From the Research
No, patients with Graves' disease should not be treated with SSKI prior to radioactive iodine ablation. The most recent and highest quality study, 1, which evaluated the efficacy of potassium iodide therapy for Graves' hyperthyroidism, does not support the use of SSKI before radioactive iodine therapy. In fact, administering SSKI before radioactive iodine therapy is contraindicated as it would significantly reduce the effectiveness of the ablation treatment. SSKI contains high concentrations of stable iodine which would compete with the radioactive iodine for uptake by the thyroid gland, resulting in less radioactive iodine being absorbed and therefore a less effective treatment.
Key Points to Consider
- The goal of radioactive iodine therapy is to deliver sufficient radiation to the thyroid to destroy the overactive thyroid tissue, and pre-treatment with iodine would interfere with this process.
- SSKI does have a role in preparing patients with Graves' disease for thyroid surgery, where it can help reduce thyroid vascularity and hormone release, typically given as 2-3 drops three times daily for 7-10 days before surgery.
- For radioactive iodine treatment, patients should instead avoid all iodine-containing medications and supplements for 1-2 weeks prior to treatment to maximize the effectiveness of the radioactive iodine, as suggested by 2 and 3.
Clinical Implications
- Clinicians should be aware of the potential interactions between SSKI and radioactive iodine therapy and avoid using SSKI before ablation treatment.
- Patients with Graves' disease should be carefully evaluated and managed to minimize the risk of complications and optimize treatment outcomes, as discussed in 4 and 5.