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Radioactive Iodine Most Effective Treatment for Hyperthyroidism

By MedImaging International staff writers
Posted on 12 Feb 2020

New guidelines issued in the UK for the treatment of hyperthyroidism, including Graves' disease, place heavier emphasis on the use of radioactive iodine as the frontline treatment for patients unlikely to remain remission-free on medication.

The guideline summary, compiled by researchers from the Royal College of Physicians (London, UK), the University of Birmingham (UB; United Kingdom), and the Royal College of Obstetricians and Gynaecologists (London, UK), are part of broader guidelines on thyroid disease issued by the UK National Institute for Health and Care Excellence ((NICE; London, United Kingdom), which concludes that radioactive iodine results in cure in as many as 90% of hyperthyroidism cases.

The new NICE guidelines cite five randomized controlled trials of people with hyperthyroid disease, which collectively indicate that long-term outcomes were improved with radioactive iodine treatment compared with antithyroid drugs, despite the former having a higher risk of thyroid eye disease (also known as Graves' ophthalmopathy). In addition, eight nonrandomized studies show no evidence of a clinically important increase in cancer diagnoses or deaths between those treated with radioactive iodine and healthy controls. The guideline was published on January 29, 2020, in BMJ.

“The strongest arguments in favor of radioactive iodine as a first-line therapy were the likelihood of inducing remission of Graves' disease with radioactive iodine, the finding that radioiodine is a safe treatment, and the reduction in the need for patients to remain on antithyroid drugs, which may have significant side effects,” said senior author Kristien Boelaert, MD, PhD, of UB. “We are very pleased to have been able to work with NICE to provide clear new guidance which we hope will improve outcomes for patients with this condition.”

Most cases of hyperthyroidism are due to Graves’ disease, an autoimmune disease of the thyroid, an endocrine gland in the neck that produces two hormones secreted into the bloodstream, thyroxine (T4) and triiodothyronine (T3); T4 is converted to T3 in cells and tissues. The hormones regulate metabolism. Thyroid disorders include hypothyroidism, hyperthyroidism, nodules, cancer, Graves’ disease, and post-partum thyroiditis. The prevalence of hyperthyroidism is about 1.2% (0.5% overt and 0.7% subclinical).

Related Links:
Royal College of Physicians
University of Birmingham
Royal College of Obstetricians and Gynaecologists
UK National Institute for Health and Care Excellence

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69 (28.848648071289): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=213 ORDER BY `ordering`

70 (278.94973754883): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294780836 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (426.05400085449): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294780836 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (689.02969360352): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (!!!!! 7600.0690460205): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (!!!!! 8025.8846282959): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (!!!!! 6090.1641845703): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (!!!!! 9763.9560699463): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (!!!!! 1430.9883117676): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (571.96617126465): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (491.14227294922): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (105.14259338379): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (57.93571472168): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (940.08445739746): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (220.06034851074): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (38.862228393555): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (157.11784362793): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (!!!!! 4224.0619659424): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294780836 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (225.06713867188): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294780836 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (241.04118347168): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (78.916549682617): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (709.05685424805): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (46.968460083008): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (24.795532226562): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (92.983245849609): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294780836 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294780836 AND published='1' LIMIT 1

105 (70.095062255859): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294780836 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294780836 AND published='1' LIMIT 1

106 (135.89859008789): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294780836 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (56.028366088867): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294780836 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 1018.0473327637): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294780836 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294780836 AND published='1' LIMIT 1

109 (!!!!! 4034.0423583984): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294780836 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294780836 AND published='1' LIMIT 1

110 (57.93571472168): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294780836 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (514.03045654297): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294780836 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (!!!!! 10462.999343872): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (!!!!! 5349.87449646): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (769.13833618164): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294780836 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294780836 AND published='1' LIMIT 1

115 (!!!!! 2336.0252380371): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294780836 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294780836 AND published='1' LIMIT 1

116 (!!!!! 2118.1106567383): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294780836 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294780836 AND published='1' LIMIT 1

117 (381.9465637207): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294780836 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294780836 AND published='1' LIMIT 1

118 (!!!!! 1494.8844909668): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294780836 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294780836 AND published='1' LIMIT 1

119 (!!!!! 1940.9656524658): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294780836 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294780836 AND published='1' LIMIT 1

120 (484.94338989258): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 150691.03240967): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

122 (123.97766113281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294780836 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294780836 AND published='1' LIMIT 1

123 (71.048736572266): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294780836 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294780836 AND published='1' LIMIT 1

124 (612.02049255371): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294780836 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294780836 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 1444471.1208344): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (!!!!! 7965.087890625): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (!!!!! 4182.8155517578): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

128 (!!!!! 11674.880981445): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

129 (!!!!! 4138.9465332031): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

130 (!!!!! 7592.9164886475): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

131 (!!!!! 7087.9459381104): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

132 (!!!!! 7977.0088195801): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

133 (957.96585083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294780836 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (493.04962158203): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294780836 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (765.08522033691): SELECT name FROM jos_deeppockets WHERE id=213

136 (200.98686218262): SELECT name FROM jos_deeppockets WHERE id=213

137 (448.94218444824): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))213((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

138 (604.15267944336): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))213((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (!!!!! 1745.9392547607): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294780836 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294780836 AND published='1' LIMIT 1

140 (81.062316894531): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294780836 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294780836 AND published='1' LIMIT 1

141 (!!!!! 17032.146453857): TRUNCATE TABLE jos_trademed_module

142 (!!!!! 5331.9931030273): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294780836 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (612.97416687012): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294780836 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (!!!!! 2355.0987243652): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294780836 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (92.029571533203): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294780836 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (!!!!! 3714.0846252441): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294780836 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294780836 AND published='1' LIMIT 1

147 (345.94535827637): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294780836 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294780836 AND published='1' LIMIT 1

148 (!!!!! 1322.0310211182): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

149 (64.849853515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294780836 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294780836 AND published='1' LIMIT 1

150 (43.869018554688): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294780836 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294780836 AND published='1' LIMIT 1

151 (!!!!! 2305.0308227539): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294780836 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294780836 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (!!!!! 3901.9584655762): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=213 or channel_id is null)

153 (45.061111450195): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=213 or channel_id is null)

154 (36.954879760742): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (88.214874267578): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294780836 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294780836 AND published='1' LIMIT 1

156 (70.095062255859): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294780836 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294780836 AND published='1' LIMIT 1

157 (385.99967956543): select jos_twitters.link from jos_twitters where cat=10

158 (47.922134399414): select jos_facebook.link from jos_facebook where cat=10

159 (39.100646972656): select jos_google_plus.link from jos_google_plus where cat=10

160 (36.954879760742): select jos_linkedin.link from jos_linkedin where cat=10

161 (304.9373626709): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 2134.0847015381): insert into jos_banners_delta values (14615,'2025-04-30 03:40:49','3.145.208.57','view'),(14202,'2025-04-30 03:40:49','3.145.208.57','view'),(14203,'2025-04-30 03:40:49','3.145.208.57','view')

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