Treatment of Hyperthyroidism with Sodium Ipodate (Oragrafin) in Addition to Propylthiouracil and Propranolol*

Abstract

Ten patients with hyperthyroidism due to Graves' disease were treated with sodium ipodate (1 g daily) in addition to propranolol (P) plus propylthiouracil (PTU; 100 mg every 8 h) and were compared with a control group of 8 patients treated with P and PTU. Patients on P and PTU had a mean (+/- SEM) basal free T3 index of 387 +/- 59 (normal, 70--160) compared with that of 409 +/- 47 (P greater than 0.05) in the sodium ipodate group. The respective basal free T4 index values (normal, 4.5-10.9) were 21.3 +/- 2.8 for the controls and 25.9 +/- 2.8 for the ipodate group (P greater than 0.5), and the basal rT3 values were 192 +/- 49 and 210 +/- 41 (normal, 16--50 ng/dl; P greater than 0.05). The average percent changes in each thyroid index and rT3 were calculated. The first 3 days on P and PTU served as the basal period for the control group, and comparisons were made to the following 9 days. The ipodate group received P and PTU for 2.7 +/- 3.0 days, and comparisons were made with the interval on ipodate, P, and PTU (mean, 9.1 +/- 0.9 days). For the free T3 index, the control group showed a mean decrement of 20.5 +/- 4.4% compared with 50.2 +/- 3.1% for the ipodate group (P less than 0.001). The respective free T4 index decrements were 14.5 +/- 4.4% and 18.5 +/- 2.7% (P greater than 0.05). The respective changes in rT3 were -13.4 +/- 7.6% and +140 +/- 26.9% (P less than 0.001). In patients with hyperthyroidism, short term daily therapy with sodium ipodate plus P and PTU produces a greater reduction of free T3 index values than that caused by P and PTU alone.

Sources of Circulating 3,5,3′-Triiodothyronine in Hyperthyroidism Estimated after Blocking of Type 1 and Type 2 Iodothyronine Deiodinases

“…Ipodate or similar compounds have been found useful for short-term therapy of hyperthyroidism (16,17) and for special indications (18) but less effective for prolonged therapy (19). In our study, PTU plus ipodate gave the most profound decrease in serum T 3 with a decrease in the T 3 /T 4 % in serum to around one third of the initial value.…”

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

“…Thirdly, as 500 mg of SI contains 308 mg iodine, large amounts of iodine are released during its metabolism, resulting in the inhibition of the organifica tion of iodine (Wolff-Chaikoff effect) [5] and of thyroid hormone release [6], Furthermore, SI seems to inhibit the hormonal secretion of the thyroid also by a direct effect which is independent of the inhibition induced by iodine [3,7,8]. It has been shown that during treatment with SI plasma T4 values decrease by 20-31 % in thyro toxic Graves' patients [1,[9][10][11][12][13], but remain unchanged or even rise in healthy adults [1,14,15]; on the other hand, plasma T3 values decrease by 67-76% in thyro toxic Graves' patients and by 25-55% in healthy adults [1,[9][10][11][12][13][14][15].…”