Advantages And Disadvantages : Radioactive Iodine

Advantages. The advantages of radioactive iodine in the treatment of Graves' disease are many. No death as a direct result of the use of the isotope has been reported, and only by a gross miscalculation of dose could such an event conceivably occur. In the nonpregnant patient, no tissue other than the thyroid is exposed to sufficient ionizing radiation to be detectably altered. Nevertheless, the continuing concern about potential effects of radiation on germ cells prompts some endocrinologists to advocate antithyroid drugs or surgery in younger patients who are acceptable operative risks . Hypoparathyroidism is a small risk of surgery. With radioactive iodine treatment, the patient is spared the risks and discomfort of surgery. The cost is low, hospitalization is not required, and patients can indulge in their customary activities during the entire procedure.

Disadvantages-The chief disadvantage of the use of radioactive iodine is the high incidence of delayed hypothyroidism that is induced. Even when elaborate procedures are used to estimate iodine uptake and gland size, a certain percentage of patients will be overtreated. A distressing feature of this complication is its rising prevalence with the passage of time; the longer the interval after treatment, the higher the incidence. Several analyses of groups of patients treated 10 or more years previously suggest that the eventual rate may exceed 80%. However, it now appears that the incidence of hypothyroidism also increases progressively after subtotal thyroidectomy, and such failure of glandular function is probably part of the natural progression of Graves' disease, no matter what the therapy.

Category: Pharmacology Notes