Process to radioactive iodine treatment for Graves' hyperthyroidism: condemned or absolved?

Area of Science:

• Endocrinology
• Nuclear Medicine

Background:

• Graves' disease hyperthyroidism is linked to increased mortality, cardiovascular events, cancer, and reduced quality of life.
• Radioactive iodine therapy (RAI) is a highly effective treatment for hyperthyroidism, with over 90% efficacy after one dose.
• RAI's popularity has decreased due to concerns about hypothyroidism, mortality, cancer, Graves' orbitopathy, and pregnancy.

Purpose of the Study:

• To review the safety and efficacy of RAI for Graves' disease.
• To address concerns regarding RAI's impact on mortality, cancer, and quality of life.
• To provide evidence-based information for physician-patient counseling on RAI treatment.

Main Methods:

• This study is a narrative review of existing literature on radioactive iodine therapy for Graves' disease.

Main Results:

• RAI does not increase all-cause, cardiovascular, or cerebrovascular mortality, nor does it raise cancer risk; it may even reduce these risks.
• RAI is safe for fertility and offspring, and recent data suggest it is reassuring for health-related quality of life.
• A small risk of mild Graves' orbitopathy occurrence or progression exists, which can be prevented with steroid prophylaxis or managed with immunosuppression.

Conclusions:

• Radioactive iodine therapy is a safe and effective treatment for Graves' hyperthyroidism.
• The declining reputation of RAI should be improved through accurate information dissemination.
• Physicians must provide patients with a balanced understanding of RAI's advantages and disadvantages.