Optimization of radioiodine therapy of thyrotoxicosis: What have we learned after 50 years? Hypothyroidism after low-dose I treatment of hyperthyroidism. Ann Intern Med ; Clinical outcome and costs of care in radioiodine treatment of hyperthyroidism.
J R Coll Physicians Lond ; Current trends in the management of Graves' disease. Treatment of thyrotoxicosis with low doses of radioactive iodine. Br Med J ; Graves' disease in the male.
A review of cases treated with an individually calculated dose of sodium iodide I Arch Intern Med ; Clinical trial of different doses of I in treatment of thyrotoxicosis. Radioiodine therapy of Graves' hyperthyroidism: Standard vs. Results from a prospective, randomized, multicentre study. Eur J Clin Invest ; Is calculation of the dose in radioiodine therapy of hyperthyroidism worth while? Clin Endocrinol Oxf ; Treatment of hyperthyroidism with radioactive iodine. Endocrinol Metab Clin North Am ; Calculation of the radioiodine dose for the treatment of Graves' hyperthyroidism: Is more than seven-thousand rad target dose necessary?
Thyroid ; Radioiodine treatment of hyperthyroidism-prognostic factors for outcome. Effects of antithyroid drugs on radioiodine treatment: Systematic review and meta-analysis of randomized controlled trials. BMJ ; Transient hypothyroidism following radioiodine therapy for thyrotoxicosis. Br J Radiol ; Transient hypothyroidism after Iodine therapy for Grave's disease.
Traino AC, Xhafa B. Accuracy of two simple methods for estimation of thyroidal I kinetics for dosimetry-based treatment of Graves' disease. Med Phys ; Iodine uptake and turnover rate vary over short intervals in Graves' disease. Nucl Med Commun ; Measurement of radiation dose to the thyroid using positron emission tomography. Dose-response study on thyrotoxic patients undergoing positron emission tomography and radioiodine therapy.
Eur J Nucl Med ; The predictive role of 24 h RAIU with respect to the outcome of low fixed dose radioiodine therapy in patients with diffuse toxic goiter. Hormones Athens ; Related articles Comparison dosimetry empiric dose Graves' disease radioiodine. Access Statistics. A physical examination usually detects an enlarged thyroid gland and a rapid pulse. The physician will also look for moist, smooth skin and a tremor of your fingers. The diagnosis of hyperthyroidism will be confirmed by laboratory tests that measure the amount of thyroid hormones— thyroxine T4 and triiodothyronine T3 —and thyroid-stimulating hormone TSH in your blood.
A high level of thyroid hormone in the blood plus a low level of TSH is common with an overactive thyroid gland. If blood tests show that your thyroid is overactive, your doctor may want to measure levels of thyrotropin receptor antibodies TRAbs , which when elevated confirm the diagnosis of Graves disease. Your doctor may also want to obtain a picture of your thyroid a thyroid scan. The scan will find out if your entire thyroid gland is overactive or whether you have a toxic nodular goiter or thyroiditis thyroid inflammation.
A test that measures the ability of the gland to collect iodine a thyroid uptake may be done at the same time. No single treatment is best for all patients with hyperthyroidism. The appropriate choice of treatment will be influenced by your age, the type of hyperthyroidism that you have, the severity of your hyperthyroidism, other medical conditions that may be affecting your health, and your own preference.
It may be a good idea to consult with an endocrinologist who is experienced in the treatment of hyperthyroid patients. If you are unconvinced or unclear about any thyroid treatment plan, a second opinion is a good idea. Methimazole is presently the preferred one due to less severe side-effects.
These drugs work well to control the overactive thyroid, and do not cause permanent damage to the thyroid gland. For patients with toxic nodular or multinodular goiter, antithyroid drugs are sometimes used in preparation for either radioiodine treatment or surgery. Common minor reactions are red skin rashes, hives, and occasionally fever and joint pains.
Graves' disease: Symptoms, treatment, and causes
A rarer occurring in 1 of patients , but more serious side effect is a decrease in the number of white blood cells. Such a decrease can lower your resistance to infection. Very rarely, these white blood cells disappear completely, producing a condition known as agranulocytosis, a potentially fatal problem if a serious infection occurs.
If you are taking one of these drugs and develop a fever or sore throat, you should stop the drug immediately and have a white blood cell count that day. Even if the drug has lowered your white blood cell count, the count will return to normal if the drug is stopped immediately. But if you continue to take one of these drugs in spite of a low white blood cell count, there is a risk of a more serious, even life-threatening infection. Liver damage is another very rare side effect. A very serious liver problem can occur with PTU use which is why this medication should not generally be prescribed.
What causes Graves disease in a child?
You should stop either methimazole or PTU and call your doctor if you develop yellow eyes, dark urine, severe fatigue, or abdominal pain. Radioactive Iodine: Another way to treat hyperthyroidism is to damage or destroy the thyroid cells that make thyroid hormone. Because these cells need iodine to make thyroid hormone, they will take up any form of iodine in your bloodstream, whether it is radioactive or not.
The radioactive iodine used in this treatment is administered by mouth, usually in a small capsule that is taken just once. The radioactive iodine that is not taken up by the thyroid cells disappears from the body within days over a period of several weeks to several months during which time drug treatment may be used to control hyperthyroid symptoms , radioactive iodine destroys the cells that have taken it up.
Reading List for Patients
The result is that the thyroid or thyroid nodules shrink in size, and the level of thyroid hormone in the blood returns to normal. Sometimes patients will remain hyperthyroid, but usually to a lesser degree than before. For them, a second radioiodine treatment can be given if needed. More often, hypothyroidism an underactive thyroid occurs after a few months and lasts lifelong, requiring treatment. Hypothyroidism can easily be treated with a thyroid hormone supplement taken once a day see Hypothyroidism brochure.
Radioactive iodine has been used to treat patients for hyperthyroidism for over 60 years and has been shown to be generally safe. Importantly, there has been no clear increase in cancer in hyperthyroid patients that have been treated with radioactive iodine.
More and more children over the age of 5 are also being safely treated with radioiodine. Surgery: Your hyperthyroidism can be permanently cured by surgical removal of all or most of your thyroid gland. This procedure is best performed by a surgeon who has experience in thyroid surgery. This extra iodine reduces the blood supply to the thyroid gland and thus makes the surgery easier and safer.