Radioactive iodine-131 is used for treatment of thyrotoxicosis, thyroid cancer and for diagnostic thyroid scanning

-It is effective in ablating the thyroid gland and producing permanent hypothyroidism

-In North America, RAI forms the mainstay of Graves’ disease 

– the only isotope used for treatment of thyrotoxicosis is 131I

-RAI is most often used in older patients or those who have relapsed after medical or surgical therapy or in whom medical or surgical therapy is contraindicated 

-Radioactive iodine should not be given to pregnant women due to the potential teratogenic effects for the fetus’s growth

-all women of childbearing age must have a negative pregnancy test prior to treatment

-After RAI, wait for 6 months before conceiving 

-Absolute contraindications to RAI: pregnancy or planning pregnancy within 6 months of treatment, breastfeeding 

-Relative contraindications to RAI: children, adolescents, those with ophthalmopathy 

-After RAI treatment, most patients become euthyroid within 2 months 

-The most common complication of RAI is hypothyroidism 

-RAI can exacerbate Graves’ ophthalmopathy especially if the patient is a smoker