The 80-year legacy of using radioactive iodine to treat thyroid disease
In short: In 1941, a medical breakthrough changed the treatment of hyperthyroidism forever. By using the radioactive isotope Iodine-131, doctors found a way to target thyroid issues directly. Today, this therapy remains a global standard for millions, yet the practice remains a delicate balance of science and clinical judgment.
The history of radioiodine therapy began in early 1941, when Dr. Saul Hertz successfully administered the first therapeutic dose of Iodine-131 to a patient suffering from Graves’ disease. This milestone marked the start of a practice that has been utilized for more than 80 years. Since that initial success, millions of patients across the globe have undergone RAI therapy to find definitive treatment for hyperthyroidism.
The therapy is primarily used to address two main types of conditions: autoimmune hyperthyroidism, known as Graves’ disease, and non-autoimmune toxic goiters, such as toxic nodular goiter (TNG) or toxic multinodular goiter (TMNG). Within the spectrum of hyperthyroidism, Graves’ disease accounts for approximately 70–80% of cases, while toxic nodular conditions represent about 20–30%. Because the thyroid naturally absorbs iodine, the radioactive isotope can be used to target these specific tissues.
While clinical guidelines, such as those provided by the European Association of Nuclear Medicine (EANM), offer frameworks for patient preparation, radiation protection, and dosimetry, they are not intended to be inflexible rules. The EANM, founded in 1985, emphasizes that medical practice is both a science and an art. Because human conditions are complex, practitioners must use their professional judgment to adapt treatments based on a patient's unique circumstances, available resources, or new technological advances. The goal is to follow a reasonable course of action to ensure safe and effective care, even when outcomes cannot be predicted with absolute certainty.
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Sources
- Summary by Intellect · source: Iodine therapy - Radiotherapy and its physics (4/15)
- Also: The EANM guideline on radioiodine therapy of benign thyroid disease
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