Radioiodine in the treatment of hyperthyroidism

INTRODUCTION

In the past, radioiodine has been the most popular treatment for hyperthyroidism in the United States. In a 1990 survey, 69 percent of North American thyroid specialists chose radioiodine for a hypothetical patient with Graves' hyperthyroidism. It has been less popular elsewhere, being chosen as first-line therapy for a similar patient by only 22 and 11 percent of European and Japanese thyroid specialists, respectively [1]. Similarly low rates of use were reported in subsequent surveys in the United Kingdom and Australia [2,3].

Radioiodine is administered orally as sodium 131-I in solution or a capsule. The radioiodine is rapidly incorporated into the thyroid and its beta-emissions result in extensive local tissue damage. The net effect is ablation of thyroid function over a period of 6 to 18 weeks.

Radioiodine for the treatment of hyperthyroidism will be reviewed here. Other treatment options for Graves' hyperthyroidism and toxic adenoma and toxic multinodular goiter are reviewed separately. (See "Treatment of Graves' hyperthyroidism" and "Treatment of toxic adenoma and toxic multinodular goiter".) Radioiodine for nontoxic multinodular goiter is also reviewed separately. (See "Diagnostic approach to and treatment of goiter in adults".)

INDICATIONS

Graves' disease — The therapeutic approach to Graves' hyperthyroidism consists of both rapid amelioration of symptoms with a beta-blocker and measures aimed at decreasing thyroid hormone synthesis with either the administration of a thionamide, radioiodine ablation, or surgery. Radioiodine has been the most popular treatment for hyperthyroidism in the United States, although it is less popular outside of the US [1-4]. (See "Treatment of Graves' hyperthyroidism".)

Toxic adenoma or multinodular goiter — Depending upon patient preference, either radioiodine therapy or surgery is the treatment of choice for these conditions. An occasional patient can be managed, if preferred or necessary for other reasons, with thionamide drugs. (See "Treatment of toxic adenoma and toxic multinodular goiter".)

                            

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Literature review current through: Apr 2012. | This topic last updated: Mar 6, 2012.
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