Thyroid nodules patients should not be treated with L-thyroxine except in selected cases.

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Topic Area


The growth of thyroid nodules, the appearance of other nodules and the increase in thyroid volume can be partially prevented by treatment with levo-thyroxine for TSH-suppressive purposes. However, a clinically significant volume reduction is achieved only with long-term therapies and in a minority of patients (small, recently diagnosed colloid nodules). The growth of the nodules is in fact influenced not only by TSH but also by other growth factors. Furthermore, suppressive therapy with l-thyroxine creates a condition of subclinical thyrotoxicosis which can be risky especially for women in menopause (favoring osteoporosis) and for the elderly (for the possible worsening of pre-existing heart disease or the onset of atrial fibrillation). This therapy can therefore be considered only in young subjects, in selected cases, while, if already in progress, it must be suspended in the case of menopausal women and elderly subjects, re-evaluating the thyroid function over time.


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