Influence of Short-Term Dietary and Therapeutic Iodine Restriction on the Therapeutic Effects of Radioactive Iodine Therapy in Patients with Graves' Disease

Nishio, Rie; Uchida, Toyoyoshi; Suzuki, Luka; Onose, Hiroyuki; Goto, Hiromasa; Yamada, Emiko; Satoh, Hiroaki; Watada, Hirotaka

doi:10.1089/thy.2020.0126

Cited by 5 publications

(8 citation statements)

References 17 publications

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“…Regarding the treatment with KI around RIT, Ross DS et al [25] reported that the administration of iodine 1 week after 131 I administration shortened the duration of hyperthyroidism without adversely affecting the outcome of RIT. Recently, Nishio R et al [26] demonstrated by analyzing Japanese patients that short-term therapeutic iodine restriction before RIT had not influenced the therapeutic effects of RIT in an iodine-sufficient area. Evaluated by the total administered activities of 131 I among the present patients with GD, the efficacy of RIT for GD was not considerably deteriorated in patients treated with KI prior to RIT.…”

Section: Discussionmentioning

confidence: 99%

Utility of outpatient fractionated radioiodine therapy for Graves disease involving a large goiter measuring more than 100 mL in volume

et al. 2021

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Contrary to large multinodular goiters, reports on 131 I radioiodine therapy (RIT) for Graves disease (GD) involving a large goiter are scarce. We retrospectively reviewed a total of 71 consecutive patients (25 males, 46 females) with GD involving a large goiter (>100 mL) who had received RIT in our clinic. Patients with a history of thyroid surgery or with large thyroid nodules and those who had dropped out less than one year after the initial RIT session were excluded. A fixed 131 I activity of 481 MBq was administered in most cases. RIT was repeated at intervals of 1-47 months, typically 3-6 months. The follow-up duration after the initial RIT session was 13-233 (median: 81) months. The thyroid volume was estimated using ultrasound. The number of 131 I doses were 1 dose in 13 patients, 2 doses in 29, 3 doses in 17, 4 doses in 5, 5 doses in 5, 6 doses in 1, and 8 doses in 1. Sixty-six patients had remission from overt hyperthyroidism after RIT: overt hypothyroidism in 45 patients, subclinical hypothyroidism or euthyroidism in 13, and subclinical hyperthyroidism in 8. Their thyroid volume decreased from 101-481 (median: 126) mL to 1.4-37 (8.2) mL. Three patients still had overt hyperthyroidism under treatment with methimazole after one to three doses, and two dropped out less than six months after the third or sixth dose. Even in GD patients with a large goiter (>100 mL), repeated RIT with an activity of 481 MBq could sufficiently shrink goiters and remit overt hyperthyroidism.

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Section: Discussionmentioning

confidence: 99%

Utility of outpatient fractionated radioiodine therapy for Graves disease involving a large goiter measuring more than 100 mL in volume

et al. 2021

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“…This findings is in accordance with Mizokami et al [37], which highlighted that Graves' disease patients with goiters and higher thyroid uptake were more prone to requiring additional RAIT. As well as, Nishio et al [38], found that patients with goiters prior to RAIT were more likely to need supplementary treatment but noted that dietary or therapeutic iodine did not impact the effectiveness of the therapy. Moreover Yu et al [39], also reported results indicating that Graves' disease patients with larger goiters higher thyroid uptake and lower initial radioiodine dose per volume had an increased likelihood of requiring additional RAIT.…”

Section: Discussionmentioning

confidence: 95%

“…As well as, Nishio et al . [38], found that patients with goiters prior to RAIT were more likely to need supplementary treatment but noted that dietary or therapeutic iodine did not impact the effectiveness of the therapy. Moreover Yu et al .…”

Section: Discussionmentioning

confidence: 99%

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Factors affecting timing of hypothyroidism following radioactive iodine therapy (RAIT) for patients with Graves’ disease: A 12-month observational study

