Skip to main content

Main menu

  • Home
  • Content
    • Current
    • Ahead of print
    • Past Issues
    • JNM Supplement
    • SNMMI Annual Meeting Abstracts
  • Subscriptions
    • Subscribers
    • Rates
    • Journal Claims
    • Institutional and Non-member
  • Authors
    • Submit to JNM
    • Information for Authors
    • Assignment of Copyright
    • AQARA requirements
  • Info
    • Permissions
    • Advertisers
    • Continuing Education
    • Corporate & Special Sales
  • About
    • About Us
    • Editorial Board
    • Editorial Contact
  • More
    • Alerts
    • Feedback
    • Help
    • SNMMI Journals
  • SNMMI
    • JNM
    • JNMT
    • SNMMI Journals
    • SNMMI

User menu

  • Subscribe
  • My alerts
  • Log in
  • My Cart

Search

  • Advanced search
Journal of Nuclear Medicine
  • SNMMI
    • JNM
    • JNMT
    • SNMMI Journals
    • SNMMI
  • Subscribe
  • My alerts
  • Log in
  • My Cart
Journal of Nuclear Medicine

Advanced Search

  • Home
  • Content
    • Current
    • Ahead of print
    • Past Issues
    • JNM Supplement
    • SNMMI Annual Meeting Abstracts
  • Subscriptions
    • Subscribers
    • Rates
    • Journal Claims
    • Institutional and Non-member
  • Authors
    • Submit to JNM
    • Information for Authors
    • Assignment of Copyright
    • AQARA requirements
  • Info
    • Permissions
    • Advertisers
    • Continuing Education
    • Corporate & Special Sales
  • About
    • About Us
    • Editorial Board
    • Editorial Contact
  • More
    • Alerts
    • Feedback
    • Help
    • SNMMI Journals
  • Follow SNMMI on Twitter
  • Visit SNMMI on Facebook
OtherLetters to the Editor

Reply: Antithyroid Drugs and Radioiodine and the Absence of Evidence

I. Ross McDougall and Andrei Iagaru
Journal of Nuclear Medicine August 2007, 48 (8) 1403b-1404; DOI: https://doi.org/10.2967/jnumed.107.041897
I. Ross McDougall
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Andrei Iagaru
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Info & Metrics
  • PDF
Loading

REPLY: We thank Professor Walter et al. for their kind remarks about our review on the treatment of thyrotoxicosis (1). Their comments concerning the effect of methimazole on radioiodine therapy are acknowledged. They point out their new data opposing their previously published data showing that methimazole did not increase resistance to 131I (2,3). We are not sure who should receive attribution for the statement that 50% of medical dogma is wrong, the corollary being that if we knew which half we would be in excellent shape.

The ability of antithyroid medications to increase resistance to radiation has been recognized for several decades, but so has the importance of that ability been debated (4). There are those who support that both methimazole and propylthiouracil cause a higher likelihood of failure of 131I and an increased need to retreat the patient. However, at the time of submission and resubmission of our article (October 30, 2006, and January 2, 2007, respectively), the weight of evidence indicated that propylthiouracil and not methimazole was the culprit (5,6). We hope that Walter et al. do not think less of us for failing to include the reference to their metaanalysis. However, their article was published on March 10, 2007 (3). Were we now writing the review, we would most certainly be including their observations. We would also like to reiterate that we recommend stopping methimazole for 5 d rather than 3 d. The paper that we did cite by Walter et al., from 2006, dealt with the shorter stoppage (2). We also believe that administration of 5.92 MBq (160 μCi) of 131I per gram to be retained in the gland is sufficient for a single-dose cure even in patients who were pretreated with antithyroid medications. Physicians using smaller doses might consider an upward adjustment.

We would like to take this opportunity to correct an omission in our review. In discussing the use of lithium as an adjuvant to radioiodine therapy, we quoted the results of a study by Bal et al. but did not include the citation. We are sorry for that oversight and have listed the reference below (7).

Footnotes

  • COPYRIGHT © 2007 by the Society of Nuclear Medicine, Inc.

References

  1. 1.↵
    Iagaru A, McDougall IR. Treatment of thyrotoxicosis. J Nucl Med. 2007;48:379–389.
    OpenUrlAbstract/FREE Full Text
  2. 2.↵
    Walter MA, Christ-Crain M, Schindler C, Muller-Brand J, Muller B. Outcome of radioiodine therapy without, on or 3 days off carbimazole: a prospective interventional three-group comparison. Eur J Nucl Med Mol Imaging. 2006;33:730–737.
    OpenUrlCrossRefPubMed
  3. 3.↵
    Walter MA, Briel M, Christ-Crain M, et al. Effects of antithyroid drugs on radioiodine treatment: systematic review and meta-analysis of randomised controlled trials. BMJ. 2007;334:514.
    OpenUrlAbstract/FREE Full Text
  4. 4.↵
    Crooks J, Buchanan WW, Wayne EJ, Macdonald E. Effect of pretreatment with methylthiouracil on results of I-131 therapy. Br Med J. 1960;1:151–154.
    OpenUrlFREE Full Text
  5. 5.↵
    Imseis RE, Vanmiddlesworth L, Massie JD, Bush AJ, Vanmiddlesworth NR. Pretreatment with propylthiouracil but not methimazole reduces the therapeutic efficacy of iodine-131 in hyperthyroidism. J Clin Endocrinol Metab. 1998;83:685–687.
    OpenUrlCrossRefPubMed
  6. 6.↵
    Santos RB, Romaldini JH, Ward LS. Propylthiouracil reduces the effectiveness of radioiodine treatment in hyperthyroid patients with Graves' disease. Thyroid. 2004;14:525–530.
    OpenUrlCrossRefPubMed
  7. 7.↵
    Bal CS, Kumar A, Pandey RM. A randomized controlled trial to evaluate the adjuvant effect of lithium on radioiodine treatment of hyperthyroidism. Thyroid. 2002;12:399–405.
    OpenUrlCrossRefPubMed
PreviousNext
Back to top

In this issue

Journal of Nuclear Medicine: 48 (8)
Journal of Nuclear Medicine
Vol. 48, Issue 8
August 2007
  • Table of Contents
  • Table of Contents (PDF)
  • About the Cover
  • Index by author
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on Journal of Nuclear Medicine.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Reply: Antithyroid Drugs and Radioiodine and the Absence of Evidence
(Your Name) has sent you a message from Journal of Nuclear Medicine
(Your Name) thought you would like to see the Journal of Nuclear Medicine web site.
Citation Tools
Reply: Antithyroid Drugs and Radioiodine and the Absence of Evidence
I. Ross McDougall, Andrei Iagaru
Journal of Nuclear Medicine Aug 2007, 48 (8) 1403b-1404; DOI: 10.2967/jnumed.107.041897

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Reply: Antithyroid Drugs and Radioiodine and the Absence of Evidence
I. Ross McDougall, Andrei Iagaru
Journal of Nuclear Medicine Aug 2007, 48 (8) 1403b-1404; DOI: 10.2967/jnumed.107.041897
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Footnotes
    • References
  • Info & Metrics
  • PDF

Related Articles

  • No related articles found.
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • The importance of an adequate surgical template during salvage lymph node dissection for node-recurrent prostate cancer
  • Quantification of the αvβ6 Integrin by PET/CT Imaging in the Lungs of Patients after SARS-CoV2 Infection and Comparison to Fibrotic Lungs
  • PSMA-Targeted Therapeutics: A Tale About Law and Economics
Show more Letters to the Editor

Similar Articles

SNMMI

© 2021 Journal of Nuclear Medicine

Powered by HighWire