Several randomized controlled studies and three meta-analysis studies together suggest that suppression of serum TSH levels with thyroid hormone may help reduce nodules and may prevent new nodules from developing in people with low iodine intake. This effect was not evident in people in areas with normal iodine intake. Large studies have reported that only 17-25% of nodules reduced by more than 50% when serum TSH levels were suppressed with levothyroxine. The routine use of thyroid hormone suppression therapy for benign thyroid nodules is not recommended in areas with normal iodine intake.