Q:

How is the dose of radioiodine 131I calculated?

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A 30-year-old woman presents with complaints of palpitations, tremulousness and weight loss of around 4 kg (despite a good appetite) over the last 2 months. On examination, she is anxious, has a pulse rate of 100/min, warm and moist peripheries, fine tremors of the outstretched hands and a visible goiter. No obvious abnormalities in the eyes. Her last menstrual period was 15 days ago. Her primary care physician orders for laboratory examination which reveals normal hemogram with an erythrocyte sedimentation rate of 25 mm in the first hour. Thyroid stimulating hormone (TSH) <0.001 mIU/L and total T4 28 mg/dL. A diagnosis of thyrotoxicosis is made. She is started on beta-blockers and she is asked to get a technetium uptake scan and review.

How is the dose of radioiodine 131I calculated?

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The goal of treatment is to render the patient hypothyroid. The dose can be calculated using the formula. This formula needs determination of uptake at 24 hrs and the estimation of the weight of the thyroid gland by the physician. Dose of 131I = 50–120 mCi × weight of thyroid in grams 24 hour uptake The other method involves administration of a fixed dose ranging from 10 to 15 mCi.

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