From the Research
Lugol's iodine is administered to patients with subclinical hyperthyroidism before total thyroidectomy to reduce thyroid vascularity and decrease the risk of intraoperative bleeding. The function of Lugol's iodine in this context is to inhibit thyroid hormone release, decrease thyroid gland size, and reduce the gland's blood supply by causing involution of the thyroid vasculature 1. This preparation makes the thyroid tissue firmer and less friable during surgery, allowing for easier dissection and potentially shortening operative time.
Some key points to consider when using Lugol's iodine in subclinical hyperthyroid patients prior to total thyroidectomy include:
- The typical regimen involves giving Lugol's solution (potassium iodide) for 7-10 days preoperatively, usually at a dose of 0.1-0.3 mL three times daily 2.
- For optimal effect, Lugol's solution should be started after the patient has achieved a euthyroid state with antithyroid medications if they were previously hyperthyroid 1.
- Patients should be informed that they might experience a metallic taste, mild gastrointestinal upset, or rarely, iodine allergic reactions 1.
- The solution should be taken with water or juice to mask the unpleasant taste and reduce gastric irritation 1.
It's also important to note that the use of Lugol's iodine in this context has been supported by studies, including one published in 2023, which highlights the importance of individualized treatment for hyperthyroidism 3. Another study published in 2016 found that Lugol's solution significantly reduced thyroid arterial blood flow, VEGF, and IL-16, even in patients with euthyroid Graves' disease 2.
Overall, the use of Lugol's iodine in subclinical hyperthyroid patients prior to total thyroidectomy is a recommended practice to reduce the risk of intraoperative bleeding and improve surgical outcomes 1, 2, 3.