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Is There a Place for Long-Term Stable Iodine in the Treatment of Graves’ Disease?

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Controversies in Clinical Thyroidology

Abstract

The 1923 report of Henry Plummer established the value of stable iodine for treatment of the hyperthyroidism of Graves’ disease.1 It soon became evident that this effect was only temporary.2 After a few weeks many patients experienced a relapse or even an exacerbation of their disease. Consequently, stable iodine has been used principally for short-term thyroid suppression, either in the preparation of patients for thyroidectomy, treatment of thyroid crisis, or following radioactive iodine (131I) therapy to hasten the return of the euthyroid state.

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References

  1. Plummer HS: Results of administering iodine to patients having exophthalmic goiter. JAMA 80:1955, 1923

    Google Scholar 

  2. Starr P, Walcott HP, Segall N, Means JH: The effect of iodine in exophthalmic goiter. Arch Intern Med 34:355, 1924

    CAS  Google Scholar 

  3. Thompson WO, Thompson PK, Brailey AG, Cohen AC: Prolonged treatment of exophthalmic goiter by iodine alone. Arch Intern Med 45:481, 1930

    Google Scholar 

  4. Hamolsky MW: Some present day concepts of the therapy of diseases of the thyroid gland. RI Med J 47:336, 1964

    CAS  Google Scholar 

  5. Nagataki S, Shizume K, Nakao K: Effect of iodide on thyroidal iodine turnover in hyperthyroid subjects. J Clin Endocrinol Metab 30:469, 1970

    Article  PubMed  CAS  Google Scholar 

  6. Hamburger JI: Clinical Exercises in Internal Medicine, Vol. I. Thyroid Disease. Philadelphia, Saunders, 1978, pp 71–73

    Google Scholar 

  7. Saxena KM, Crawford JD, Talbot NB: Childhood thyrotoxicosis: A long-term perspective. Br Med J 2:1153, 1964

    Article  PubMed  CAS  Google Scholar 

  8. Emerson CH, Anderson AJ, Howard WJ, Utiger RD: Serum thyroxine and triiodothyronine concentrations during iodide treatment of hyperthyroidism. J Clin Endocrinol Metab 40:33, 1975

    Article  PubMed  CAS  Google Scholar 

  9. Braverman LW: Disorders of iodine excess and deficiency. In Werner SC, Ingbar SH (eds): The Thyroid, 4th ed. Hagerstown, Md., Harper & Row, 1978, pp 528–536

    Google Scholar 

  10. Wartofsky L: Low remission after therapy for Graves’ disease. JAMA 226:1083, 1973

    Article  PubMed  CAS  Google Scholar 

  11. Engbring NH: Current treatment of hyperthyroidism. Wis Med J 67:265, 1968

    PubMed  CAS  Google Scholar 

  12. Wood LC, Ingbar SH: Hypothyroidism as a late sequela in patients with Graves’ disease treated with antithyroid agents. J Clin Invest 64:1429, 1979

    Article  PubMed  CAS  Google Scholar 

  13. Volpé R, Johnston MW: The effect of small doses of stable iodine in patients with hyperthyroidism. Ann Interm Med 56:577, 1962

    Google Scholar 

  14. Thompson WO, Thompson PK: Low basal metabolism following thyrotoxicosis. I. Temporary type without myxedema with special reference to role of iodine therapy. J Clin Invest 5:441, 1928

    Article  PubMed  CAS  Google Scholar 

  15. Slingerland DW, Burrows BA: Long-term antithyroid treatment in hyperthyroidism. JAMA 242:2408, 1979

    Article  PubMed  CAS  Google Scholar 

  16. Yamamoto M, Igarshi T, Kimura S, Tsukamoto S, Togawa K, Ogata A: Thyroid suppression test and outcome of hyperthyroidism treated with antithyroid drugs and triiodothyronine. J Clin Endocrinol Metab 48:72, 1979

