Lugol's solution-induced painless thyroiditis

[helvella]

A short and interesting paper about Lugol's solution.

Lugol's solution-induced painless thyroiditis

Summary

Lugol’s solution is usually employed for a limited period for thyroidectomy preparation in patients with Graves’ disease and for the control of severe thyrotoxicosis and thyroid storm. We describe a rare case of Lugol’s solution-induced painless thyroiditis. In November 2014, a 59-year-old woman was prescribed Lugol’s solution four drops per day for the alleviation of menopausal symptoms. She was referred to our clinic in June 2015 for fatigue, hair loss, and a 20-lb weight loss without thyroid pain or discomfort. Physical examination revealed a normal thyroid gland. On 7 May 2015, laboratory tests revealed a suppressed thyroid-stimulating hormone (TSH) 0.01 U/L with elevated free T4 3.31 ng/dL (42.54 pmol/L). Repeat testing on 25 May 2015 showed spontaneous normalization of the free thyroid hormone levels with persistently low TSH 0.10 U/L. Following these results, a family physician prescribed methimazole 10 mg PO TID and very soon after, the TSH concentration rose to >100 U/L along with subnormal free T4 and T3 levels. Methimazole was promptly discontinued, namely within 18 days of its initiation. Over the course of the next few months, the patient spontaneously achieved clinical and biochemical euthyroidism. To our knowledge, this is a unique case of painless thyroiditis induced by Lugol’s solution, which has not been reported before. Lugol’s solution is a short-term medication given for the preparation of thyroidectomy in patients with Graves’ disease and for the control of severe thyrotoxicosis. Iodine excess can cause both hyperthyroidism and hypothyroidism. Rarely, Lugol’s solution can cause acute painless thyroiditis.

Full paper (it is only short) available here:

edmcasereports.com/articles...

[humanbean]

My overwhelming impression is that this poor woman was treated by a group of doctors who didn't have a clue what they were doing!

[helvella Administrator Thyroid UK in reply to humanbean]

That seems very much what the authors are saying.

[Justiina]

How can it be uncommon or rare if it's known that elderly women that have been iodine deficient can go hyper after supplementing iodine? Even moving from iodine deficient area to iodine sufficient area can trigger it for one that has been deficient for long.