This version (2024/08/23 09:42) was approved by annie.tonks.

Hull University Teaching Hospitals NHS Trust - Nuclear Medicine

Uncontrolled if printed

SOP CodeTitleReview Date
REF007Radioiodine Treatment of Thyrotoxicosis Referral Criteria2027-08-23


Authorised By Authorising Role Authorisation Signature
(only on master paper copy)
Date Authorised
Prof. Sathyapalan ARSAC Licence Holder 2024-08-23

REF007 - Radioiodine Treatment of Thyrotoxicosis Referral Criteria

See REF000 - Referring to Nuclear Medicine (HUTH) for details of how to refer.

Description

Radioiodine therapy is a useful treatment for hyperthyroidism. In most cases it is the first-line treatment for solitary hyperfunctioning thyroid nodules or it can be administered if hyperthyroidism is not controlled or recurs after initial antithyroid drug treatment[1]. The radioiodine is in the form of a capsule and is administered orally. This is performed in an outpatient setting with the patient having to subsequently follow radiation protection restrictions regarding hygiene and close contact for a period of time dependent on the prescribed activity.

ARSAC Licence HoldersIndication
Dr Mo Ayetreatment of benign thyroid disease
Prof Thozhukat Sathyapalantreatment of benign thyroid disease

Radiation Protection Restrictions

Following the treatment the patient will be required to follow some radiation protection measures:

  • Good hygiene restrictions to prevent contamination with their bodily fluids
  • Close contact restrictions where they will have to distance from others to reduce the radiation exposure to them

If there is any reason to believe that the patient may have difficulties following these restrictions (e.g. if the patient has continence issues including use of a catheter and/or incontinence pads; requires assistance from carers or acts as a carer; or lives in a home not connected to mains drainage) please ensure the Nuclear Medicine department is informed and a note is included in the referral. Additional measures may be required in such cases and we may need to perform a radiation risk assessment before appointing the patient for treatment.

Staff Entitled to Refer

All UK Registered Endocrinologists may refer however referrals from individuals not listed below will have to be authorised by one of the ARSAC licence holders listed above.

Dr Mo Aye
Prof Thozhukat Sathyapalan
Mr R. England
Dr Shiva Mongolu
Dr Kamrudeen Mohammed
Mr Ashley Walden
Dr Rehmat Karim
Dr Sufyan Benamer

Contraindications

Absolute:Pregnancy[1][2]
Breastfeeding[1][2]
Relative:Uncontrolled hyperthyroidism[1]
Active thyroid orbitopathy (especially in smokers)[1]

Clinical Indications

Hyperthyroidism (Graves’ disease, toxic multinodular goitre, solitary toxic thyroid nodule)[1][3]
Non toxic multinodular/diffuse goitre [1][3]

The referral must indicate the prescribed activity of I-131 to be administered.

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