    Article  PubMed  CAS  Google Scholar 

  17. Tamai H, Nakagawa T, Fukino O, et al.: Thionamide therapy in Graves’ disease: Relation of relapse rate to duration of therapy. Ann Intern Med 92:488, 1980

    PubMed  CAS  Google Scholar 

  18. Vagenakis AG, Wang CA, Burger A, Maloof F, Braverman L, Ingbar SH: Iodide-induced thyrotoxicosis in Boston. N Engl J Med 287:523, 1972

    Article  PubMed  CAS  Google Scholar 

  19. Dobyns BM, Sheline GE, Workman JB, Tompkins EA, McConahey WM, Becker DV: Malignant and benign neoplasms of the thyroid in patients treated for hyperthyroidism: A report of the Cooperative Thyrotoxicosis Therapy Follow-up Study. J Clin Endocrinol Metab 38:976, 1974

    Article  PubMed  CAS  Google Scholar 

  20. Wolff J: Physiological aspects of iodide excess in relation to radiation protection. J Mol Med 4:151, 1980

    CAS  Google Scholar 

  21. Curd JG, Milgrom H, Stevenson DD, Mathison DA, Vaughan JH: Potassium iodide sensitivity in four patients with hypocomplementemic vasculitis. Ann Intern Med 91:853, 1979

    PubMed  CAS  Google Scholar 

  22. McGregor AM, Smith BR, Hall R: Prediction of relapse in hyperthyroid Graves’ disease. Lancet 1:1101, 1980

    Article  PubMed  CAS  Google Scholar 

  23. Pimstone B, Joffe B, Pimstone N, Bonnici F, Jackson WPU: Clinical response to long-term propranolol therapy in hyperthyroidism. S Afr Med J 43:1203, 1978

    Google Scholar 

  24. Hagen GA, Ouellette RP, Chapman EM: Comparison of high and low dosage levels of 131I in the treatment of thyrotoxicosis. N Engl J Med 277:559, 1967

    Article  PubMed  CAS  Google Scholar 

  25. Feek CM, Sawers JS, Irvine WJ, Beckett GJ, Ratcliffe WA, Toft AD: Combination of potassium iodide and propranolol in preparation of patients with Graves’ disease for thyroid surgery. N Engl J Med 302:883, 1980

    Article  PubMed  CAS  Google Scholar 

  26. Wood LC, Maloof F: Thyroid failure after potassium iodide treatment of diffuse toxic goiter. Trans Assoc Am Physicians 88:235, 1975

    PubMed  CAS  Google Scholar 

  27. Winkler AW, Man EB, Danowski TS: Minimum dosage of thiourea, given together with iodine medication, necessary for the production and maintenance of a remission in hyperthyroidism. J Clin Invest 26:446, 1947

    Article  CAS  Google Scholar 

  28. Harden RM, Koutras DA, Alexander WD, Wayne EJ: Quantitative studies of iodine metabolism in iodide-treated thyrotoxicosis. Clin Sci 27:399, 1964

    PubMed  CAS  Google Scholar 

  29. Nagataki S: Effect of excess quantities of iodide. Handb Physiol Endocrinol 3:329, 1974

    Google Scholar 

  30. Nagataki S, Uchimura H: Treatment of Graves’ disease with inorganic iodide. Clin Endocrinol 22:231, 1974 (in Japanese)

    CAS  Google Scholar 

  31. Nagataki S, Uchimura H, Matsuzaki F, Masuyama Y: Comparison of the triiodothyronine suppression test by the 20-minute and the 24-hour thyroidal1311 uptake in patients receiving thionamide drugs. J Clin Endocrinol Metab 38:255, 1974

    Article  PubMed  CAS  Google Scholar 

  32. The Report of the Ministry of Health and Welfare, Japan, on “Hashimoto’s Disease,” 1975

    Google Scholar 

  33. Shizume K, Irie M, Nagataki S, Matsuzaki F, Shishiba Y, Suematsu H, Tsushima T: Long-term result of antithyroid drug therapy for Graves’ disease: Follow-up after more than 5 years. Endocrinol Jpn 17:327, 1970

