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Dr. Richard Guttler's Twitter Updates

2 years after I writing the questions for ultrasound certification, I was finally allowed to take the test.Many were certified before me. 5 days ago
Are your eyes bugged?Do you have Hashimoto's?10 % have a crossover disease of Graves/Hash. Hypothyroid due to HASH,& Bug Eyes from Graves. 5 days ago
Pregnant thyroid patient:You need an endo to follow you, not just the OB. Too many things can go wrong if you are not followed closely. 5 days ago
Family history of thyroid cancer? Children age 6-puberty have the risk of a more aggressive cancer. Get a screening consult and ultrasound. 5 days ago
Men with a family history of thyroid disease, are at risk. Your neck is thick, & the GP can't feel your big goiter. Ask for a consultation. 5 days ago
 

Iodine Induced Graves' Disease Why Treat with Iodine?

Posted Jun 24 2009 7:01pm
48 Y/O Female with hypothyroidism was treated with iodine pills and T3 cytomel. While on high dose T3 and iodine, she developed double vision and pop eye on the right. MR= swollen eye muscles=Graves Eye Disease.The patient was hyperthyoid on examination. The thyroid was enlarged, firm, and Ultrasound showed Graves'firestorm blood flow. The iodine was stopped, as was the T3. She was started on beta blocker and a I/123 uptake was planned. No ultrasound was ever done.A real time ultrasound was positive. Several nodules were suspicious for cancer.A Biopsy was done, and it was negative for cancer.The patient was cooled off with beta blocker, and was treated with RAI/131.The eye disease stabilized and then a muscle relocation procedure cured the double vision.
What did we learn?
Always see an endocrinologist or thyroidologist if you are told by your primary MD, you have thyroid disease.
www.thyroidologists.com
www.aace.com
www.thyroid.org

Good luck,
Dr.G.
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