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A major expected side-effect of radioiodine in people with Graves' disease is the development of lifelong hypothyroidism, requiring daily treatment with thyroid hormone. On occasion, some people may require more than one radioactive treatment, depending on the type of disease present, the size of the thyroid, and the initial dose administered.
The primary treatment of thyroid storm is with inorganic iodine and antithyroid drugs (propylthiouracil or methimazole) to reduce synthesis and release of thyroid hormone. Temperature control and intravenous fluids are also mainstays of management. Beta blockers are often used to reduce the effects of thyroid hormone. [5]
However, deprescribing may be considered if a patient experiences side effects like rapid heart rate, anxiety, or bone loss, or if their thyroid function tests normalize.”
Thyroid disease is a medical condition that affects the function of the thyroid gland. The thyroid gland is located at the front of the neck and produces thyroid hormones [1] that travel through the blood to help regulate many other organs, meaning that it is an endocrine organ. These hormones normally act in the body to regulate energy use ...
Administering the radioactive isotope causes the thyroid to take in the lethal iodine and quickly radiation destroys it. [12] Typically overproduction of thyroxine using radio-iodine is blocked with one dose. The drawback to this treatment is the thyroid gland is completely destroyed and patients often develop hypothyroidism. Some do so only a ...
The effects of excess thyroid hormone typically respond to the administration of a non-selective beta blocker, such as propranolol (as most of the symptoms are driven by increased levels of adrenaline and its effect on the β-adrenergic receptors). Subsequent attacks may be prevented by avoiding known precipitants, such as high salt or ...
TSH is the preferred initial test of thyroid function as it has a higher sensitivity to changes in thyroid status than free T 4. [60] Time of day can affect the results of this test; TSH peaks early in the morning and slumps in the late afternoon to early evening, [61] with "a variation in TSH by a mean of between 0.95 mIU/mL to 2.0 mIU/mL". [62]
Other side effects include granulocytopenia (dose dependent, which improves on cessation of the drug) and aplastic anemia, and in case of propylthiouracil, severe, fulminant liver failure. [20] Patients on these medications should see a doctor if they develop sore throat or fever. The most common side effects are rash and peripheral neuritis. [21]
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