SFEBES2013 Debate (1) (2 abstracts)
University of Birmingham, Birmingham, UK.
Radioiodine is a highly effective and safe treatment for hyperthyroidism, including Graves disease. Remission rates for Graves hyperthyroidism following medical therapy alone, even with a full course of antithyroid drugs, are poor (∼40% overall), especially in certain groups such as those with severe hyperthyroidism, those with large goitres and probably in males. Furthermore, antithyroid drugs can themselves cause significant morbidity and occasional life threatening side effects; obtaining good biochemical control can also be challenging. With increasing evidence of long term complications of hyperthyroidism, especially cardiovascular, and increasing evidence for significantly increased long term mortality from vascular diseases, prompt and effective treatment of Graves hyperthyroidism becomes crucial. Given the excellent safety profile of radio iodine and its efficacy in curing hyperthyroidism there is a strong case for using this therapeutic option in all cases of Graves disease, albeit with important caveats regarding timing in those with active thyroid eye disease and those desiring pregnancy or with young children in the home.