The Effect of Antithyroid Drug Pretreatment on Acute Changes in Thyroid Hormone Levels after 131I Ablation for Graves' Disease

2001 ◽  
Vol 86 (7) ◽  
pp. 3016-3021 ◽  
Author(s):  
H. B. Burch
Keyword(s):  
Thyroid Hormone ◽  
Antithyroid Drug ◽  
Graves Disease ◽  
Hormone Levels ◽  
131I Ablation ◽  
Thyroid Hormone Levels ◽  
Acute Changes

scholarly journals The Effect of Antithyroid Drug Pretreatment on Acute Changes in Thyroid Hormone Levels after 131I Ablation for Graves’ Disease1

2001 ◽  
Vol 86 (7) ◽  
pp. 3016-3021 ◽  
Author(s):  
H. B. Burch ◽  
B. L. Solomon ◽  
D. S. Cooper ◽  
P. Ferguson ◽  
N. Walpert ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Radioiodine Therapy ◽  
Antithyroid Drug ◽  
Antithyroid Drugs ◽  
Free T4 ◽  
Hormone Levels ◽  
Free T3 ◽  
Average Decrease ◽  
Thyroid Hormone Levels ◽  
Acute Changes

Acute changes in thyroid hormone levels before and after radioiodine therapy for Graves’ disease were compared in 42 patients randomized to receive either antithyroid drug pretreatment or no pretreatment. Five patients (11.9%), including 3 in the pretreatment arm and 2 in the no pretreatment arm experienced a late exacerbation of thyrotoxicosis after radioiodine therapy. The majority (19 of 21, 90.5%) of pretreated patients experienced a transient increase in free T4 and free T3 after discontinuation of antithyroid drugs, with little further elevation after radioiodine therapy. After stopping antithyroid drugs and before radioiodine administration, mean serum free T4 values rose from 14.7 ± 6.9 to 21.6 ± 12.1 pmol/L, representing a 46.9% increase, whereas serum free T3 levels rose from 4.9± 1.7 to 8.1 ± 6.3 pmol/L, representing a 65.3% increase. The average pretreated patient experienced a 52.4% increase [95% confidence interval (CI), +26.4% to +78.5%] in free T4 and a 61.8% increase (95% CI, +23.5% to +100.0%) in free T3. Conversely, the majority (19 of 21, 90.5%) of nonpretreated patients experienced a rapid decline in thyroid hormone levels after radioiodine treatment. Over the 14 days after radioiodine therapy mean free T4 values in nonpretreated patients fell from 85.8 ± 60.4 to 58.0 ± 76.5 pmol/L, representing a 32.4% decrease, whereas mean free T3 levels fell from 16.1 ± 8.0 to 10.8 ± 11.1 pmol/L, representing a 32.9% decrease. The average nonpretreated patient experienced a 20.6% decrease (95% CI, −47.3% to +7.0%) in free T4 and a 24.3% decrease (95% CI, −1.2% to −47.4%) in free T3 during this time period. Excluding 2 patients with a late exacerbation after radioiodine, 19 nonpretreated patients experienced a decrease in mean free T4 values from 76.8 ± 46.6 to 36.6 ± 19.8 pmol/L, representing a 52.3% decrease, whereas mean free T3 levels fell from 15.5 ± 7.7 to 7.8 ± 3.6 pmol/L, representing a 49.7% decrease. The average decrease in free T4 levels among this subgroup of patients was 30.1% (95% CI, −4.6% to −55.6%), whereas the average decrease in free T3 was 34.4% (95% CI, −13.7% to −55.1%). High levels of TSH receptor autoantibodies at diagnosis were associated with an acute worsening of thyrotoxicosis after stopping antithyroid drug pretreatment. We conclude that pretreatment with antithyroid drugs does not protect against worsening thyrotoxicosis after radioiodine, but may allow such patients to start from a lower baseline level should an aggravation in thyrotoxicosis occur. The findings support the recommendation that most patients with Graves’ disease do not require antithyroid drug pretreatment before receiving radioiodine.

scholarly journals Rescue pre-operative treatment with Lugol’s solution in uncontrolled Graves’ disease

2017 ◽  
Vol 6 (4) ◽  
pp. 200-205 ◽  
Author(s):  
Jan Calissendorff ◽  
Henrik Falhammar
Keyword(s):  
Heart Rate ◽  
Thyroid Hormone ◽  
Side Effects ◽  
Definitive Treatment ◽  
Graves Disease ◽  
Free T4 ◽  
Hormone Levels ◽  
Free T3 ◽  
Adherence To Medication ◽  
Thyroid Hormone Levels

Background Graves’ disease is a common cause of hyperthyroidism. Three therapies have been used for decades: pharmacologic therapy, surgery and radioiodine. In case of adverse events, especially agranulocytosis or hepatotoxicity, pre-treatment with Lugol’s solution containing iodine/potassium iodide to induce euthyroidism before surgery could be advocated, but this has rarely been reported. Methods All patients hospitalised due to uncontrolled hyperthyroidism at the Karolinska University Hospital 2005–2015 and treated with Lugol’s solution were included. All electronic files were carefully reviewed manually, with focus on the cause of treatment and admission, demographic data, and effects of iodine on thyroid hormone levels and pulse frequency. Results Twenty-seven patients were included. Lugol’s solution had been chosen due to agranulocytosis in 9 (33%), hepatotoxicity in 2 (7%), other side effects in 11 (41%) and poor adherence to medication in 5 (19%). Levels of free T4, free T3 and heart rate decreased significantly after 5–9 days of iodine therapy (free T4 53–20 pmol/L, P = 0.0002; free T3 20–6.5 pmol/L, P = 0.04; heart rate 87–76 beats/min P = 0.0007), whereas TSH remained unchanged. Side effects were noted in 4 (15%) (rash n = 2, rash and vomiting n = 1, swelling of fingers n = 1). Thyroidectomy was performed in 26 patients (96%) and one was treated with radioiodine; all treatments were without serious complications. Conclusion Treatment of uncontrolled hyperthyroidism with Lugol’s solution before definitive treatment is safe and it decreases thyroid hormone levels and heart rate. Side effects were limited. Lugol’s solution could be recommended pre-operatively in Graves’ disease with failed medical treatment, especially if side effects to anti-thyroid drugs have occurred.

