Management of hyperthyroidism with radioactive iodine

Radioactive iodine (RAI) is an accepted modality for “curing” thyrotoxicosis, particularly among patients who had failed medical therapy, i.e., not cured by antithyroid drugs (ATD). However, procedures involved in RAI treatment vary greatly among different centers around the world. This possibly rests on at least 2 factors. Firstly, it was never possible to do a randomized control trial. Secondly, the definition of “cure” differs; in one it is a return to the euthyroid state, in another the euthyroid state needs to be maintained with thyroxine replacement (i.e., RAI produced permanent hypothyroid). This latter needs less monitoring than administration of ATD in a persisting hyperthyroid state. The present review provides evidence with regard to varied practices of RAI therapy, which include procedures before giving RAI, the dosage schemes and procedures given after RAI. Aside from that, some aspects of radiation care will be touched upon. It is hoped this article will be useful to medical practitioners when advising their patients about RAI therapy.