Mahmoud,

Alsanory,

Mostafa

et al. 2024

Nuclear Medicine Communications

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Background: This retrospective study analyzed factors influencing hypothyroidism development after radioactive iodine therapy for Graves’ disease. Patients and methods Three hundred and three patients with Graves’ disease treated with radioactive iodine (RAI) from 2013 to 2022 at two Egyptian hospitals were included. Data collected included demographics, lab values, thyroid imaging, RAI doses, and outcomes. Patients were followed for ≥1 year to assess hypothyroidism onset. Results At the end of 1 year, around 79.5% of the individuals developed hypothyroidism while 12.5% continued to experience hyperthyroidism. The onset of hypothyroidism occurred earlier in those with thyroid volume (≤75.5 cm3), lower thyroid weight (≤84.7 g), thyroid uptake (≤18.8%), and higher RAI dose/volume (≥0.1022 mCi/ml) (P < 0.001). Additionally, there was a correlation between anti-thyroid peroxidase (anti-TPO) antibodies and faster development of hypothyroidism compared to those who were negative for antibodies (2.9 vs 8.9 months, P = 0.001). When considering factors in analysis it was found that anti-TPO antibodies were the only independent predictor, for developing hypothyroidism (hazard risk 30.47, P < 0.001). Additionally, thyroid volume and uptake independently predicted successful treatment outcomes (P < 0.05). Conclusion Positive anti-TPO antibodies strongly predict hypothyroidism risk after RAI therapy for Graves’ disease. Smaller thyroid size, lower uptake, and higher RAI dose/volume correlate with earlier hypothyroidism onset but are less significant predictors than anti-TPO status. Findings can guide RAI therapy personalization to optimize outcomes.

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“…However, a Japanese study conducted in 2021 reported that limiting iodine intake within 5 to 7 days before RAI therapy had no effect on GD treatment efficacy. No associations were observed between dietary iodine and therapeutic potassium iodide intake and the therapeutic effect of RAI (OR=0.974, 95% CI 0.956-0.993) ( 57 ). In addition, a clinical study from Germany confirmed that patients with GD taking 600 mg of inactive potassium iodide for three days during RAI therapy had significantly improved efficacy of RAI therapy and did not need a second RAI dose ( 34 ).…”

Section: The Application Of Inorganic Iodine In Specific Cases Of Gdmentioning

confidence: 99%

Application of oral inorganic iodine in the treatment of Graves’ disease

Huang

et al. 2023

Front. Endocrinol.

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Iodine is a crucial trace element for the human body and the basic raw material for the synthesis of thyroid hormones. Oral inorganic iodine includes dietary iodine and therapeutic iodine, both of which are closely associated with thyroid immunity and metabolism. Graves’ disease (GD), also known as diffuse toxic goiter, is characterized by hyperthyroidism and high iodine metabolism. Clinically, patients diagnosed with GD are often asked to limit iodine intake or even avoid iodine in their diet. The latest research has demonstrated that the interference of dietary iodine with antithyroid drugs (ATDs) treatment may be overestimated. In addition, as a medication for GD treatment, the administration of inorganic iodine has shown positive results in patients with mild hyperthyroidism, a low thyroid autoantibody concentration, a small thyroid volume, a high iodine diet and so on. Inorganic iodine may also be used as an alternative when patients experience side effects with traditional ATDs and for those who still prefer conservative treatment. Due to its low teratogenicity, blood toxicity and bone marrow toxicity, inorganic iodine plays a unique role in special populations, such as pregnant or lactating patients and patients receiving tumor radiotherapy or chemotherapy. In this review, the research progress, biological function, doses and effects, applicable populations and specific applications of dietary iodine and therapeutic iodine are summarized to provide references for the diagnosis and treatment of GD, thus improving the quality of life of GD patients.

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Influence of Short-Term Dietary and Therapeutic Iodine Restriction on the Therapeutic Effects of Radioactive Iodine Therapy in Patients with Graves' Disease

Cited by 5 publications

References 17 publications

Utility of outpatient fractionated radioiodine therapy for Graves disease involving a large goiter measuring more than 100 mL in volume

Utility of outpatient fractionated radioiodine therapy for Graves disease involving a large goiter measuring more than 100 mL in volume

Factors affecting timing of hypothyroidism following radioactive iodine therapy (RAIT) for patients with Graves’ disease: A 12-month observational study

Application of oral inorganic iodine in the treatment of Graves’ disease

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