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Review Article
Online Published: 02 Sep 2026
 


Radioiodine-induced salivary gland dysfunction: what current guidelines recommend and what we practice in resource-limited settings

Sabeen Zia, Muhammad Iqbal, Shaheen Iqbal, Amir Bahadur, Aakif Ullah Khan.


Abstract
Background: Radioiodine therapy (RAIT) remains a cornerstone in the management of differentiated thyroid cancer, however the salivary gland toxicity associated with RAIT is an under-recognized yet clinically relevant complication. Patients may develop a spectrum of manifestations ranging from acute sialadenitis to chronic xerostomia, with substantial impact on quality of life and long-term oral health. The 2025 American Thyroid Association guidelines acknowledge salivary gland dysfunction as a potential adverse effect of RAIT and emphasize patient counselling and preventive measures such as hydration. However, detailed, evidence-based protocols for prevention and management are not clearly outlined. This review summarizes current guideline recommendations and available evidence regarding prevention and management strategies, including hydration, sialogogues, pharmacologic agents such as pilocarpine, and emerging interventions like sialendoscopy. It further highlights gaps between guideline recommendations and real-world practice, particularly in resource-limited settings. The aim is to provide a concise, clinically applicable framework for nuclear medicine physicians managing radioiodine-induced salivary gland dysfunction.

Key words: Key words: Salivary gland dysfunction, radioiodine therapy (RAIT), differentiated thyroid cancer, acute sialadenitis, chronic xerostomia, sialendoscopy.


 
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How to Cite this Article
Pubmed Style

Zia S, Iqbal M, Iqbal S, Bahadur A, Khan AU. Radioiodine-induced salivary gland dysfunction: what current guidelines recommend and what we practice in resource-limited settings. Pak J Nucl Med. 2026; 16(1): 29-32. doi:10.24911/PJNMed.175-1777666065

Web Style

Zia S, Iqbal M, Iqbal S, Bahadur A, Khan AU. Radioiodine-induced salivary gland dysfunction: what current guidelines recommend and what we practice in resource-limited settings. https://www.pjnmed.com/?mno=319384 [Access: September 19, 2026]. doi:10.24911/PJNMed.175-1777666065

AMA (American Medical Association) Style

Zia S, Iqbal M, Iqbal S, Bahadur A, Khan AU. Radioiodine-induced salivary gland dysfunction: what current guidelines recommend and what we practice in resource-limited settings. Pak J Nucl Med. 2026; 16(1): 29-32. doi:10.24911/PJNMed.175-1777666065


Vancouver/ICMJE Style

Zia S, Iqbal M, Iqbal S, Bahadur A, Khan AU. Radioiodine-induced salivary gland dysfunction: what current guidelines recommend and what we practice in resource-limited settings. Pak J Nucl Med. (2026), [cited September 19, 2026]; 16(1): 29-32. doi:10.24911/PJNMed.175-1777666065


Harvard Style

Zia, S., Iqbal, . M., Iqbal, . S., Bahadur, . A. & Khan, . A. U. (2026) Radioiodine-induced salivary gland dysfunction: what current guidelines recommend and what we practice in resource-limited settings. Pak J Nucl Med, 16 (1), 29-32. doi:10.24911/PJNMed.175-1777666065


Turabian Style

Zia, Sabeen, Muhammad Iqbal, Shaheen Iqbal, Amir Bahadur, and Aakif Ullah Khan. 2026. Radioiodine-induced salivary gland dysfunction: what current guidelines recommend and what we practice in resource-limited settings. Pakistan Journal of Nuclear Medicine, 16 (1), 29-32. doi:10.24911/PJNMed.175-1777666065


Chicago Style

Zia, Sabeen, Muhammad Iqbal, Shaheen Iqbal, Amir Bahadur, and Aakif Ullah Khan. "Radioiodine-induced salivary gland dysfunction: what current guidelines recommend and what we practice in resource-limited settings." Pakistan Journal of Nuclear Medicine 16 (2026), 29-32. doi:10.24911/PJNMed.175-1777666065


MLA (The Modern Language Association) Style

Zia, Sabeen, Muhammad Iqbal, Shaheen Iqbal, Amir Bahadur, and Aakif Ullah Khan. "Radioiodine-induced salivary gland dysfunction: what current guidelines recommend and what we practice in resource-limited settings." Pakistan Journal of Nuclear Medicine 16.1 (2026), 29-32. Print. doi:10.24911/PJNMed.175-1777666065


APA (American Psychological Association) Style

Zia, S., Iqbal, . M., Iqbal, . S., Bahadur, . A. & Khan, . A. U. (2026) Radioiodine-induced salivary gland dysfunction: what current guidelines recommend and what we practice in resource-limited settings. Pakistan Journal of Nuclear Medicine, 16 (1), 29-32. doi:10.24911/PJNMed.175-1777666065




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