Relationship between serum TSH and the responsiveness of toxic solitary autonomous thyroid nodules to radioiodine therapy

Radioiodine therapy in elderly patients with subclinical hyperthyroidism due to non-voluminous nodular goiter and its effect on bone metabolism

“…In the 12 patients with uninodular disease, the volume of the nodule estimated by ultrasound ranged from 3.6 to 20 cm 3 , and total gland volume ranged from 12.5 to 32.1 cm 3 . Uptake of 131 I in the 24 th hour ranged from 11.5% to 32.1% (mean: 18.7%).…”

“…Uptake of 131 I in the 24 th hour ranged from 11.5% to 32.1% (mean: 18.7%). In the 24 patients with multinodular disease, thyroid volume ranged from 28 to 58 cm 3 . Uptake of 131 I in the 24 th hour ranged from 9.5% to 30.2% (mean: 17.1%).…”

“…Radioiodine therapy is an excellent option for patients with a contraindication to or who refuse surgery; it is also an alternative to thyroidectomy in patients with non-voluminous goiter without compressive symptoms or suspicion of malignancy (1). If 131 I is administered in the presence of undetectable levels of TSH, normal thyroid tissue does not take up, or takes up very little radioiodine, reducing the risk of hypothyroidism (3,4). In addition, the chance of success (resolution of hyperthyroidism) may be greater in patients who did not receive antithyroid drugs (ATDs) before the administration of 131 I (5).…”

Outcome of radioiodine‐131 therapy in hyperfunctioning thyroid nodules: a 20 years’ retrospective study

“…Previous MMI administration increases the risk of hypothyroidism, as reported previously. 7,23 The present work covers a long time-span, thus it was not possible to obtain the precise TSH serum values now obtainable using current third-generation tests for all patients pretreated with MMI. 15,21,22 Indeed, the occurrence of hypothyroidism in subjects previously treated with MMI was shown to have a strong inverse relationship with the degree of suppression of the extranodular parenchyma.…”

“…21 The partial suppression of extranodular parenchyma may be related to an incompletely suppressed serum TSH at the time of therapy, which has been indicated as a risk factor for development of hypothyroidism. 7,23 The present work covers a long time-span, thus it was not possible to obtain the precise TSH serum values now obtainable using current third-generation tests for all patients pretreated with MMI. Because of the higher frequency of partial parenchyma suppression in patients pretreated with MMI associated with a higher risk of hypothyroidism, we suggest that MMI treatment should be avoided in mildly hyperthyroid patients scheduled for 131 I treatment and be restricted to elderly patients with severe hyperthyroidism, especially if associated with cardiac disease.…”