Prophylaxis of recurrent goiter by high‐dose L‐thyroxine

In a prospective, randomized, controlled study of 64 patients after bilateral subtotal thyroidectomy, a high dosage of 1.0 mg L‐thyroxine taken once a week was compared to the usual intake of 0.1 mg L‐thyroxine daily for prevention of recurrent goiter. During a follow‐up study for 52 weeks, the effectiveness and acceptability of an intermittent high dosage was assessed clinically and also by measuring basal TSH, stimulated TSH, iT4, and iT3. In both groups, postoperative elevated TSH levels could be reduced to subnormal levels by L‐thyroxine intake. iT3 and iT4 levels remained in the normal range after either daily or intermittent therapy. The weekly high dosage of 1.0 mg L‐thyroxine has proved to be at least as effective as the usual therapy with no apparent disadvantage.