Antithyroid Drugs and Radioiodine Therapy: A Grain of (Iodized) Salt

Editorials15 October 1994Antithyroid Drugs and Radioiodine Therapy: A Grain of (Iodized) SaltDavid S. Cooper, MDDavid S. Cooper, MDSinai Hospital of Baltimore; Baltimore, MD 21215Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-121-8-199410150-00009 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Most thyroid specialists prefer to use radioiodine to treat the typical adult patient with hyperthyroidism [1]. Radioiodine therapy is simple, cost-effective, and, except for iatrogenic hypothyroidism, free from long-term side effects. Nevertheless, controversies about its use continue [2]. One major area of dispute is the wisdom and necessity of antithyroid drug pretreatment in the weeks before radioiodine therapy. This practice has become commonplace, especially in elderly patients or those with cardiac disorders, in whom the risk of exacerbating the underlying thyroid problem would be particularly hazardous.The use of adjunctive drug therapy began early in the radioiodine era [3], when ...References1. Solomon B, Glinoer D, Lagasse R, Wartofsky L. Current trends in the management of Graves' disease. J Clin Endocrinol Metab. 1990; 70:1518-24. Google Scholar2. Graham GD, Burman KD. Radioiodine treatment of Graves disease. An assessment of its potential risks. Ann Intern Med. 1986; 105:900-5. Google Scholar3. Williams RH, Towery BT, Jaffe H, Rogers WF, Tagnon R. Radioiodotherapeusis. Am J Med. 1948; 7:702-17. Google Scholar4. Larsen PR. Thyroidal triiodothyronine and thyroxine in Graves' disease: correlation with presurgical treatment, thyroid status, and iodine content. J Clin Endocrinol Metab. 1975; 41:1098-104. Google Scholar5. Meier DA, Hamburger JI. 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Burch HB, Solomon BL, Wartofsky L, Burman KD. Discontinuation of antithyroid therapy before ablation with radioiodine in Graves' disease. Ann Intern Med. 1994; 121:553-9. Google Scholar12. Cooper DS. Antithyroid drugs. N Engl J Med. 1984; 311:1353-62. Google Scholar13. Steinbach JJ, Donoghue GD, Goldman JK. Simultaneous treatment of diffuse goiter with I-131 and antithyroid drugs: a prospective study. J Nucl Med. 1979; 20:1263-7. Google Scholar14. Shafer RB, Nuttall FQ. Acute changes in thyroid function in patients treated with radioactive iodine. Lancet. 1975; 2:635-7. Google Scholar15. Tamagna EI, Levine GA, Hershman JM. Thyroid-hormone concentrations after radioiodine therapy for hyperthyroidism. J Nucl Med. 1979; 20:387-91. Google Scholar16. Aro A, Huttunen JK, Lamberg BA, Pelkonen R, Ikkala E, Kuusisto A, et al. Comparison of propranolol and carbimazole as adjuncts to iodine-131 therapy of hyperthyroidism. Acta Endocrinol (Cophenh). 1981; 96:321-7. Google Scholar17. Marcocci C, Gianchecchi D, Masini I, Golia F, Ceccarelli C, Biacci E, et al. A reappraisal of the role of methimazole and other factors on the efficacy and outcome of radioiodine therapy of Graves' hyperthyroidism. J Endocrinol Invest. 1990; 13:513-20. Google Scholar18. Connell JM, Hilditch TE, McCruden DC, Robertson J, Alexander WD. Effect of pretreatment with carbimazole on early outcome following radio-iodine (Iodine-131) therapy. Eur J Nucl Med. 1984; 9:464-6. Google Scholar19. Crooks J, Buchanan WW, Wayne EJ, MacDonald E. Effect of pretreatment with methythiouracil on results of Iodine-131 therapy. Br Med J. 1960; 1:151-4. Google Scholar Author, Article, and Disclosure InformationAuthors: David S. Cooper, MDAffiliations: Sinai Hospital of Baltimore; Baltimore, MD 21215 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDiscontinuing Antithyroid Drug Therapy before Ablation with Radioiodine in Graves Disease Henry B. Burch , Barbara L. Solomon , Leonard Wartofsky , and Kenneth D. Burman Metrics Cited byApport de l’iode 131 dans le traitement de la maladie de Basedow dans le service de médecine nucléaire de l’hôpital Ibn Sina de RabatRadioiodine treatment for benign thyroid diseasesRadioiodine Treatment of HyperthyroidismA Randomized Controlled Trial to Evaluate the Adjuvant Effect of Lithium on Radioiodine Treatment of HyperthyroidismAdvanced Training in Adult PsychiatryUse of Cold Iodine in Patients With Graves’ Disease: Observations From a Clinical PracticeEffect of Methimazole Pretreatment on Serum Thyroid Hormone Levels after Radioactive Treatment in Graves’ Hyperthyroidism1TREATMENT OF HYPERTHYROIDISM WITH RADIOACTIVE IODINEAntithyroid Drugs: Their Mechanism of Action and Clinical UseTreatment with Propylthiouracil before Radioactive Iodine Therapy Is Associated with a Higher Treatment Failure Rate Than Therapy with Radioactive Iodine Alone in Graves' Disease 15 October 1994Volume 121, Issue 8Page: 612-614KeywordsDrug administrationDrug therapyDrugsElderlyHyperthyroidismStormsThyroidThyroid hormonesThyroidectomyTriiodothyronine ePublished: 15 August 2000 Issue Published: 15 October 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. 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