Objective To investigate the dose-dependent effects of iodine-131 treatment on the efficacy, bone metabolism changes, and adverse reactions in patients with hyperthyroidism. Methods A retrospective analysis was conducted on the medical records of 386 hyperthyroid patients treated at our hospital from June 2020 to June 2024. Based on the dose of iodine-131 used, the patients were divided into four groups: low-dose group (92 patients, 70 Ci/g), medium-dose group (94 patients, 100 µCi/g), medium-high-dose group (103 patients, 120 µCi/g), and high-dose group (97 patients, 150 µCi/g). Within five months after treatment, the efficacy, thyroid function, bone mineral density (BMD), bone metabolism markers, anxiety scores (STAI-S), and the incidence of adverse reactions were compared across the four groups. Results The efficacy rates for the low-dose, medium-dose, medium-high-dose, and high-dose groups were 66.30%, 77.66%, 88.35%, and 93.81%, respectively. The high-dose group demonstrated a significantly higher efficacy compared to the low- and medium-dose groups. Post-treatment, the levels of free triiodothyronine (FT3) and free thyroxine (FT4) decreased, while thyroidstimulating hormone (TSH) levels increased in all groups. The high-dose group showed the most significant reduction in FT3 and FT4 and the greatest increase in TSH levels. Bone mineral density increased in all groups, with the greatest increase observed in the high and medium-high-dose groups. Bone metabolism markers such as osteocalcin (OST), β-C-terminal telopeptide (β-CTX), and N-terminal propeptide of type I collagen (PINP) all significantly decreased, while total vitamin D (VIT-D) levels increased, with the most pronounced changes in the high-dose group. Anxiety scores (STAI-S) decreased significantly post-treatment, with the high-dose group exhibiting the lowest scores, showing a statistically significant difference. The incidence of adverse reactions increased with the iodine-131 dose, with the high-dose group having a significantly higher overall incidence (41.24%) compared to the low-dose group (17.38%). Conclusion The therapeutic efficacy of iodine-131 in treating hyperthyroidism is dose-dependent, with the high-dose group showing the best treatment outcomes but also higher rates of adverse reactions. Proper adjustment of iodine-131 dosage is crucial for improving therapeutic efficacy while minimizing side effects.
Key words
hyperthyroidism /
Iodine-131 /
thyroid function /
bone mineral density /
bone metabolism
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