Ultrasonography was performed at least 12 months (median 7.90 years) after radioiodine treatment for Graves' disease. The subjects included 359 women and 87 men (aged 53 ± 14 years [mean ± standard deviation]). Thyroid function tests were performed one month after radioiodine treatment and every six months after stabilization.
Is radioiodine an effective treatment for Graves’ disease?
Radioiodine is an effective therapy for Graves’ Disease with few complications. The majority of patients achieve remission with a single dose. Those who require a second dose are more likely to have higher TSH receptor antibody titres at diagnosis.
What tests are used to diagnose Graves disease?
The diagnosis of Graves' disease may include: Physical exam. Blood sample. Radioactive iodine uptake. Ultrasound. Imaging tests.
What is the best treatment for Graves disease?
Treatment 1 Radioactive iodine therapy. With this therapy, you take radioactive iodine, or radioiodine, by mouth. ... 2 Anti-thyroid medications. Anti-thyroid medications interfere with the thyroid's use of iodine to produce hormones. ... 3 Beta blockers. ... 4 Surgery. ... 5 Treating Graves' ophthalmopathy. ...
Does Graves'disease show up on CT scan?
If the diagnosis of Graves' disease isn't clear from a clinical assessment, your doctor may order special imaging tests, such as a CT scan or MRI. Care at Mayo Clinic Our caring team of Mayo Clinic experts can help you with your Graves' disease-related health concerns Start Here
When should I check my TSH after Rai?
Patients should be seen by their GP or in medical outpatients 12 weeks after RAI treatment, having had a TFT measured 6 weeks after their RAI.
How do you follow up with Graves disease?
Radioactive iodine uptake. The amount of radioactive iodine taken up by the thyroid gland helps determine if Graves' disease or another condition is the cause of the hyperthyroidism. This test may be combined with a radioactive iodine scan to show a visual image of the uptake pattern.
How often should thyroid labs be monitored in a patient with Graves disease undergoing current treatment?
Following radioiodine therapy, thyroid indices should be monitored every 1–2 months for the next 6 months to detect hypothyroidism and ensure that euthyroidism has been restored. Thereafter, measuring thyroid indices every 3 months for 1 year and then every 6–12 months is recommended.
What happens after Rai for graves?
Some people may have a feeling of tightness or swelling in their neck for a few days after treatment. This is more common if you still had a large part of your thyroid gland when you have radioactive iodine treatment. Some people also feel flushed. Rarely, people can feel pain in their neck.
Do you still have Graves disease after radioactive iodine treatment?
For some patients who are treated with radioactive iodine to reduce the size of a goitre, there is also a small risk that they may develop Graves' disease. There is no risk that patients treated with radioactive iodine for an overactive or enlarged thyroid will lose their hair as a result of the treatment.
What is the antibody test for Graves disease?
TSH receptor antibody (TRAb) is considered the gold standard diagnostic test for the autoimmunity of Graves' disease (GD), which is commonly diagnosed clinically.
Why anti TPO test is done?
The presence of TPO antibodies in your blood suggests that the cause of thyroid disease is an autoimmune disorder, such as Hashimoto's disease or Graves' disease. In autoimmune disorders, your immune system makes antibodies that mistakenly attack normal tissue.
What labs are elevated in Graves disease?
Testing Total T3 and T4 Hormone Levels People with Graves' disease will usually have too much T3 and T4 in their blood. That's because the antibody thyroid-stimulating immunoglobulins (TSI) are misdirecting the thyroid to make too much T3 and T4.
Can you have a normal TSH with Graves disease?
Some patients with Graves' disease may have subclinical (mild) hyperthyroidism without symptoms but with a goiter, suppressed TSH, TSH receptor antibodies, but with normal T4 and T3.
Can Graves disease come back after RAI treatment?
Early recurrences are reported in 20–54% of cases within 3–6 months, which can be due to inadequate RAI treatment or early Marine Lenhart syndrome. True recurrence is relapse after an extended period of time following attainment of hypothyroidism.
How many times can you have radioactive iodine treatment?
You may only need to have this treatment once. But it can be repeated every 3 months if needed, until there is no sign of any thyroid cancer on your scans.
What is the most common complication of radioiodine therapy?
The most common adverse reaction to medical therapy was a rash in 8 patients, followed by neutropaenia (neutrophils < 1.0 × 109/L) in 6 patients. LFT derangement was reported in 3 patients taking PTU and 1 patient taking carbimazole.
What is Graves disease?
Graves’ disease (GD) is an autoimmune condition characterised by elevated levels of thyroid stimulating (TSH) receptor antibodies with increased production of thyroid hormone. Among patients with hyperthyroidism, 60–80% have GD.
What is the primary treatment for thyrotoxicosis?
Carbimazole (CMZ), Methimazole (MTZ) and propylthiouracil (PTU) are used for the primary treatment of thyrotoxicosis due to GD or as a means of preparing the patient for definitive therapy with surgery or RAI (19).
