B.; and Crawford, J. D.:  Goiter Due to Lymphocytic Thyroiditis ( Hashimoto's Struma): Its Occurrence in Preadolescent and Adolescent Girls , New England J. Med. 250:555-557 ( (April 1) ) 1954;.
Skillern, P. G., and others:  Struma Lymphomatosa: Primary Thyroid Failure with Compensatory Thyroid Enlargement , J. Clin. Endocrinol. 16:35-54 ( (Jan.) ) 1956;.
Doniach, D., and Roitt, I. M.:  Auto-immunity in Hashimoto's Disease and Its Implications , J. Clin. Endocrinol. 17:1293-1304 ( (Nov.) ) 1957;
McConahey, W. M.; Woolner, L. B.; Black, B. M.; and Keating, F. R.:  Effect of Desiccated Thyroid in Lymphocytic ( Hashimoto's ) Thyroiditis , J. Clin. Endocrinol. 19:45-52 ( (Jan.) ) 1959;.
Crile, G., Jr.:  Papillary Carcinoma of Thyroid , in Clinical Endocrinology I , edited by E. B. Astwood, New York, Grune & Stratton, 1960;, pp. 179-184.
Thomas, C. G.:  Hormonal Treatment of Cancer of Thyroid , J. Clin. Endocrinol. 17:232-237 ( (Feb.) ) 1957;.

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Greer, M. A., and Astwood, E. B.:  Treatment of Simple Goiter with Thyroid , J. Clin. Endocrinol. 13:1312-1331 ( (Nov.) ) 1953;.
Burrows, B. A.:  Tracer Studies in Medical Diagnosis , M. Clin. North America 41:1181-1192 ( (Sept.) ) 1957;.
Astwood, E. B.:  Problem of Nodules in Thyroid Gland: Commentary , Pediatrics 18:501-505 ( (Sept.) ) 1956;.
Sokal, J. E.:  Problem of Malignancy in Nodular Goiter —Recapitulation and Challenge , J. A. M. A. 170:405-412 ( (May 23) ) 1959;.
Vertán, E.:  Beneficial Effect of Dried Thyroid Preparation on Goiter , Klin. Wchnschr. 19:250-252 ( (March 16) ) 1940;.
Papper, S., and others:  Effects of L-thyroxine Sodium on Nontoxic Goiter, on Myxedema and on Thyroid Uptake of Radioactive Iodine , New England J. Med. 247: 897-899 ( (Dec. 4) ) 1952;.
Gorzkowski, T.:  Therapeutic Effects of Thyroid Preparations in Simple Goiter , Polski tygodnik lek. 8:1501-1503 ( (Nov. 2) ) 1953;.
Gomez Afanador, J. C.:  Clinical Study of 244 Cases of Goiter: Treatment of Simple Goiter with Thyroid , Rev. Soc. colomb. endocrinol. 1:21-53 ( (Dec.) ) 1955;.
Crile, G., Jr.:  Endocrine Dependency of Certain Thyroid Cancers and Danger That Hypothyroidism May Stimulate Their Growth , Cancer 10:1119-1137 ( (Nov.) -Dec.) 1957;.
Starr, P., and Goodwin, W.:  Use of Triiodothyronine for Reduction of Goiter and Detection of Thyroid Cancer , Metabolism 7:287-292 (July pt. (1) ) 1958;.
Doniach, D.; Hudson, R. V.; Trotter, W. R.; and Waddams, A.:  Effect of Thyroxine, Triiodotyrosine and TRIAC on Metabolic Rate, Blood Lipids and Thyroid Size and Function in Subjects with Nontoxic Goiter , Clin. Sc. 17:519-529 ( (Aug.) ) 1958;.
Lamberg, B. A.; Hernberg, C. A.; and Hakkila, R.:  Treatment of Nontoxic Goitre with Thyroid Preparations , Acta endocrinol. 33:584-592 ( (April) ) 1960;.
Statland, H.; Wasserman, M. M.; and Vickery, A. L.:  Struma Lymphomatosa (Hashimoto's Struma): Review of 51 Cases with Discussion of Endocrinologic Aspects , A. M. A. Arch. Int. Med. 88:659-678 ( (Nov.) ) 1951;.
Furr, W. E., and Crile, G., Jr.:  Struma Lymphomatosa: Clinical Manifestations and Response to Treatment , J. Clin. Endocrinol. 14:79-86 ( (Jan.) ) 1954;.
Gribetz, D.; Talbot, N. B.; and Crawford, J. D.:  Goiter Due to Lymphocytic Thyroiditis ( Hashimoto's Struma): Its Occurrence in Preadolescent and Adolescent Girls , New England J. Med. 250:555-557 ( (April 1) ) 1954;.
Skillern, P. G., and others:  Struma Lymphomatosa: Primary Thyroid Failure with Compensatory Thyroid Enlargement , J. Clin. Endocrinol. 16:35-54 ( (Jan.) ) 1956;.
Doniach, D., and Roitt, I. M.:  Auto-immunity in Hashimoto's Disease and Its Implications , J. Clin. Endocrinol. 17:1293-1304 ( (Nov.) ) 1957;
McConahey, W. M.; Woolner, L. B.; Black, B. M.; and Keating, F. R.:  Effect of Desiccated Thyroid in Lymphocytic ( Hashimoto's ) Thyroiditis , J. Clin. Endocrinol. 19:45-52 ( (Jan.) ) 1959;.
Crile, G., Jr.:  Papillary Carcinoma of Thyroid , in Clinical Endocrinology I , edited by E. B. Astwood, New York, Grune & Stratton, 1960;, pp. 179-184.
Thomas, C. G.:  Hormonal Treatment of Cancer of Thyroid , J. Clin. Endocrinol. 17:232-237 ( (Feb.) ) 1957;.
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