Skip to main content

CLINICAL TRIAL article

Front. Endocrinol.
Sec. Thyroid Endocrinology
Volume 15 - 2024 | doi: 10.3389/fendo.2024.1420154

Assessing the Impact of Short-Term Lugol's Solution on Toxic Nodular Thyroid Disease: A Pre-Post-Intervention Study

Provisionally accepted
Fredric Hedberg Fredric Hedberg 1*Per K. Cramon Per K. Cramon 2Robert Bränström Robert Bränström 1Henrik Falhammar Henrik Falhammar 1Jan Calissendorff Jan Calissendorff 1
  • 1 Department of Molecular Medicine and Surgery, Karolinska Institutet (KI), Stockholm, Stockholm, Sweden
  • 2 Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark

The final, formatted version of the article will be published soon.

    Preoperative iodine therapy in toxic nodular goiter (TNG) is discouraged as iodine may cause aggravation of hyperthyroidism. We aimed to examine if a short course of iodine treatment is safe to administer in TNG.Patients with TNG (n=20) and subclinical to mild hyperthyroidism (free (f)T4 <30 pmol/L) without complicating illnesses were included in this pre-post-intervention study at Karolinska University Hospital. All participants received Lugol's solution 5%, three oral drops thrice daily for 10 days. Heart rate, TSH, fT4, fT3 concentrations were collected before (day 0) and after treatment (day 10). Thyroid hormone concentrations were also measured at two time points during treatment to discover aggravations of hyperthyroidism. ThyPRO39se, a qualityof-life questionnaire, was filled out day 0 and day 10. Differences in heart rate, thyroid hormone concentrations, and quality-of-life before and after treatment were compared. Adverse reactions were reported.The median age was 63.5 years. Female to male ratio 19:1. FT4 and fT3 concentrations decreased (both p<0.001), and TSH concentration increased (p<0.001) after 10 days of treatment. There was no difference in heart rate. No aggravations of thyrotoxicosis were noticed in any of the participants. ThyPRO39se scores improved on three scales, including hyperthyroid symptoms, while the remaining scale scores were unchanged. Mild and transient symptoms related to or possibly related to treatment were observed in six participants.A short course of Lugol's solution improved thyroid hormone concentrations, reduced patient-reported hyperthyroid symptoms and was safe in TNG. Lugol's solution might be an option for preoperative treatment in TNG. Clinical trial registration https://www.clinicaltrials.gov, identifier NCT04856488.

    Keywords: Lugol, Iodine, toxic adenoma, Toxic nodular goiter, Thyrotoxicosis, Hyperthyroidism

    Received: 19 Apr 2024; Accepted: 17 Jul 2024.

    Copyright: © 2024 Hedberg, Cramon, Bränström, Falhammar and Calissendorff. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Fredric Hedberg, Department of Molecular Medicine and Surgery, Karolinska Institutet (KI), Stockholm, SE-171 76, Stockholm, Sweden

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.