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Radioiodine treatment for benign thyroid disorders: results of a nationwide survey of UK endocrinologists

Lookup NU author(s): Dr Bijayeswar Vaidya, Professor Simon Pearce

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Abstract

Background A survey of physicians' practice relating to radioiodine administration for hyperthyroidism was carried out in the UK over 15 years ago and showed wide variations in patient management. This led to the development of national guidelines for the use of radioiodine in hyperthyroidism. As there have been significant advances in the field since that survey, we carried out another survey to study the prevalent practices relating to radioiodine therapy for benign thyroid disorders across the UK. Subjects and methods We mailed 698 UK consultant endocrinologists a questionnaire on radioiodine treatment based on three patient scenarios: hyperthyroid Graves' disease, subclinical hyperthyroidism and nontoxic goitre. Results The response rate was 40%. For the scenario of an initial presentation of Graves' disease, 80%, 19% and 0·4% of respondents preferred thionamide, radioiodine or thyroidectomy, respectively. There were inconsistencies in respondents' recommendations on radioiodine dose, the use of pre- and post-radioiodine supplementary treatments, timing of a repeat dose, and the use of radioiodine in thyroid eye disease. For the case of subclinical hyperthyroidism, one-third of respondents would generally initiate treatment. The majority were more likely to treat subclinical hyperthyroidism in the presence of paroxysmal atrial fibrillation or osteoporosis. If a decision were made to treat subclinical hyperthyroidism, 63%, 35%, 1% and 0·4% would recommend radioiodine, thionamide, beta-blocker and thyroidectomy, respectively. For the scenario of nontoxic goitre, 62%, 21%, 13% and 5% favoured observation, thyroidectomy, radioiodine and thyroxine, respectively. Conclusions There remain significant differences in several aspects of clinical practice relating to the use of radioiodine treatment for benign thyroid disorders in the UK.


Publication metadata

Author(s): Vaidya B, Williams GR, Abraham P, Pearce SHS

Publication type: Article

Publication status: Published

Journal: Clinical Endocrinology

Year: 2008

Volume: 68

Issue: 5

Pages: 814-820

Date deposited: 05/08/2008

ISSN (print): 0300-0664

ISSN (electronic): 1365-2265

Publisher: Wiley-Blackwell

URL: http://dx.doi.org/10.1111/j.1365-2265.2007.03097.x

DOI: 10.1111/j.1365-2265.2007.03097.x


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