How is radiation exposure determined in utero?
Radiation exposure in utero is determined by the gestational age, foetal thyroid activity and maternal thyroid uptake (47) . Administration of a maximum dose of 15 mCi (550MBq) given up to 10 weeks of gestation does not severely affect foetal thyroid function and the low fetal exposure does not justify termination (48).
What is the precursor of thyroxine?
Iodine is the precursor of thyroxine. The radioactive form of iodine is taken up by iodide transporter of the thyroid the same way as natural iodine and is similarly processed. The b particle destroys the follicular cell, gradually leading to volume reduction and control of the thyrotoxicosis.
Is hyperthyroidism a cause of CV?
A recent study (51) showed that chronic hyperthyroidism and not the treatment modality, is a cause of excess cardiovascular ( CV) mortality. This can be attributed to cerebrovascular disease and atrial fibrillation (AF). AF occurs in 5–15% of patients with hyperthyroidism (52).
Is RAI a treatment for GD?
RAI is the most widely used treatment for patients with GD in the United States (2) . Although therapy is well established for definitive treatment of GD, the approach to dosing remains controversial. This is due to differing goals of treatment (control of hyperthyroidism vs. avoidance of hypothyroidism).
Is RAI contraindicated in pregnancy?
The foetal thyroid at 10–12 weeks of gestation is capable of forming colloid, concentrating iodine, and synthesising thyroid hormones (43). RAI treatment is absolutely contraindicated in pregnancy, because it is readily transferred across the placenta.
Introduction
Radioiodine is a safe and effective treatment for Graves' disease. Iatrogenic hypothyroidism is very common after treatment, but its onset is unpredictable. Even a short episode of hypothyroidism can result in significant morbidity and ideally should be avoided.
Methods
The objective was to compare the two protocols for incidence of biochemical and clinical hypothyroidism during a 12 month post-radioiodine follow-up period and effects on weight gain and development or progression of orbitopathy. Patients with Graves' disease who were treated between January 2008-December 2009 were included.
Results
One hundred and twenty two patients were studied, 78 treated with Regimen A and 43 with Regimen B. Euthyroidism at 8 weeks, 6 months and 12 months post-radioiodine was achieved in 50%, 64% and 73% of patients with Regimen A and 65.1%, 71% and 65% in patients with regimen B respectively.
Conclusions
A 6 month course of block and replace followed by levothyroxine after a standard 400MBq dose of radioiodine is associated with better clinical outcomes than a watchful approach and initiation of levothyroxine based on biochemical and clinical indicators.
Why is RAI treatment important?
Because the development of hypothyroidism seems to be inevitable and un predictable by any clinical factors, the objective of RAI treatment should be to minimize the persistence of hyperthyroidism with the simplest possible form of treatment.
Is radioiodine effective for hyperthyroidism?
Long-term follow-up study of radioiodine treatment of hyperthyroidism. RAI treatment is effective in treating hyperthyroidism in patients with Graves' disease, but hypothyroidism will develop in 82% of patients in 25 years. Because the development of hypothyroidism seems to be inevitable and unpredictable by any clinical factors, ...
What is Graves disease?
Graves’ disease is a common cause of an overactive thyroid gland (hyperthyroidism). Studies have shown that having Graves’ disease may have negative impact on patient’s quality of life. Graves’ disease is usually treated with antithyroid drugs, radioactive iodine therapy, or surgery.
What is radioactive iodine used for?
Radioactive iodine: this plays a valuable role in diagnosing and treating thyroid problems since it is taken up only by the thyroid gland. I-131 is the destructive form used to destroy thyroid tissue in the treatment of thyroid cancer and with an overactive thyroid.
Is radioactive iodine therapy less desirable?
If these findings are confirmed in other studies in other countries, it would suggest that radioactive iodine therapy may be less desirable in the long term as compared to antithyroid drugs or surgery. — Sun Y. Lee, MD.
Treatment
- The treatment goals for Graves' disease are to stop the production of thyroid hormones and to block the effect of the hormones on the body. Some treatments include:
Clinical Trials
- Explore Mayo Clinic studiestesting new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.
Lifestyle and Home Remedies
- If you have Graves' disease, make your mental and physical well-being a priority: 1. Eating well and exercisingcan enhance the improvement in some symptoms during treatment and help you feel better in general. For example, because your thyroid controls your metabolism, you may have a tendency to gain weight when the hyperthyroidism is corrected. Brittle bones also can occur wit…
Preparing For Your Appointment
- You'll probably see your primary care doctor first. You may be referred to a specialist in disorders of hormone function and the endocrine system (endocrinologist). If you have Graves' ophthalmopathy, your doctor may also recommend that you see a doctor who has trained in eye disorders (ophthalmologist). Here's some information to help you get ready for your appointmen…