-  Assess the presence and severity of ofthalmopathy. In 15% it may progress after radioiodine therapy, in particular in severe cases and with augmented TRABS. Consider surgery instead.

-  Withdraw thyroid medications. PTU and Thyrosol 5 days before therapy.

-  Avoid recent ingestion of foods rich in iodine content (Salt, Shellfish).

-  Avoid use of contrast material in previous weeks.

-  Make sure radioiodine thyroid uptake is elevated.

-  In fertile females rule out pregnancy with Beta GCH

-  Patient must fast 4-6 h before receiving 131-I orally and wait 3h before resuming any food ingestion.

1 Jairo Wagner, Hans Graf, Marcia Khaled Puñales, Suzana Nesi França. DIAGNOSTICO Y TRATAMIENTO DE LAS MALFORMACIONES Y DISFUNCIONES DEL TIROIDES , p: 177 -184 in: Medicina Nuclear Aplicaciones Clínicas. Eds: I. Carrio - P. González. Editorial Masson, Barcelona España, 2003.

2 Meier D.A. et al. Therapy of Thyroid Disease with Iodide-131 (Sodium Iodide) V1.0 Procedure Guideline. 2002: 1-11. Society of Nuclear Medicine.

3 Bartalena L, Tanda ML. Clinical practice. Graves' ophthalmopathy. N Engl J Med. 2009 Mar 5; 360(10):994-1001.