Hyperthyroidism iodide therapy

The administration of SSKI a few days after for the treatment of hyperthyroid Graves disease and continued for weeks later has been reported to more rapidly ameliorate the symptoms of thyrotoxicosis and to reduce the dose of l necessary to effectively treat the hyperthyroidism (10). However, hypothyroidism not infrequently occurred during iodide therapy and disappeared when iodides were discontinued. Years ago, we reported that the administration of 5 drops SSKI to euthyroid patients treated years earlier with 1 or surgery for Graves disease almost always induced hypothyroidism within weeks (11). The euthyroid state rapidly returned when the iodine was withdrawn. It is likely that these... 

Blockers are usually used as adjunctive therapy with antithyroid drugs, RAI, or iodides when treating Graves disease or toxic nodules in preparation for surgery or in thyroid storm. /3-Blockers are primary therapy only for thyroiditis and iodine-induced hyperthyroidism. 

Thionamides are the most important class of antithyroid compounds in clinical practice used in nondestructive therapy of hyperthyroidism. These agents are potent inhibitors of TPO, which is responsible for the iodination of tyrosine residues of thyroglobulin and the coupling of iodotyrosine residues to form iodothyronines. These drugs have no effect on the iodide pump or on thyroid hormone release. The most clinically useful thionamides are thioureylenes, which are five- or six-membered heterocyclic derivatives of thiourea and include the thiouracil 6-n-propyl-2-thiouracil (PTU) and the thioimidazole 1-methyl-2-mercaptoimidazole (methimazole, Tapazole, MMI). The uptake of these drugs into the thyroid gland is stimulated by TSH and inhibited by iodide. 

In another study of the possible effects of iodide intake on thyroid function in 10 patients on lithium therapy, 3 to 5 weeks of potassium iodide caused hypothyroidism in 2 patients and hyperthyroidism in one. Little effect on thyroid function was seen in 5 control patients given potassium iodide without lithium. A case of hypothyroidism involving lithium and a product containing isopropamide iodide plus haloperidol (Vesalium) has also been reported. ... 

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