Controversy in thyroid disease

Effective management for hypothyroidism has been available for a century, thanks to the pioneering efforts of George Murray, who first tested injection of thyroid gland extracts in Newcastle. Radioiodine for the diagnosis and then treatment of Graves' hyperthyroidism was introduced by Hertz and Roberts in Boston, and by Leblond in Paris, in 1943, the same year that Astwood in the USA began to use the predecessors of modern antithyroid drugs. Despite this lengthy history, debate continues as to the most effective management of these common disorders. More use of radioiodine, including its use in euthyroid goitre, is being advocated as its safety is now well established. Recent developments in optimising these treatments will be considered in this brief review.