The medical treatment of XXXX : several questions remain.

@entity1 @entity1496 @entity137 @entity1955 @entity5651 @entity299 @entity1954 @entity1374
In this review it is concluded that @entity1955 (T4), @entity1954 (T3) and @entity1496 (KI), singly or in combination, are all effective in reducing the @entity5651 size, but there is insufficient evidence to prove which is the best (possibly the combination of T4 + KI?). Higher doses are more effective than smaller, but also lead to more side-effects. Thus, the optimal dose has yet to be found. The suppression of the @entity1374 plays a major role in the treatment of @entity137 , but it is not definite that this is the only mechanism responsible for the beneficial effect of the agents mentioned. In view of the lack of better evidence, it is simply suggested that @entity137 in young @entity1 should be initially treated aggressively with 200 micrograms of T4/day or more for some months. If the @entity5651 shrinks then the dose should be gradually decreased. If the @entity5651 persists, it is futile to continue with large doses for more than 6-12 months. One may continue with smaller doses, maintaining the serum TSH in the low-normal range. The treatment of benign thyroid nodules with @entity1955 is controversial. Probably @entity1955 is beneficial in about a third of the cases. For both @entity137 and nodules, autonomy should be excluded before starting @entity1955 treatment, and old age, @entity299 and a poor general condition are contraindications.
