The world’s leading thyroid societies report that the proportion of patients currently expected to choose iodine-131 therapy is about 45% globally, 60% in North America and 30% in Asia. In the United States and Europe, iodine-131 treatment is mostly used as the preferred option for adult hyperthyroidism. In China, due to the gap and difference between historical, economic and cultural development and the West, the proportion of patients with hyperthyroidism treated with iodine-131 is currently low in China. This situation is just like the situation in Europe and America where nuclear power supply accounts for 20-78% of national electricity consumption, while nuclear power in China only accounts for a single-digit percentage of national electricity consumption. This difference in the proportion of hyperthyroidism iodine 131 treatment between China and the West is not only the difference in the level of scientific and technological development, but also the difference in the concept and cultural background is an important factor. In Europe and the United States, not only is iodine-131 treatment preferred for hyperthyroidism in the elderly, but iodine-131 treatment for hyperthyroidism in adults has become the majority choice. In China, on the other hand, the technology is not popular because the business of iodine-131 treatment for hyperthyroidism mostly resides in large hospitals or medical centers. Due to the non-objective and incorrect interpretation by individual doctors, it even generates core fear among the public and produces many misconceptions in perception. It should be emphasized here that iodine 131 is not equal to nuclear weapons, nor is it an atomic bomb, and there is no need to worry too much about being endangered. In some cases, it is even the only lifesaver. Myth 1: Iodine-131 cannot be used to treat hyperthyroidism in children. Internal medication is the preferred treatment for hyperthyroidism in children, but it does not mean that Iodine-131 cannot treat hyperthyroidism in children. The correct understanding is that iodine-131 is not preferred but is not contraindicated in the treatment of hyperthyroidism in children. The immaturity and instability of the personality of children and adolescents, their inability to take long-term medication, and their heavy school burden may aggravate hyperthyroidism, often make medical treatment more difficult than that of adults. If the condition is not controlled after years of treatment, or if the patient has poor compliance, or if the condition is severe and complications or side effects of hyperthyroidism occur, then iodine-131 therapy should be used decisively and actively to control the condition. As early as 2004, the Ministry of Health organized authoritative experts to prepare a treatment specification (guiding and regulating medical practice) for hyperthyroidism iodine-131 treatment without setting an age limit, which is different from the old textbooks. Combined with medical research at home and abroad, experts suggest that if a child (older than 5 years old) decides to take iodine-131 treatment for hyperthyroidism, it is best to take a high dose to cure it at one time, i.e. to convert it into hypothyroidism and then replace it. Myth 2: You cannot treat hyperthyroidism with iodine-131 without being married. Among the patients they see every day, many hyperthyroid patients who have not been cured for a long time and urgently want to get pregnant tell their doctors about this concept. When asked about its origin, it is mostly said by other patients or non-specialist doctors with good intentions. They think that if they are unmarried and undergo iodine-131 treatment for hyperthyroidism, they will not be able to have children in the future. This is a big joke. There is no scientific basis for this notion, and it is also harmful. In Europe and the United States, it has become a consensus that iodine-131 treatment is the first choice for married women with hyperthyroidism who want to get pregnant early. Our clinical practice has also confirmed that even if hypothyroidism occurs after iodine-131 treatment for hyperthyroidism, it still does not affect fertility after regular replacement therapy. Myth 3: Iodine-131 treatment for hyperthyroidism is an inevitable and compelling choice. For historical reasons, iodine-131 was once thought to cause malignant tumors, but after decades of medical practice at home and abroad, it has been confirmed that there is no scientific basis for the above-mentioned view, and that therapeutic doses of iodine-131 will not lead to an increased incidence of malignant tumors. Because of this, the United States and other developed countries have long made iodine-131 treatment the first choice for adult and elderly hyperthyroidism. In 2004, the Ministry of Health of China organized authoritative experts to draft the diagnosis and treatment specification for iodine-131 treatment of hyperthyroidism, which only mentioned contraindications for pregnant women and breastfeeding women with hyperthyroidism, while the latest operation specification eliminated “hyperthyroidism with acute heart attack and severe kidney failure”. Myth 4: Iodine-131 treatment for hyperthyroidism can only be given once. Many patients have great concerns about iodine-131 treatment, believing that hyperthyroidism can no longer be treated after iodine-131 treatment, and that iodine-131 treatment is the ultimate treatment for hyperthyroidism. In fact, iodine-131 treatment is one of the treatment options for hyperthyroidism. If the hyperthyroidism is not cured after treatment, a second iodine-131 treatment can be given at a later date, and the treatment process is not qualitatively different from the first treatment. Of course, if hyperthyroidism is not cured by iodine-131 treatment, you can also choose other options for further treatment, such as taking methimazole, etc. If necessary, you can also choose surgery. In fact, western medicine, iodine-131 and surgery for hyperthyroidism are not contradictory, but interdependent if necessary, so as to show the maximum effect or safer for patients. For example, in the case of severe hyperthyroidism iodine-131 treatment, it is generally safer to use methimazole and other drugs to control the condition first, and then iodine-131 treatment after the condition improves, and it is safer to use methimazole or iodine-131 to control the condition before surgery for severe hyperthyroidism, and then operate at an optional stage. Misconception 5: Hypothyroidism occurs only after iodine-131 treatment. Many patients believe that hypothyroidism occurs in 100% of patients after treatment of hyperthyroidism with iodine-131, and that hypothyroidism does not occur after treatment with endocortisone and tabazol. This view is wrong both in theory and in practice. We know that Graves’ hyperthyroidism is an autoimmune disease of the thyroid gland, which means that the natural course of the disease ends in hypothyroidism, mainly as a consequence of the destruction of thyroid follicular cells by autoantibodies. There is also a lot of information at home and abroad which shows that permanent hypothyroidism will occur regardless of whether it is treated with medical drugs, iodine-131 or surgery, and the incidence of hypothyroidism will increase with time. Myth 6: Iodine-131 treatment for hyperthyroidism is a dangerous and scary treatment method. The horrible thing is that hypothyroidism takes medication for a lifetime, becomes stupid, dumb, dull, cannot get pregnant, and even leads to leukemia or malignant tumor, death, etc. Imagine if this is true, then aren’t all hyperthyroid patients in Europe and America retarded and competing for an inferior option to treat hyperthyroidism, and it also shows that hyperthyroid doctors in Europe and America are so irresponsible to their patients that they allow them to be treated with horrible and dangerous options. This view is no different from this situation, where intravenous penicillin is also administered to patients who react positively to penicillin. Logically this understanding is not valid, and in practice it is not broken. The residents of Europe and America are generally more educated than China, and their concepts and cultural backgrounds are very different from China’s. They advocate science and efficiency, they value time like gold, and cherish their health more, and safe, easy and effective treatment methods are the fundamental reasons why they choose iodine-131 treatment. This includes former U.S. President George Bush Sr. and some social celebrities.