A 28-year-old woman visits her physician complaining of fatigue, palpitations, loss of weight, diarrhea and irritability for 4 months. She is also intolerant to hot weather. She does not smoke or drink coffee or alcohol. Her vital signs are within normal limits except for rapid regular pulse. She has fine tremors and her skin is warm and moist. Her thyroid gland is asymmetrically enlarged and lobulated. Laboratory tests show:
Thyroid stimulating hormone (TSH) 0.02 mu/ml and T4 28 mu/dL
Her physician discusses advantages and disadvantages of all treatment options with the patient.
What is the most important disadvantage of radioactive iodine therapy?
A- Anemia and agranulocytosis
C- Ablation of the gland and future hypothyroidism
D- Repeated doses due to repeated failures
E- Acute renal failure
Radioactive iodine therapy is the treatment of choice for hyperthyroidism with complications. It leads to ablation of the gland and future hypothyroidism. Patients should be informed before starting treatment of radioactive iodine therapy about the possibility of receiving long life treatment of levothyroxine.
The correct answer is C