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EIICHI YAMAZAKI, AKITO NOGUCHI, D. WARD SLINGERLAND, EFFECT OF THYROIDECTOMY ON PLASMA BUTANOL-EXTRACTABLE AND PROTEIN-BOUND RADIOIODINE LEVELS AND ON THE TURNOVER OF RADIOTHYROXINE, The Journal of Clinical Endocrinology & Metabolism, Volume 21, Issue 3, 1 March 1961, Pages 336–342, https://doi.org/10.1210/jcem-21-3-336
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In 5 of 7 euthyroid patients given radioiodine seventy-two hours before subtotal thyroidectomy there was approximately a two-fold increase in the plasma PBI131 level forty-eight hours after surgery. There was no change, however, in the level of BEI131. In patients with Graves' disease prepared for operation with antithyroid drugs and given radiothyroxine, there was a sudden diminution in the rate of disappearance of radioactivity from the blood about six days after unilateral or bilateral subtotal thyroid lobectomy. The hypothesis is presented that manipulation of the thyroid at operation may sometimes release a significant amount of thyroglobulin which later undergoes protcolysis to release iodinated compounds including thyroxine. This proteolysis may occur close to, or at the site of the deiodination of thyroxine in the tissues, releasing a large local concentration of stable thyroxine which successfully competes with the labeled thyroxine and reduces its rate of deiodination and disappearance from the blood.
