Rapid blockade with sodium ipodate in the pre-surgical management of thyrotoxicosis

S Ball

University of Newcastle and Department of Endocrinology, Newcastle Hospitals NHS Trust,
Newcastle NE1 4LP, UK

Summer School 5-8 July 2005
St Aidan’s College, Durham University, Durham, UK

Thyroidectomy is an effective treatment for Graves’ Disease (GD). However, a significant number of patients are intolerant of antithyroid drugs (ATD). Moreover, patients with active thyrotoxicosis may require surgery for interim disease prior to euthyroidism. Optimum pre-surgical management of both groups is unclear. Rapid thyroid blockade (RTB) with the contrast agents Sodium Ipodate (SI) or Iopanoic Acid (IA) is an attractive option. These agents utilize the Wolff-Chiakoff effect to reduce thyroid hormone secretion and, in addition, reduce the conversion of Thyroxine (T4) to Triiodothyronine (T3). Together, this results in prompt and effective reduction in circulating thyroid hormone levels and renders the patient in a safe condition for surgery. This presentation will discuss the mechanism of action of these agents, the evidence-base for the clinical effectiveness and demonstrate the utility of this approach in clinical practice.

The opinions expressed in this paper are those of the speaker and do not necessarily reflect the views of the Society

Revised: 28-Jul-2005