• Vol. 48 No. 6
  • 15 June 2019

High Thyroid Stimulating Receptor Antibody Titre and Large Goitre Size at First-Time Radioactive Iodine Treatment are Associated with Treatment Failure in Graves’ Disease

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Graves’ disease (GD) is the most common cause of
endogenous hyperthyroidism. Remission with medical
therapy ranges from 20% to 60% after 1 to 2 years of
treatment.1 Definitive treatment options include radioactive
iodine (RAI) and thyroidectomy, with the latter
associated with complications of surgery and general
anaesthesia. As such, the preferred mode of definitive
therapy in uncomplicated GD is RAI.2 The goal of RAI
in GD is to render the patient hypothyroid or euthyroid.
Ideally, 1 dose of RAI should achieve this goal in a predictable
manner to allow timely initiation of thyroxine
and to minimise symptoms associated with prolonged
hypothyroidism. In most instances, post-RAI treatment
hypothyroidism occurs from 4 weeks after treatment,
most commonly between 2 to 6 months post-treatment.

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