Thyroid gland disorders are common, being second to Diabetes Mellitus in Endocrine practice. The normal thyroid gland is not visible and is not palpable. More than 90% of thyroid gland disorders present with goitre. Thyroid gland hormone excess has marked effects on most systems of the body, especially the nervous and cardiovascular systems. Similarly, hormone deficiency affects all the systems, although is more insidious in onset. A detailed history, physical examination, and investigations will determine the diagnosis, and the type and cause of the disorder. There is need to determine if the patient is euthyroid, hyperthyroid or hypothyroid. The management may be medical, surgical, and/or radioiodine therapy. All patients for surgery or radioiodine therapy should be rendered euthyroid as much as possible with medical treatment to reduce the chances of
complications intraoperatively or postoperatively. In the United States of America (USA), most patients with Graves Disease are offered antithyroid drugs, radioiodine therapy, or a mixture of both. Surgery is used to treat large and giant goitre, or patients not likely to achieve relapse on medical treatment - such patients usually require more than 10 mg of Methimazole for
maintenance therapy daily, and patients with high titre of Thyroid Receptor Antibodies (TRAbs). Radioiodine therapy could be by dosimetry or ablative dosing. For instance, 20 mCi of radioactive iodine, Iodine 131 (1) alleviates hyperthyroidism in almost all patients and induce hypothyroidism in 90% of cases. Replacement with Levo-Thyroxine for life is indicated and should be communicated clearly to ensure follow- up. Antithyroid drugs are withdrawn 7 days before radioiodine therapy. Post radioiodine therapy, antithyroid drugs may be needed to ameliorate excess thyroid hormone in the blood. Radioiodine therapy is
contraindicated in pregnancy and lactation. Therefore, all women in the child bearing age must undergo pregnancy test before radioiodine therapy.