Can anabolic agents be used in a patient with history of radioactive iodine treatment for hyperthyroidism?

This is an interesting question. When PTH was approved it had a black box warning for patients who had a history of radiation to the skeleton due to risk of potential osteosarcomas. The black box has been removed for the duration of use. Since we have another anabolic agent without that black box, I would use romosozumab first, and then if a PTH therapy is needed after that, I would advise the patient of the potential risk and let the patient decide. I do not think radioactive iodine that was used a long time (more than 10 years ago) would prevent me from prescribing the medication, however, I would provide the patient with the potential risk.