Use of oral glucocorticoids for prevention of thyroid eye disease development or progression when radioactive iodine is used to treat Graves' hyperthyroidism*

RAI: radioiodine; TED: thyroid eye disease; ATDs: antithyroid drugs; TRAb: thyrotropin receptor antibodies.

* ATDs or thyroidectomy are also recommended treatment options in each of these scenarios, and they are the preferred choice of therapy in patients with active and moderate-to-severe or sight-threatening TED.

¶ The decision regarding use of concurrent glucocorticoids should be made in light of the risk-benefit ratio relative to the patient's overall health. Risk factors for TED deterioration (high TRAb level, smoking) increase the benefit of glucocorticoids in preventing TED deterioration. Poorly controlled diabetes, osteoporosis, psychiatric illness, high risk for infections increase the likelihood of complications from glucocorticoids.