Why is a patient with a hot nodule in the thyroid gland more likely to end up euthyroid?
Patients with hot nodules have a higher likelihood of ending up euthyroid because the hot nodule typically causes suppression of the remainder of the thyroid gland. This suppression protects the gland from 131 I therapy. When the nodule is eliminated by 131 I, the patient’s thyroid function decreases, and eventually the TSH level begins to increase. This increased TSH stimulates the remaining thyroid tissue to begin producing thyroid hormone again. Because most of the suppressed tissue was protected, the patient may be able to make normal amounts of thyroid hormone.