Radioactive iodine therapy for patients with hypothyroidism due to Hashimoto’s thyroiditis with persistent large goiters despite levothyroxine treatment: A report of four cases

In some patients with Hashimoto’s hypothyroidism and a large goiter, levothyroxine therapy dose not reduce goiter size. We herein report four cases of successful treatment with radioactive iodine therapy. In three cases, a single session of radioactive iodine therapy achieved a sufficient reduction in goiter size; in the remaining case, two sessions were required. Elevated thyroid-stimulating hormone levels and an adequate technetium-99m uptake in the thyroid gland two to four weeks after levothyroxine withdrawal are crucial for the success of radioiodine therapy in these patients. Radioactive iodine therapy is a viable alternative treatment for patients with hypothyroidism due to Hashimoto’s thyroiditis who present with a large goiter despite LT4 administration.