Lithium-enhanced radioactive iodine ablation of hyperthyroid patients

  • Emmanuel Nii Boye Hammond University of the Witwatersrand
  • Mboyo-Di-Tamba Heben Willy Vangu University of the Witwatersrand
Keywords: hyperthyroidism, lithium, radioactive iodine ablation, thyroid stimulating hormone, thyroxine

Abstract

Objective: The objective of this study was to compare the effect of adjuvant lithium therapy on the efficacy of radioactive iodine therapy in hyperthyroidism. Methods: This was a prospective simple randomised comparative, experimental cohort study of hyperthyroid patients for radioactive iodine (RAI) ablation therapy. A total of 163 of the 185 hyperthyroid patients recruited completed the study. Cure was defined by achievement of euthyroidism or hypothyroidism. Results: From of total of 163 patients, 75 received RAI alone and 88 received RAI with lithium. Those who received RAI with adjuvant lithium showed a higher cure rate (78.4%) compared with those who received RAI only (68.1%) (p = 0.002). At one month post RAI therapy, 27.4% of patients who received RAI with adjuvant therapy were cured. This finding showed a trend of being significant compared with just 14.5% cure rate in the group of patients who received RAI alone (p = 0.08). This is an indication of a faster cure rate for patients receiving RAI with lithium. Difference in mean T4 concentration at three months between RAI only (17.67 pmol/l) and RAI with lithium (11.55 pmol/l) was significant with a small size effect (U = 2328.5, Z = –2.700, p = 0.007, r = 0.01). A significant drop in T4 concentrations was observed between the baseline and one-month visit with small effect size (p = 0.001, r = 0.287) in patients who received both RAI and lithium. Conclusion: Adjuvant lithium therapy increases the efficacy of radioactive iodine treatment in hyperthyroidism by increasing overall cure rate and also shortening the time to cure. (Full text available online at www.medpharm.tandfonline.com/oemd) Journal of Endocrinology, Metabolism and Diabetes of South Africa 2016; DOI: 10.1080/16089677.2016.1228745

Author Biographies

Emmanuel Nii Boye Hammond, University of the Witwatersrand
Division of Nuclear Medicine and Molecular Imaging Department of Radiation Sciences Charlotte Maxeke Johannesburg Academic Hospital University of the Witwatersrand
Mboyo-Di-Tamba Heben Willy Vangu, University of the Witwatersrand
Division of Nuclear Medicine and Molecular Imaging Department of Radiation Sciences Charlotte Maxeke Johannesburg Academic Hospital University of the Witwatersrand
Published
2016-11-29
Section
Research Articles