What monitoring protocols should I follow for a patient undergoing treatment for Graves' disease?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

For patients undergoing treatment for Graves' disease, monitor thyroid function tests (TFTs) every 6 weeks until the TSH is within the reference range, then every 3 months until antithyroid drugs are stopped .

After stopping antithyroid drugs, measure TSH (with cascading) within 8 weeks, then every 3 months for a year, and annually thereafter .

During radioactive iodine treatment follow-up, measure TSH, FT4, and FT3 levels every 6 weeks for the first 6 months until TSH is within the reference range .

If hyperthyroidism persists after radioactive iodine treatment, consider antithyroid drugs until the 6-month appointment, with ongoing monitoring .

Post-thyroid surgery, if total thyroidectomy was performed, start levothyroxine and monitor TSH and FT4 at 2 and 6 months, then annually. For hemithyroidectomy, TSH may be measured annually .

Educational content only. Always verify information and use clinical judgement.