The role of radioactive iodine usage in the management of thyroid disorders with emphasis on sub-Saharan Africa

Radioactive iodine (RAI) usage is increasingly becoming a standard therapeutic and diagnostic measure in the management of thyroid disorders. Despite these advances, there are varying opinions on the appropriate usage of this treatment option of thyroid disorders. In sub-saharan Africa, reports on RAI in the management of thyroid disorders are scanty and RAI usage is shrouded in mystery. This review article sought to evaluate the role of RAI in the diagnosis and treatment of thyroid disorders with emphasis on its usage in Africa. It also addresses specific areas of concern amongst others such as RAI use in children, in large compressive goiters, reproductive function and the issue of associated iatrogenic hypothyroidism. A systematic review of literature--local and otherwise--on radioactive iodine usage from indexed and online journals using Pubmed, Google and Google Scholar in the period between 1942 till 2007. The most common complication of RAI therapy is hypothyroidism which appears to be almost inevitable. There is controversy as to whether RAI therapy is a risk factor for thyroid cancer or cancer of other iodine-concentrating organs. Equally controversial is whether RAI leads to infertility or genetic disorders of children whose parents were treated with RAI. The use of RAI in the diagnosis and treatment of thyroid disorders appears unduly limited. Radioactive iodine--a major tool in the diagnosis and management of benign and malignant thyroid disorders--is underutilized in the African. There is a need for heightened awareness amongst endocrinologists from the African continent on the usage of this all-important treatment modality of thyroid disorders.