2025 Korean Thyroid Association Management Guidelines for Radioactive Iodine Therapy in Patients with Hyperthyroidism
10.11106/ijt.2025.18.1.65
- Author:
Kyeong Jin KIM
1
;
Eyun SONG
;
Mijin KIM
;
Hyemi KWON
;
Eu Jeong KU
;
Hyun Woo KWON
;
Jee Hee YOON
;
Eun Kyung LEE
;
Won Woo LEE
;
Young Joo PARK
;
Dong-Jun LIM
;
Sun Wook KIM
;
Ho-Cheol KANG
;
Jae Hoon CHUNG
;
Tae Yong KIM
;
Sin Gon KIM
;
Dong Gyu NA
;
Jee Soo KIM
Author Information
1. Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
- Publication Type:REVIEW ARTICLE
- From:International Journal of Thyroidology
2025;18(1):65-79
- CountryRepublic of Korea
- Language:English
-
Abstract:
Hyperthyroidism is a clinical condition characterized by excessive production of thyroid hormones, leading to thyrotoxicosis, with Graves’ disease being the most common underlying etiology. The treatment options for hyperthyroidism include antithyroid drug (ATD) therapy, radioactive iodine (RAI) therapy, and thyroidectomy. To establish standardized clinical recommendations specific to RAI therapy focusing on the safety, efficacy, pre- and post-treatment protocols, and follow-up monitoring, the Korean Thyroid Association convened a Task Force dedicated to developing evidence-based guidelines. Six key clinical questions were identified through expert panel discussion. A systematic review of literature published between 2013 and 2022 was conducted using PubMed and Embase with “hyperthyroidism” and “Graves’ disease” as search terms. Additional studies published during manuscript development were also included. The guideline classifies the clinical indications for RAI therapy into three categories: cases in which RAI is strongly recommended, may be considered, or not recommended. A fixed dose of 10–15 mCi is recommended for RAI therapy. While a routine low-iodine diet is not required, patients should avoid iodine-rich foods for at least one week before treatment. ATD should be discontinued 3–7 days prior to RAI and may be resumed afterward in selected cases. Prophylactic glucocorticoids are advised for patients with mild active thyroid eye disease and may be considered in those with additional risk factors. Thyroid function should be monitored at 4–6 weeks post-treatment, then every 2–3 months until stabilization, and subsequently at 6–12 month intervals or as clinically indicated. This guideline reflects recent advances in RAI therapy for hyperthyroidism and emphasizes the importance of individualized treatment decisions based on clinical characteristics, comorbidities, and patient preferences in Korea.
