Fast Five Quiz: Test Yourself on Key Thyroid Conditions

Romesh Khardori, MD, PhD


August 06, 2018

Radioactive iodine therapy for Graves disease is a risk factor for Graves ophthalmopathy. Ethnic factors are also important for Graves ophthalmopathy after radioactive iodine treatment; Japanese patients are less prone to Graves ophthalmopathy after radioactive iodine.

Thyroidectomy is not the recommended first-line therapy for hyperthyroid Graves disease in the United States. Surgery is a safe alternative therapeutic option in patients who are not compliant with or cannot tolerate antithyroid drugs, have moderate to severe ophthalmopathy, have large goiters, or refuse or cannot undergo radioiodine therapy.

The most commonly used therapy for Graves disease is radioactive iodine. Indications for radioactive iodine over antithyroid agents include a large thyroid gland, multiple symptoms of thyrotoxicosis, high levels of thyroxine, and high titers of thyroid-stimulating immunoglobulins (TSI). Patients currently taking antithyroid drugs must discontinue the medication at least 2 days prior to taking the radiopharmaceutical. If thyroid function does not normalize within 6-12 months of radioactive iodine treatment, a second course at a similar or higher dose can be given. Third courses are rarely needed.

For more on the treatment of Graves disease, read here.


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