ee a em eeeapy ae weer eer en 49 D. HORMONE TREATMENT In 1965, the seriousness ofthe development of thyroid lesions in the Rongelap people was recog- nized, and a panelof experts was cabled together to review the findings and make recom dedations regarding the possibility of initiating preventive therapy.!9-23 The concensus was that the-more heavily exposed Rongelap group should beplated on replacement thyroxinefor life in ordettedtodk. © TSH secretion by the pituitary gland. It was hoped that nullifying the stimulating activity of this hormoneon the thyroid would inhibit development of benign and malignant nodules, and that growth and development in the hormonedeficient children would be improved. Thepossibility of development of pituitary tumors, which has been noted in hypothyroid animals*®5 and hu- manbeings,8& might be prevented. Ethical con- siderations ruled out randomizedclinicaltrials of therapy. | aol Synthetic L-thyroxine (Synthroid, Flint Drug Co.), which might be morestable than dessicated thyroid under tropical conditions, was recommended at a dose of 0.3 mg/day for people <50 years of agp and 0.2 mg/day for those >50. Treat- ment waSsupervised by the health aide, but diffi- culties in maintaininga strictly regular treatment ese . Figure 37.ee rison as in Figure 36, for subject No, 3 anil younger brother (No. 83 . a . regimen soon became apparent. oi bt tO ing . Face a aa i J 2S : ' ovgrcome this problemit-wasfoundhat Pyare the entire weeklf-dbése at 6pe:timeswas,effi * andsafe, and resulted in maintenance. of nersnal levels of thyroxine.87 Even on:ehis'sifap mentschedule a few ofthe peoplé-including oie. who had undergaste:thyspidectomy,sshowed low thyroxinelevels indicating that they were not consistently taking the medication. (This was one of the reasons for establishing the post of resident physician in the Islands in 1972 to monitor the treatment program as well as offer health care.) For4 peopleon thisregumen whodeveloped above- rege roronsseas program. a a The hormone therapy has unquestionably en= hanced growth and dgvelopmen#in-the growthretarded Rongelap:children (Fi s 21,36, and Figure 36. Left: Subject No. 5 (shorter) and his younger brother (No. 85) in 1963. Right: Same two boys in 1973 after No. 5 had been given thyroid hormonefor 8 years. 37 show the improvément#n the Two mos@@tunted boys). However, thabenefit ofargh treatment Fegarding development of nodularities in the thyroid” is uncertain. Of the children exposed at age < 10 years in the more highly exposed Rongelap group, only two have not developed lesions. Theless exposed Ailingnae group,in which developmentof PRIVACY ACT MATERIAL REMOVED