Effect of sodium ipodate and iodide on free T4 and free T3 concentrations in patients with Graves’ disease

Abstract

Graves' hyperthyroid patients were treated daily for 10 days with 1 g sodium ipodate, a cholecystographic agent which exerts a blocking effect on the peripheral conversion of T4 to T3, or with 12 drops of saturated solution of potassium iodide (SSKI). Serum concentrations of free T4 (FT4) and free T3 (FT3) were measured before, during and 5 and 10 days after the administration of each drug. Sodium ipodate treatment induced a rapid decrement of serum FT4 concentrations which declined from 48.9 +/- 6.6 pg/ml to 26.0 +/- 2.7 pg/ml. In these patients serum FT3 concentrations declined from 12.4 +/- 2.0 pg/ml to 2.5 +/- 0.4 pg/ml. Ten days after sodium ipodate withdrawal, serum FT4 and FT3 concentrations returned to baseline values. In patients treated with SSKI serum FT4 concentrations declined from 51.1 +/- 8.8 pg/ml to 11.3 +/- 1.4 pg/ml and FT3 from 15.7 +/- 2 pg/ml to 2.6 +/- 0.3 pg/ml. Moreover, after therapy interruption serum free thyroid hormone concentrations returned to baseline values in these patients. Serum FT4 pattern during the study was not different between the two groups of subjects whereas serum FT3 concentrations were significantly lower in patients treated with sodium ipodate. These findings indicate that SSKI and sodium ipodate are effective in inducing a rapid decrement of serum free thyroid hormone concentrations. Therefore the employment of these drugs may be useful in the treatment of patients with thyroid storm and those undergoing thyroidectomy.

The Use of Oral Radiographic Contrast Agents in the Management of Hyperthyroidism

“…Basal and TRH-stimulated thyrotropin (TSH) values have been shown to increase or remain unchanged (2,(14)(15)(16)(22)(23)(24)(25)(26). In hyperthyroid subjects with Graves' disease, where there is increased expression of 59-MDI, T 4 levels decrease or remain unchanged (10,(27)(28)(29)(30)(31). In subacute thyroiditis, where there is uncontrolled release of thyroid hormones, and in euthyroid and hypothyroid subjects, serum T 4 levels increase or remain unchanged (2,12,15,16,25,26,32,33).…”

Sodium Ipodate in the Preparation of Graves’ Hyperthyroid Patients for Thyroidectomy

“…The use of SI in the preparation of thyrotoxic patients for thyroidectomy has been advocated but not yet been reported [24,25]. In the preparation of Graves' patients for thyroidectomy beta blockers, iodine, or thionamides, alone or in combination, have been used [24,[26][27][28][29].…”

Rapid Preparation of Hyperthyroid Patients for Thyroidectomy

“…Whi le Pan zer et al as ses sed se rum to tal T4, T3 and fT4 in dex and Ba e za et al as ses sed to tal T4, T3 and re ver se T3, we me a su red se rum fT3 and fT4 le vels, sin ce they mo re cor rectly ref lect the thyro id hor mo ne sta tus of pa ti ents. 3,8,9,16 Ho we ver, the ma jor dif fe ren ce bet we en IR CAs and LS ap pe ars to be the ti me re qu i red for res to ra ti on of euth yro i dism, which is shor ter with IR CAs, where as dec re ments in se rum fT4 le vels are gre a ter with LS.…”

“…8,9,11,12 Lu gol's so lu ti on (LS) (8 mg io di de/drop) and sa tu ra ted so lu ti on of po tas si um io di de (SSKI) (40 mg io di de/drop) are the ot her opti ons ava i lab le for use as an io di de do nor. [13][14][15][16] In the pre sent study, we ai med to in ves ti ga te the ef fects of LS used alo ne or to get her with thi o na mi des for the ra pid pre pa ra ti on of hyperth yro id pa ti ents for thyro id sur gery. In ad di ti on, we com pa red the ef fects of LS in hyperth yro id pa ti ents with Gra ves' di se a se (GD) and to xic mul ti no du lar go i ter (TMNG).…”