Surgery iodine-induced hyperthyroidism

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. 

The use of iodine has been held responsible for the increasing frequency of relapse of Graves disease in the USA. Treatment of more severe cases of iodine-induced hyperthyroidism can be difficult, as thyroid synthesis inhibitors are not immediately active and 131I cannot be used because of low thyroid uptake. The carefully supervised combination of perchlorate and methimazole is effective (40), but surgery has also occasionally been advocated. 

The direct and immediate treatment result, as opposed to the delayed effect of radioiodine, is another advantage of surgery. The latter may be particularly relevant to patients who require rapid correction of thyrotoxicosis in case of thyroid storm or severe iodine-induced hyperthyroidism. 

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 The euthyroid state rapidly returned when the iodine was withdrawn.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... 

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