Some patients have hyperthyroidism related to a nodule with autonomous function (AFTN). These nodules make some patients hyperthyroid, or mildly hyperthyroid. This clinical entity can lead to both symptoms of anxiety and fatigue. Longstanding hyperthyroid patients develop heart conditions as well as osteoporosis. The determination of AFTN is optimally made with an I131 Iodine Uptake Scan which demonstrates increased iodine uptake in the nodule compared to the remainder of the gland. Until now the only therapy available for these patients was either surgery or radioactive iodine ablation. Radioactive iodine ablation causes hypothyroidism in one year in about 85% of patients. Ultimately these people will require daily thyroid medication. Surgery requires the removal of the entire thyroid lobe containing the autonomous nodule. The alternative therapy which destroys these nodules with RFA successfully avoids an operation and hypothyroidism. Restoration of normal thyroid function is accomplished in most patients. Generally, no daily thyroid medications are required after RFA.
Hyperthyroidism caused by Grave’s disease is a contraindication for this therapy.