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The main objective is to prevent the patient with severe Graves' exophthalmos from becoming hypothyroid. We usually use an alternative approach of close follow-up of such patients after131I therapy and institution of thyroid hormone replacement as soon as the serum thyroxine value drops into the lower normal range.
Thomason AM, Nusynowitz ML. Treatment of Graves' Disease-Reply. JAMA. 1980;244(14):1558. doi:10.1001/jama.1980.03310140018011