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Antithyroid Drugs and Radioiodine Therapy: A Grain of (Iodized) Salt

David S. Cooper, MD
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Sinai Hospital of Baltimore; Baltimore, MD 21215

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1994;121(8):612-614. doi:10.7326/0003-4819-121-8-199410150-00009
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Most thyroid specialists prefer to use radioiodine to treat the typical adult patient with hyperthyroidism [1]. Radioiodine therapy is simple, cost-effective, and, except for iatrogenic hypothyroidism, free from long-term side effects. Nevertheless, controversies about its use continue [2]. One major area of dispute is the wisdom and necessity of antithyroid drug pretreatment in the weeks before radioiodine therapy. This practice has become commonplace, especially in elderly patients or those with cardiac disorders, in whom the risk of exacerbating the underlying thyroid problem would be particularly hazardous.

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