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Why Do Clinicians Continue to Debate the Use of Levothyroxine in the Diagnosis and Management of Thyroid Nodules?

Manfred Blum, MD
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Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1995;122(1):63-64. doi:10.7326/0003-4819-122-1-199501010-00011
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Why do clinicians still debate whether thyroid nodule volume decreases in response to therapy with levothyroxine, given that many types of nodules do not get smaller and that the therapy could have adverse effects [1]? The reasons include the enormous number of patients with enlarged thyroids, the myriad clinical variations of the condition, insecurity about clinical findings, exceptions to current diagnostic guidelines that identify malignancy, and questions about the long-term management of benign nodules or the contralateral lobe after surgery.

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