[Should thyroxine treatment be discontinued for four weeks before I(131) thyroid ablation?]

Endocrinol Nutr. 2012 Apr;59(4):227-31. doi: 10.1016/j.endonu.2012.02.004. Epub 2012 Mar 19.
[Article in Spanish]

Abstract

Background: It is a usual practice to discontinue thyroxine treatment for four weeks before (131)I ablation. Symptoms of hypothyroidism usually occur during this time. Use of rhTSH is a helpful alternative in some cases, but problems of availability of this agent during 2012 will limit its use.

Patients and methods: Plasma TSH and FT4 levels were measured on days 7, 14, 21, and 28 after total thyroidectomy (12 patients) or discontinuation of thyroxine treatment (20 patients). A Mann-Whitney U test was used to compare quantitative variables, and a Chi-square test was used for nominal variables.

Results: On day 14, TSH levels were 30μIU/mL of higher in 71% of patients (66% in the thyroidectomy group and 75% in the group discontinued thyroxine treatment). On day 21, almost all patients from both groups (91% in the thyroidectomy group and 100% in the group discontinued thyroxine treatment) had TSH levels of 30μIU/mL or higher. On day 14, most patients in both groups had FT4 levels below the normal range.

Conclusions: Discontinuation of thyroxine treatment for four weeks is not required. Fourteen days is an adequate time in most patients, and 21 days are sufficient in virtually all patients.

Publication types

  • Clinical Trial

MeSH terms

  • Adenocarcinoma, Follicular / blood
  • Adenocarcinoma, Follicular / diagnostic imaging
  • Adenocarcinoma, Follicular / radiotherapy*
  • Adenocarcinoma, Follicular / surgery
  • Adult
  • Aged
  • Carcinoma, Papillary / blood
  • Carcinoma, Papillary / diagnostic imaging
  • Carcinoma, Papillary / radiotherapy*
  • Carcinoma, Papillary / surgery
  • Chi-Square Distribution
  • Drug Administration Schedule
  • Female
  • Hormone Replacement Therapy*
  • Humans
  • Iodine Radioisotopes / pharmacokinetics
  • Iodine Radioisotopes / therapeutic use*
  • Luminescent Measurements
  • Male
  • Middle Aged
  • Radionuclide Imaging
  • Radiopharmaceuticals / pharmacokinetics
  • Radiopharmaceuticals / therapeutic use*
  • Statistics, Nonparametric
  • Thyroid Neoplasms / blood
  • Thyroid Neoplasms / diagnostic imaging
  • Thyroid Neoplasms / radiotherapy*
  • Thyroid Neoplasms / surgery
  • Thyroidectomy
  • Thyrotropin / blood
  • Thyrotropin / metabolism*
  • Thyroxine / adverse effects*
  • Thyroxine / blood
  • Thyroxine / therapeutic use

Substances

  • Iodine Radioisotopes
  • Radiopharmaceuticals
  • Thyrotropin
  • Thyroxine