Indications and results of thyrostatic therapy

The thyreostatic medication in almost all cases helps to normalize the thyroid metabolism. The long-term treatment, however, necessitates a several years long intensive therapy and control of the patient, co-operation of the family doctors and the health insurances is made difficult by the long-lasting treatment. Before all, however, the long-term results are disappointing. Frequency of recidivation is stated as 35-85% by most groups of authors. Nobody succeeded yet, however, in working out prognostic criteria and rules for medicamentous treatment of the hyperfunction. Therefore, in treatment with thyreostatica, the so-called 'omission test' was generally adopted. In this test, treatment is interrupted a few months after thyreostatic medication in order to recognize the result. A negative result of the omission test justifies the contining of the thyreostatic medication or to choose another form of treatment, e.g. operation or radio-iod therapy. Generally also in patients who badly react to thyreostatic medication in the long run, the metabolism is successfully normalized by combination with other methods. (orig./AJ)