2. Radioactive iodine. This treatment is used for either Graves Disease or toxic multinodular goitre (or for solitary toxic adenoma, a rare condition not discussed elsewhere). Iodine is incorporated into thyroid hormone being produced in the thyroid gland. If the incorporated iodine is radioactive the released gamma rays will damage the thyroid gland and lead inevitably to the destruction of the thyroid gland. For this reason radioactive iodine therapy (in a dose 100 times that used for the thyroid test mentioned above) is highly effective and need be given only once usually. Fewer than 10% patients require a second dose.

Because it leads to the destruction of the thyroid gland, thyroid function will eventually become low and will never recover. For this reason every individual who receives radioactive iodine should assume that he or she will eventually need to take replacement thyroid hormone (thyroxine) every day for the rest of his or her life. Most patients require replacement therapy within 6 months and almost every patient within 10 years.

Radioactive iodine is taken in a small glass of water, occasionally as a tablet and rarely by injection. It will not cause an individual to glow in the dark and will have completely left their system within 3-4 days. During that time an individual should not cuddle a baby closely to the neck. Other social activities may be maintained without risk or fear of contamination. Radioactive iodine must not be used if an individual is pregnant or may be pregnant. Women breast feeding must stop for 4 to 5 days after taking the treatment before resuming nursing.

3. Thyroid Surgery. For individuals with hyperthyroidism, surgery is reserved for difficult cases during pregnancy, for toxic multinodular goitre or toxic solitary nodule. Most individuals spend only 1 night in hospital post-operatively.

Dr. Tom Elliott is an active researcher and educator and the President of the BC Endocrine Research Foundation. He is also a busy physician treating individuals with endocrine disorders.