Introduction: Radioiodine is a safe and effective treatment for benign thyroid disease. It aims to treat hyperthyroidism and achieve a euthyroid state. Radioiodine is indicated in cases of hyperthyroidism caused by Graves disease or toxic goitre (solitary toxic adenomas or multi-nodular goitre). In practice there has been concerns about long term safety, worsening of eye disease and weight gain with this treatment.
Aims: To audit outcome, management, complications and follow up of patients treated with radioiodine at a district general hospital, and compare results with the Royal College of Physicians guidelines.
Method: A retrospective review of patients treated with Radioiodine at North Middlesex Hospital between January 2012 and December 2014.
Results: All patients were treated with 555MBq as a fixed dose. We had a total number of 27 patients. Of these, the average age was 49 years (2188). 23 patients(88%) were on antithyroid therapy prior to radioiodine treatment, 21patients (78%) had their thyroid function checked at ~6 weeks and only 11 patients (40%) had it rechecked at 12 weeks. 23 patients (85%) had ongoing thyroid function monitoring at 1 year. Five patients (18%) failed radioiodine treatment with only one having a further dose within 6 months. Overall outcome 13 patients (48%) became hypothyroid requiring levothyroxine, eight patients (29%) became euthyroid, five patients (18%) remained hyperthyroid and one did not attend follow up. Average time to commence levothyroxine was 4.5 months. 16 patients (59%) gained weight with an average weight gain of 4.9 kg over 12 months. Four patients (14%) had graves eye disease but did not require prophylactic steroids. There was no worsening of eye disease. There were no other complications of Radioiodine treatment recorded.
Conclusion: We conclude that with appropriate patient selection and monitoring, radioiodine treatment for benign thyroid disease is a safe and effective treatment option.