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Low iodine diet in differentiated thyroid cancer: a review.
Clin Endocrinol (Oxf) 2016; 84(1):3-12CE

Abstract

Radioactive iodine (RAI) ablation is a beneficial, adjuvant therapy for the management of differentiated thyroid cancer (DTC) after thyroidectomy. The goal of RAI is to destroy remnant thyroid and microscopic cancerous tissue. Radioactive iodine uptake is enhanced by elevating TSH levels and initiating a low iodine diet (LID) prior to ablation. An ideal LID should preferably not exceed 50 mcg/day of dietary iodine for 1-2 weeks, although the duration may be shortened to a week with a structured patient education programme. A pre-ablation spot urinary iodine concentration (UIC) of <100 mcg/l and/or a urinary iodine to creatinine ratio (UICR) of <100 mcg/gCr would support an adequate LID preparation. Hyponatraemia, most likely due to iatrogenic hypothyroidism, is a potential side effect associated with LID and occurs during and a few days after the LID. Although the overall incidence of hyponatraemia is low, patients at high risk (older age, female sex, use of thiazide diuretics) may benefit from serum sodium monitoring. The existing evidence on the impact of LID on RAI ablation has been largely inconsistent due to retrospective study designs and the lack of an objective measurement of urinary iodine levels. Future large prospective randomized control trials are needed to elucidate and confirm the crucial role of LID in achieving successful RAI ablation and greater disease-free survival in DTC.

Authors+Show Affiliations

Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.Department of Medicine, Cambridge Health Alliance, Cambridge, MA, USA.Division of Clinical and Molecular Endocrinology, Department of Medicine, University Hospitals/Case Medical Center, Cleveland, OH, USA.Division of Endocrinology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

26118628

Citation

Li, Josephine H., et al. "Low Iodine Diet in Differentiated Thyroid Cancer: a Review." Clinical Endocrinology, vol. 84, no. 1, 2016, pp. 3-12.
Li JH, He ZH, Bansal V, et al. Low iodine diet in differentiated thyroid cancer: a review. Clin Endocrinol (Oxf). 2016;84(1):3-12.
Li, J. H., He, Z. H., Bansal, V., & Hennessey, J. V. (2016). Low iodine diet in differentiated thyroid cancer: a review. Clinical Endocrinology, 84(1), pp. 3-12. doi:10.1111/cen.12846.
Li JH, et al. Low Iodine Diet in Differentiated Thyroid Cancer: a Review. Clin Endocrinol (Oxf). 2016;84(1):3-12. PubMed PMID: 26118628.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low iodine diet in differentiated thyroid cancer: a review. AU - Li,Josephine H, AU - He,Zhiheng H, AU - Bansal,Vivek, AU - Hennessey,James V, Y1 - 2015/07/29/ PY - 2015/03/18/received PY - 2015/04/23/revised PY - 2015/06/12/revised PY - 2015/06/23/accepted PY - 2015/6/30/entrez PY - 2015/6/30/pubmed PY - 2016/11/1/medline SP - 3 EP - 12 JF - Clinical endocrinology JO - Clin. Endocrinol. (Oxf) VL - 84 IS - 1 N2 - Radioactive iodine (RAI) ablation is a beneficial, adjuvant therapy for the management of differentiated thyroid cancer (DTC) after thyroidectomy. The goal of RAI is to destroy remnant thyroid and microscopic cancerous tissue. Radioactive iodine uptake is enhanced by elevating TSH levels and initiating a low iodine diet (LID) prior to ablation. An ideal LID should preferably not exceed 50 mcg/day of dietary iodine for 1-2 weeks, although the duration may be shortened to a week with a structured patient education programme. A pre-ablation spot urinary iodine concentration (UIC) of <100 mcg/l and/or a urinary iodine to creatinine ratio (UICR) of <100 mcg/gCr would support an adequate LID preparation. Hyponatraemia, most likely due to iatrogenic hypothyroidism, is a potential side effect associated with LID and occurs during and a few days after the LID. Although the overall incidence of hyponatraemia is low, patients at high risk (older age, female sex, use of thiazide diuretics) may benefit from serum sodium monitoring. The existing evidence on the impact of LID on RAI ablation has been largely inconsistent due to retrospective study designs and the lack of an objective measurement of urinary iodine levels. Future large prospective randomized control trials are needed to elucidate and confirm the crucial role of LID in achieving successful RAI ablation and greater disease-free survival in DTC. SN - 1365-2265 UR - https://www.unboundmedicine.com/medline/citation/26118628/full_citation L2 - https://doi.org/10.1111/cen.12846 DB - PRIME DP - Unbound Medicine ER -