Principle of iodine treatment for hyperthyroidism

In the process of treating hyperthyroidism, we must have heard of iodine. Iodine has a good alleviating effect on hyperthyroidism, but we should use it correctly under the advice and guidance of a doctor to avoid blind treatment. Because iodine may have many side effects, we should be careful when using it and avoid consuming spicy and greasy foods. So, what is the principle of using iodine to treat hyperthyroidism and what are the precautions?

1. Diagnosis

1. There is a recent history of increased iodine intake and clinical manifestations of hyperthyroidism: tachycardia, sweating, fatigue, weight loss, etc.

2. Laboratory examination showed that blood FT4 and FT3 were elevated, but not proportional to the increase in T4; TSH was decreased; and the iodine absorption rate was decreased (type 2 iodine-induced hyperthyroidism).

3. Thyroid scans can reveal the presence of "hot areas" (only seen in patients with "autonomous hot nodules of thyroid function").

4. Other causes of hyperthyroidism should be ruled out.

II. Treatment

Iodine-induced hyperthyroidism is relatively self-relieving, and treatment must stop supplementing with additional iodine. Due to the increase in thyroid iodine storage and plasma iodine, hyperthyroidism often persists for weeks to months. After stopping additional iodine, hyperthyroidism can be relieved naturally. Mild cases can be treated with beta-blockers alone, and severe cases can be treated with antithyroid drugs for a short period of time. Surgery is generally not required. Due to the low iodine uptake rate of the thyroid gland, radioactive iodine treatment is not suitable. Hyperthyroidism caused by amiodarone can be treated with antithyroid drugs (methimazole or propylthiouracil) and 1g of potassium perchlorate at the same time. The effect can be seen in 3 weeks, and the treatment lasts for 2 months. Thyroid function should be tested every week. Because potassium perchlorate has the side effect of suppressing bone marrow, blood routine should be checked every 2 weeks, and bone marrow examination should be performed if necessary. Treatment lasts for 8 weeks. If T4 drops to the normal range, potassium perchlorate should be stopped and the dose of anti-thyroid drugs should be reduced. If T4 remains elevated after 2 to 4 weeks of treatment, prednisone should be increased to 40 to 60 mg/day. Surgical treatment may also be considered for patients with unsatisfactory control of hyperthyroidism.

Since iodine has the property of inducing hyperthyroidism, the dosage of iodine should be appropriate when preventing and treating endemic goiter, especially for those with thyroid nodules. For those with non-iodine-deficient nodular goiter, the use of iodine agents should be avoided, and those who take amiodarone for a long time should pay attention to follow-up. Nearly half of the patients with iodine-induced hyperthyroidism can recover on their own after stopping medication, with an average time of about 5.5 months.

3. Prevention

Iodine-induced hyperthyroidism often occurs in patients with thyroid abnormalities, so patients with thyroid diseases (including goiter, hyperthyroidism, chronic thyroiditis, etc.) need to avoid some high-iodine foods and medicines (such as kelp, seaweed, iodine contrast agents and amiodarone, etc.). If you need to take high-iodine foods or medicines for treatment or other reasons, you need to do thyroid function tests during and after treatment to detect problems early and deal with them early.