This case highlights the importance of recognizing the potential for iodine exposure to precipitate or unmask autoimmune thyroid dysfunction, which is particularly important in patients with pre-existing thyroid autoimmunity. Our case suggests that in high-risk individuals, anti-TPO antibodies can be used as a valuable screening tool to guide the decision-making process and optimize the timing between diagnostic evaluation, initiation of treatment, and thyroid scan. This evidence concerns the gene TPO and autoimmune thyroid disease.