How Long to Wait After Operation Before RAI Ablation?

Question

Dear experts-

In the literature it is always suggested that the radio iodine abalation is administered approx 4-6 weeks post operatively after total /near total thyroidectomy for ca. One of the reasons is for stimulation of TSH so it is at least above 30 mIU/L, but if this level of TSH is reached before this period (by end of first week?) can RAI be administered sooner ?

Thanks,

Hamda Saleh, Registrar
The Children's Hospital at Westmead, NSW, Australia

Response

I am not aware of any reason that one needs to wait longer than the interval required to raise the TSH, or of a study on the question. Note that the TSH may go up slowly or never reach 30 if a large amount of thyroid is left in place. The prior approach involved allowing patients to recover from the operation, and then preparing for ablation. Probably either way is acceptable.

Leslie J De Groot, MD