Should I be treated with antithyroid drugs for several months first, prior to receiving radioactive iodine for Graves disease?
The answer depends on how you are feeling and the severity of your hyperthyroidism. For example, if you are extremely ill, or have underlying heart disease with abnormal cardiac rhythms and/or symptoms of heart disease such as shortness of breath and chest pain, then pretreatment with antithyroid drugs first may be advisable. If you have mild to moderate hyperthyroidism which you are tolerating well, you may not need pretreatment with antithyroid drugs. In fact, patients pretreated for several months with PTU or methimazole prior to radioactive iodine will often experience a more severe rebound, albeit transient worsening of their hyperthyroidism after radioactive iodine. Discuss your clinical condition and this issue with your physician if you remain uncertain. More recent data suggests that a 48 hr period of discontinuation of antithyroid drugs prior to radioactive iodine may produce less severe rebound hyperthyroidism, and seems to give reasonable treatment results that are comparab