Graves' disease: An analysis of thyroid hormone levels and hyperthyroid signs and symptoms

1989 ◽  
Vol 87 (5) ◽  
pp. 558-561 ◽  
Author(s):  
Paula T. Trzepacz ◽  
Irwin Klein ◽  
Michelle Roberts ◽  
Joel Greenhouse ◽  
Gerald S. Levey
Keyword(s):  
Thyroid Hormone ◽  
Signs And Symptoms ◽  
Graves Disease ◽  
Hormone Levels ◽  
Thyroid Hormone Levels

Characteristics of Patients with Graves' Disease Whose Thyroid Hormone Levels Increase After Substituting Potassium Iodide for Methimazole in the First Trimester of Pregnancy

Thyroid ◽  
2020 ◽  
Vol 30 (3) ◽  
pp. 451-456 ◽  
Author(s):  
Ai Yoshihara ◽  
Jaeduk Yoshimura Noh ◽  
Natsuko Watanabe ◽  
Yo Kunii ◽  
Miho Suzuki ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Potassium Iodide ◽  
First Trimester ◽  
Graves Disease ◽  
Hormone Levels ◽  
First Trimester Of Pregnancy ◽  
Thyroid Hormone Levels

Catatony in Graves' disease

1998 ◽  
Vol 13 (8) ◽  
pp. 419-420 ◽  
Author(s):  
J Rudolf ◽  
M Grond ◽  
M Neveling ◽  
W-D Heiss
Keyword(s):  
Thyroid Hormone ◽  
Psychiatric Symptoms ◽  
Normal Serum ◽  
Prior History ◽  
Graves Disease ◽  
Drug Induced ◽  
Hormone Levels ◽  
Neuroleptic Syndrome ◽  
Serum Thyroid Hormone ◽  
Thyroid Hormone Levels

SummaryWe report a 27-year-old female patient with prior history of Graves' disease and relapsing episodes of tachycardia, hyperpyrexia, muscular rigidity and coma. With the subsequent manifestation of an acute schizophreniform psychotic disorder unresponsive to neuroleptics, the primary syndrome was re-classified as febrile catatony. Hyperthyroidism was ruled out with normal serum thyroid hormone levels, as were toxic effects of thyrostatic treatment, drug-induced hypothyroidism and a malignant neuroleptic syndrome. All psychiatric symptoms subsided completely following subtotal thyroidectomy. Febrile catatatony has to be added to the spectrum of psychotic phenomena that may be caused by Graves' disease, irrespective of serum thyroid hormone levels.

Three basic patterns of changes in serum thyroid hormone levels in Graves’ disease during the one-year period after radioiodine therapy

2005 ◽  
Vol 19 (4) ◽  
pp. 297-308 ◽  
Author(s):  
Masayuki Nakajo ◽  
Shinsaku Tsuchimochi ◽  
Hiroaki Tanabe ◽  
Yoshiaki Nakabeppu ◽  
Megumi Jinguji
Keyword(s):  
Thyroid Hormone ◽  
Radioiodine Therapy ◽  
Graves Disease ◽  
Hormone Levels ◽  
Serum Thyroid Hormone ◽  
Thyroid Hormone Levels ◽  
One Year ◽  
The One

scholarly journals Acute Changes in Thyroid Hormone Levels among Thai Pesticide Sprayers

Toxics ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 16
Author(s):  
Pornpimol Kongtip ◽  
Noppanun Nankongnab ◽  
Ritthirong Pundee ◽  
Nichcha Kallayanatham ◽  
Sumate Pengpumkiat ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Hormones ◽  
Urine Samples ◽  
Blood Collection ◽  
Free Triiodothyronine ◽  
Blood Samples ◽  
Hormone Levels ◽  
Pesticide Exposures ◽  
Thyroid Hormone Levels ◽  
Acute Changes

The objective of this study was to investigate the relationship of acute pesticide exposures and acute changes in thyroid hormones among Thai farmers. We recruited 78 farmers, who were scheduled to spray insecticides (chlorpyrifos and/or cypermethrin) or herbicides (paraquat and/or glyphosate). On the day before spraying, farmers collected their first morning void urine and went for blood collection. On the spray day, urine samples were collected at end of the spraying event and they were interviewed with questionnaires. The next morning, the first morning void urine and blood samples were collected. Blood samples were analyzed for thyroid hormones. Urine samples were analyzed for the metabolites of the pesticide sprayed. The results showed that the thyroid hormones, free triiodothyronine (FT3) and total triiodothyronine (T3) were significantly reduced as urinary chlorpyrifos metabolite increased the day after spraying. Total thyroxine (T4) significantly increased as cypermethrin metabolites increased the day after spraying. T4 significantly increased as urinary glyphosate levels increased; however, FT3 and T3 decreased significantly as urinary paraquat levels increased the day after spraying. These findings suggest that acute exposures to the pesticides chlorpyrifos, cypermethrin, paraquat and glyphosate can produce acute effects on the hypothalamic–pituitary–thyroid (HPT) axis, acutely altering thyroid hormone levels.

Sign in / Sign up

Export Citation Format

Share Document