1. Indications for 131 iodine therapy for Graves’ hyperthyroidism.
(i) Allergy to ATD or other adverse reactions.
(ii) Poor efficacy of ATD or multiple relapses.
(iii) Contraindication to surgery or high risk of surgery.
④ history of neck surgery or external irradiation.
⑤ long duration of disease; elderly patients (especially those with high risk factors for cardiovascular disease).
(vi) Combined liver function impairment.
(vii) Combined leukocytopenia or thrombocytopenia.
(viii) Combined heart disease, etc.
⑨ Patients with Graves’ hyperthyroidism combined with chronic lymphocytic thyroiditis and increased RAIU can be treated with 131I.
2. Contraindications for 131I treatment of Graves’ hyperthyroidism.
①Pregnancy, lactation.
(ii) Confirmed or clinically suspected thyroid cancer in patients with GD (surgery is preferred at this time).
③ Inability to follow radiotherapy safety guidelines.
(iv) 131I therapy is also not indicated in women who are planning to become pregnant within the next 6 months.
In addition, women of childbearing age should pay attention to exclude pregnancy before 131I treatment.
3.What preparations should be made before radionuclide 131I treatment for hyperthyroidism patients?
Since iodine-containing foods, medications and anti-thyroid drugs can affect the uptake of 131I by the thyroid gland, anti-thyroid drugs should generally be discontinued for 1-2 weeks, and iodine and iodine-containing foods and medications for about 2-4 weeks before treatment. During the discontinuation period patients with hyperthyroidism symptoms such as accelerated heart rate and comorbidities such as low white blood cells and abnormal liver function should continue symptomatic treatment.
4.What tests should be done before radionuclide 131I treatment for hyperthyroidism?
①Thyroid function, blood and urine routine, biochemical index, electrocardiogram, echocardiogram and other tests to understand the function of the main organs.
②Thyroid ultrasound and thyroid nuclear imaging to clarify the size of the thyroid gland and to determine the nature of thyroid nodules.
③Iodine uptake rate measurement of thyroid gland to calculate drug dose.