Patients were assessed at an average of 8 years after the diagnosis of Graves’ disease. Patients in surgery group were generally younger (average age 35 years, compared to 43 years for the antithyroid drug group and 54 years for the radioactive iodine therapy group). More patients in radioactive iodine therapy group had other medical conditions that may affect quality of life (44%, compared to 29% in the antithyroid drug group and 33% in the surgery group).
Overall, patients with treated Graves’ disease had worse thyroid-related quality of life scores than the general population. Among the three treatment groups, patients who received radioactive iodine therapy had worse thyroid-specific quality of life scores than patients treated with antithyroid drugs or surgery, as measured by ThyPRO. The radioactive iodine therapy group had worse scores for goiter symptoms, hyperthyroid symptoms, tiredness, anxiety, depression, emotional susceptibility, impaired social life, impaired daily life, and impaired sex life than the antithyroid drug and surgery groups. In addition, the radioactive iodine therapy group had worse scores in hypothyroid symptoms, eye symptoms, and appearance than the antithyroid drug group. A similar pattern was found in general quality of life measures as assessed with the SF-36 questionnaire, with worse scores in radioactive iodine therapy group compared to the antithyroid drug or surgery groups.
WHAT ARE THE IMPLICATIONS OF THIS STUDY?
In this study, quality of life scores were worse in patients with Graves’ disease treated with radioactive iodine therapy compared to antithyroid drugs or surgery at 6-10 years after treatment. This is different from previous studies of quality of life in patients treated for Graves’ disease which showed similar quality of life in patients treated with three treatment methods. This study had a larger number of participants and a longer duration of follow up than previous studies. If these findings are confirmed in other studies in other countries, it would suggest that radioactive iodine therapy may be less desirable in the long term as compared to antithyroid drugs or surgery
— Sun Y. Lee, MD