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Part of the reason is that anti-TNF agents block one specific cytokine while leaving the rest of the inflammatory network intact

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Women who are willing to avoid pregnancy for at least 612 months after Radioiodine therapy Patients with increased surgical risk (comorbidities, prior neck surgery or neck radiation) Lack of access to high-volume thyroid surgeon Reasons not to use radioactive iodine include: Moderate to severe thyroid eye disease due to the risk of worsening eye disease