I am wondering what is the proper way to prepare a patient with toxic adenoma prior to rai. How long and how much t4 do we give? How about those patients who are clinically and biochemically toxic? Thanks so much Doctor for your generosity.
L. W.Bilar, MD
Usually in patients with a single toxic adenoma the rest of the thyroid is quite suppressed, so that there is little or no RAIU. In this situation the nodule can be treated, with only modest radiation to the rest of the gland, and typically with no preparation other than the RAIU and scan. If the patient is highly toxic, certainly pre-treatment with antithyroid drugs is possible, but rarely needed. Does this answer your questions?
L De Groot,MD