Henry Ford Hospital Medical Journal


Thyroid reserve was measured in 41 patients who were euthyroid 5 to 15 years after therapy for diffuse toxic goiter. Twenty-one of them had been treated by 131I, 20 by surgery and 10 were normal controls. All had a PBI (protein bound iodine) and 3-hour thyroidal 131I uptake. The same parameters of function were measured again 24 hours after they were given 10 units of thyroid stimulating hormone (TSH) intramuscularly. Only two patients in each treatment group responded with normal elevation of both the PBI and 131I uptake. In 52% of the 131I-treated patients and in 55% of those surgically treated there was no significant increase in either PBI or thyroidal iodine uptake. These results suggest that current efforts to reduce the early post 131I incidence of hypothyroidism may result in a long-term reduction of this complication as well and make this group comparable to those treated surgically. It is certain, however, that no patient receiving either therapy should be dismissed from continuing medical followup.