Effect Oral Levothyroxine Plus Intrathyroidal Injection Of Dexamethasone On Conversion Of Subclinical Hypothyroidism And Overt Hypothyroidism Caused By Hashimoto's Thyroidis

Hashimoto's thyroiditis (HT) is a kind of organ-specific autoimmune disease, thyroid gland is the main target organ of immune damage. Its basic characteristics are the extensive invasion of lymph cells in the thyroid tissues and its own high titer antibodies in blood circulation. The clinical manifestations are goiter and the gradual decrease of thyroid gland functions. At present, when it develops to subclinical hypothyroidism(SCH) and overt hypothyroidism (OH) stage, usually oral administration of levothyroxine (LT₄) is adopted for supplementary treatment, in order to maintain the normal function of hypothalamus-pituitary-thyroid axis. The supplementary dose has little direct effect on autoimmune disease-causing process of HT patients. Therefore, for the treatment of HT, apart from maintaining the normal function of pituitary-thyroid axis, the derangement of immune functions should also be corrected. The study compared the curative effects of HT patients who only taking LT₄ orally for supplement and who combining intrathyroid injection of dexamethasone (Dex) with OH.Methods and ResultsThe first part: Method: In a 2-year prospective study, 294 subjects with HT were randomly divided into 2 groups.Subjects in levothyroxine group (147 cases) were treated with oral levothyroxine for 20 weeks to maintain normal levels of free T₄, free T₃ and sensitive TSH in serum and then discontinued taking the drug. Subjects in group dexamethasone (147 cases) were treated with oral LT₄ plus intrathyroidal injection of Dex (5mg, once per week for 8 weeks;...