A short course of lithium is safe and significantly increases the cure rate of Graves’ hyperthyroidism

The Treatment Paradigm (Figure 1) Methimazole (MMI) was started 3 to 6 months before 131I therapy to restore euthyroidism and was discontinued 5 days (T-5) before 131I was initiated. On the same day, lithium, 900 mg/day was started. Seven days after 131I was administered (day T0), lithium was withdrawn, comprising 12 days of lithium, and oral prednisone was started at 0.5 mg/kg daily to avoid 131I-associated Graves’ ophthalmopathy. Prednisone was gradually tapered from 0.1 to 0.3 mg/kg every 7 to 17 days and was withdrawn after 2 months. (Figure 1). Radioactive iodine (131I) was given at a dose of 260 μCi/g of estimated thyroid tissue, corrected for the 24-hr radioactive iodine uptake (RAIU).