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¹²³I Thyroid Uptake and Thyroid Size at 24, 48, and 72 Hours after the Administration of Recombinant Human Thyroid-Stimulating Hormone to Normal Volunteers

Section of Endocrinology, Diabetes, and Nutrition (S.P., S.A., E.N.P., L.E.B.), Section of Nuclear Radiology (M.C., M.E.O.), Department of Radiology, and Department of Laboratory Medicine (B.M.), Boston University Medical Center, Boston, Massachusetts 02118

Address all correspondence and requests for reprints to: Elizabeth N. Pearce, M.D., M.Sc., Section of Endocrinology, Diabetes, and Nutrition, Evans 201, 88 East Newton Street, Boston, Massachusetts 02118. E-mail: elizabeth.pearce{at}bmc.org.

Context: Recombinant human TSH (rhTSH) is used to evaluate thyroid carcinoma patients and off-label for ¹³¹I thyroid ablation and nontoxic goiter therapy.

Objective: Our objective was to determine the optimal time for ¹³¹I administration after rhTSH.

Participants: Twenty-five euthyroid nongoitrous volunteers participated in the study.

Design: Baseline 24-h thyroid ¹²³I uptake (RAIU) was measured, and then 0.1 mg rhTSH was administered. ¹²³I was administered 24, 48, or 72 h after rhTSH, and a repeat 24-h RAIU was obtained.

Setting: The study was conducted at an academic research center.

Main Outcome Measures: Thyroid function tests, thyroid ultrasounds, and electrocardiograms were measured before rhTSH, then daily for 4 d, and finally 7 d after rhTSH.

Results: Serum TSH concentrations 24 h after rhTSH increased from 1.7 ± 0.5 µU/ml (mean ± SD) to 13.3 ± 4. The 24-h RAIUs rose from 25 ± 5 to 47 ± 8% (88% increase) when the ¹²³I was given at 24 h after rhTSH and from 29.8 ± 7 to 40.5 ± 13% (36% increase) when the ¹²³I was given at 48 h and were unchanged when the ¹²³I was given at 72 h. The post-rhTSH RAIU increase was greater at 24 than at 72 h (P < 0.005) and marginally greater than at 48 h (P = 0.057). Thyroid volumes significantly increased 48 h after rhTSH (10 ± 3.8 vs. 11.1 ± 3.7 ml; P < 0.009). Electrocardiograms were normal.

Conclusions: Marked increases in RAIU occurred when ¹²³I was given 24 h after rhTSH administration to euthyroid volunteers. Smaller increases were observed at 48 h and none at 72 h.

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