    Article  PubMed  CAS  Google Scholar 

  34. Niitani H, lino S, Hayashi K, Watanabe T, Igaya K, Yuri H, Ohno T, Miyamoto M, Ban Y: Treatment of Graves’ disease. J Jpn Soc Intern Med 62:164, 1969 (in Japanese)

    Google Scholar 

  35. Solomon DH, Beck JC, Vandeaan WP, Astwood EB: Prognosis of hyperthyroidism treated by antithyroid drugs. JAMA 152:201, 1953

    CAS  Google Scholar 

  36. Reveno WS, Rosenbaum H: Observations on the use of antithyroid drugs. Ann Intern Med 60:982, 1964

    Google Scholar 

  37. Hershman JE, Givens JR, Cassidy CE, Astwood EB: Long-term outcome of hyperthyroidism treated with antithyroid drugs. J Clin Endocrinol Metab 26:803, 1966

    Article  PubMed  CAS  Google Scholar 

  38. McCullagh EP, Cassidy CE: Propylthiouracil: 4- to 6-year follow-up of selected patients with Graves’ disease. J Clin Endocrinol Metab 13:1507, 1953

    Article  PubMed  CAS  Google Scholar 

  39. Trotter WR: Nonsurgical treatment thyrotoxicosis Proc R Soc Med 54:869, 1961

    PubMed  CAS  Google Scholar 

  40. Alexander WD, McLarty DG, Horton P, Phyrmakiotis AD: Sequential assessment during drug treatment of thyrotoxicosis. Clin Endocrinol 2:43, 1973

    Article  CAS  Google Scholar 

  41. Alexander WD, McLarty DG, Robertson J, Shimmins J, Brownlie BEW, Harden RMcG, Patel AR: Prediction of the long-term results of antithyroid drug therapy for thyrotoxicosis. J Clin Endocrinol Metab 30:540, 1970

    Article  PubMed  CAS  Google Scholar 

  42. Stewart RDH, Murray IPC: Effect of small doses of carrier iodide upon the organic binding of radioactive iodine by the human thyroid gland. J Clin Endocrinol Metab 27:500, 1967

    Article  PubMed  CAS  Google Scholar 

  43. Childs DS Jr, Keating FR Jr, Rail JE, Williams MMD, Power MH: Effect of varying quantities of inorganic iodide “carrier” on urinary excretion and thyroidal accumulation of radioiodine in exophthalmic goiter. J Clin Invest 29:726, 1950

    Article  PubMed  CAS  Google Scholar 

  44. Weaver DK, Batsakis JG, Nishiyama RH: Relationship of iodine to “lymphocytic goiters.” Arch Surg 98:183, 1969

    PubMed  CAS  Google Scholar 

  45. Follis RH Jr: Further observations on thyroiditis and colloid accumulation in hyperplastic thyroid glands of hamsters receiving excess iodine. Lab Invest 13:1590, 1964

    PubMed  Google Scholar 

  46. Belshaw BE, Becker DV: Necrosis of follicular cells and discharge of thyroidal iodine induced by administering iodide to iodine-deficient dogs. J Clin Endocrinol Metab 36:466, 1973

    Article  PubMed  CAS  Google Scholar 

  47. Boudoulas H, Lewis RP, Kates RE, Dalamangas G: Hypersensitivity to adrenergic stimulation after propranolol withdrawal in normal subjects. Ann Intern Med 87:433, 1977

    PubMed  CAS  Google Scholar 

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© 1981 Springer-Verlag New York Inc.

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Hamburger, J.I. (1981). Is There a Place for Long-Term Stable Iodine in the Treatment of Graves’ Disease?. In: Hamburger, J.I., Miller, J.M. (eds) Controversies in Clinical Thyroidology. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-5916-9_6

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  • DOI: https://doi.org/10.1007/978-1-4612-5916-9_6

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4612-5918-3

  • Online ISBN: 978-1-4612-5916-9

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