Radioiodine therapy in elderly patients with subclinical hyperthyroidism due to non-voluminous nodular goiter and its effect on bone metabolism
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OBJECTIVE: To evaluate 131I therapy in elderly patients with subclinical hyperthyroidism (SCH) due to nodular disease and who did not receive antithyroid drugs (ATDs), and the effect of the treatment on bone metabolism. SUBJECTS AND METHODS: Thirty-six patients with TSH ≤ 0.1 mIU/L and non-voluminous goiter (< 60 cm³) were studied. Bone mineral density (BMD) was assessed in 17 women with osteopenia. RESULTS: Mean 24-h 131I uptake was 17.5%. Symptoms of thyrotoxicosis were reported by two (5.5%) patients in the first week after therapy. One year after radioiodine treatment, SCH was resolved in 30 (83.3%) patients, and hypothyroidism was detected in one (2.7%). In the patients in whom TSH returned to normal, femoral and lumbar spine BMD increased by 1.9% and 1.6%, respectively, in average. CONCLUSIONS: In elderly patients with SCH and non-voluminous goiter, radioiodine not preceded by ATDs is a safe and effective therapeutic alternative. Resolution of SCH has beneficial effects on BMD in postmenopausal women with osteopenia.
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There are smaller, nonrandomized trials that have shown improvement in bone mineral density with therapy of SH with ATDs or RAI.
“There are smaller, nonrandomized trials that have shown improvement in bone mineral density with therapy of SH with ATDs or RAI (414-417).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [417]
The evidence rests only with small uncontrolled studies that have shown improvements in cardiac structure and function, heart rate and the frequency of premature atrial and ventricular beats, bone mineral density, and muscle strength.
“Thus, the evidence rests only with small uncontrolled studies that have shown improvements in cardiac structure and function, heart rate and the frequency of premature atrial and ventricular beats, bone mineral density, and muscle strength (393)(394)(395)(396)405,(414)(415)(416)(417)426).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [417]
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References 17 · Cited by 19
Research works printed but not linked: 1
- Faber J, Jensen IW, Petersen L, Nygaard B, Hegedus L, Siersbaek- -Nielsen K. Normalization of serum thyrotropin by mean of radio- iodine treatment in subclinical hyperthyroidism: effect of bone loss in postmenopausal women. Clin Endocrinol (Oxf). 1998;48:285-90.
- Authors
- Rosario, P. W.
- Venue
- Arquivos Brasileiros de Endocrinologia & Metabologia
- Publisher
- FapUNIFESP (SciELO)
- Published
- 2013-03
- Volume
- 57
- Issue
- 2
- Pages
- 144-147
- ISSN
- 0004-2730 (ISSN-L)
- OpenAlex
- W2160619040
- Cited by
- 19
- References
- 17
- Citations by year
- 2025: 1 · 2024: 3 · 2022: 4 · 2021: 1 · 2020: 3 · 2017: 1 · 2016: 1 · 2015: 3 · 2014: 1 · 2013: 1
- FWCI
- 1.57
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by-nc
- Locations
- Arquivos Brasileiros de Endocrinologia & Metabologia (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (publishedVersion, other-oa)
- Americanae (AECID Library) (submittedVersion, cc-by-nc)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
- Keywords
- radioiodine therapy, subclinical hyperthyroidism, nodular goiter, elderly patients, bone mineral density, bone metabolism, osteopenia, postmenopausal women, antithyroid drugs, hypothyroidism, 131I uptake, thyrotoxicosis
- MeSH terms
- Aged, Aged, 80 and over, Female, Goiter, Nodular, Humans, Hyperthyroidism, Iodine Radioisotopes, Bone Density, Osteoporosis, Postmenopausal
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