AN ANALYSIS OF THE MEDICAL TREATMENT OF HYPERTHYROIDISM WITH THIOUREA AND IODINE: WITH SPECIAL REFERENCE TO THE BEHAVIOR OF THE SERUM PRECIPITABLE IODINE DURING THERAPY*

Abstract

DURING the past four years thiourea together with strong solution of iodine (Lugo's solution) has been used in the prolonged medical treatment of 139 patients, with hyperthyroidism. Analysis of the usefulness of these agents in certain of these cases has already been made in preliminary reports from this department. (1, 2). For a period, all patients with hyperthyroidism of whatever nature were treated with these drugs. Since a similar group is now being treated with propyl thiouracil, for comparison, it seems pertinent to summarize the information derived from the study of patients treated for long periods with thiourea. The development of this mode of therapy with thiourea in preference to other thyroid-depressant drugs has been discussed (2). In addition to the basal metabolic rate, changes in weight and pulse rate, and other clinical manifestations of the disease, the concentration of the precipitable iodine in the serum (SPI) has been used in evaluating the condition of the patients during the course of therapy. The value of the SPI in establishing the existence of hyperthyroidism has been demonstrated (3, 4, 5). Since the concentration of the SPI is more immediately concerned with thyroidal activity than with the ultimate effects of the thyroid hormone as measured by the basal metabolic rate and clinical manifestations, a study of its behavior during the course of the disease has not only added precision to the analysis of the patient's response to various therapeutic measures, but has also clarified certain aspects of the course of hyperthyroidism. The initial response of the basal metabolic rate, heart rate and weight to the administration of iodine and other thyroid-depressant drugs has been surveyed by others (6, 7). In this study particular emphasis will be given to the behavior of the SPI during the initial phase of therapy, during prolonged therapy, and during relapses of the disease after one or more of the drugs had been discontinued. Though these data on SPI were derived during the study of thiqurea, the findings are equally pertinent to other thyroid-depressant drugs related to thiourea. The effectiveness and results of treatment will also be analyzed. The incidence and nature of certain possible toxic reactions to thiourea have been reported (8).