1: What kind of patients are treated with radioactive iodine?
Patients with GD, especially those mentioned below, are suitable for this method.
1) Patients who do not wish to undergo surgical treatment.
2) Patients with enlarged thyroid gland.
3) Patients with chronic diseases such as heart disease and liver disease.
4) Patients who have side effects from taking antithyroid drugs.
5) Patients who stop taking antithyroid drugs and have a relapse of hyperthyroidism.
(6) Patients with recurrence of hyperthyroidism after surgery.
PS: If a patient with GD wishes to undergo radioactive iodine therapy, the above-mentioned items are indications.
2: People who are not suitable for radioactive iodine treatment
The following patients are not suitable for radioactive iodine treatment.
1) Pregnant women and women who may be pregnant.
2）Women who are within 4 months of pregnancy.
3）.Women who are breastfeeding.
4) Children under 18 years of age in principle (there are exceptions).
PS: Women who are pregnant or breastfeeding cannot be treated with this method. Radioactive iodine can be taken up by the thyroid gland of the fetus or baby. Pregnancy is not a problem after 6 months to more than 1 year after treatment
3: Therapeutic goals of radioactive iodine therapy
The therapeutic goals of radioactive iodine therapy for GD patients are the following 2.
1) When normal thyroid function is the goal.
2) When aiming for hypothyroidism. Ensuring normal thyroid function is difficult (when too much radioactive iodine is given, thyroid function soon returns to normal), and hypothyroidism occurs after a period of time.
4. Methods of giving radioactive iodine
1) Outpatient administration of a certain radioactive dose of 131 sodium iodide solution.
GD radioactive iodine treatment method is mainly performed in outpatient clinics. Taking 1 capsule containing radioactive iodine in one treatment is a simple treatment method. (PS: One treatment is followed by several months of treatment. (Depending on the patient’s status, hospitalization is necessary, but most of them are treated on an outpatient basis).
2) The dosage of radioactive iodine is determined by the degree of goiter and uptake rate.
The dosage of radioactive iodine is related to the degree of the patient’s hyperthyroidism, the size of the thyroid gland, and the goal of treatment. Radioactive iodine therapy involves taking a solution containing 131-iodine to take advantage of the specific uptake of more than 60% of iodine by thyroid cells during hyperthyroidism to achieve therapeutic goals. The extent to which the patient’s thyroid gland absorbs radioactive iodine, and the rate of absorption must be checked before treatment in order for the treatment to be effective. The amount of treatment is decided after consultation with the treating physician.
3) How to check the uptake rate.
A radioactive iodine uptake rate test is performed by taking a solution containing a test amount of 131 iodine and measuring the state of radioactive iodine uptake by the thyroid gland over time. The uptake rate of 131 iodine is measured at 3 hours, 6 hours and 24 hours after taking the 131 iodine solution. Also checking the iodine uptake rate is the main method to differentiate between hyperthyroidism and thyroiditis.
4): What is an iodine-restricted diet
Radioactive iodine is taken up by the thyroid gland in the same way as iodine contained in food. In order for the thyroid gland to take in more radioactive iodine, it is necessary to control its intake of iodine contained in food, etc., before treatment. In this case, it is necessary to restrict the diet for 1-2 weeks before treatment.
(1), seaweeds (kelp, wakame, etc.), iodized eggs, condiments containing kelp, sea fish, sea shrimp, sea crabs and other seafood should not be eaten.
(2) Drugs containing a lot of iodine (mouthwash, iodine contrast agent, etc.) should be avoided as much as possible.
(3), salt, try to eat less iodized salt and eat coarse salt. If you cannot buy it, you can put salt earlier when frying or store salt is, leaving the mouth of the container open.
5: Side effects of radioactive iodine internal therapy
Radioactive iodine therapy is a safe treatment method. There is no basis for causing cancer and leukemia. Moreover, there are no effects on future generations. Many patients who have undergone radioactive iodine therapy for 50 years have not reported thyroid cancer and leukemia caused by the treatment dosage of radioactive iodine. The appearance of hypothyroidism is taken as a result of the efficacy of radioactive iodine treatment. The number of people who develop hypothyroidism increases with the number of years since treatment. In case of hypothyroidism, thyroid hormone preparations must be taken for life. However, this preparation has no side effects and is safe to take in the correct dosage for a long period of time to ensure normal levels of thyroid hormones and to live as normal. Moreover, this preparation is relatively inexpensive and can be afforded financially for lifelong use.
6: Precautions after treatment
1) Metabolism of radioactive iodine.
After taking radioactive iodine, most of it is excreted from the body via urine after uptake by the thyroid gland. A small portion is excreted by sweat and saliva. Radiation has no bad effect on the body itself, but it should not irradiate others either.
(2) Precautions for the week after treatment.
(1) Drink plenty of water during this week, as it will help to excrete the remaining radioactive iodine as soon as possible.
(2) Wash your hands twice after urination and defecation during this week. For male patients, splashing urine will increase the chance of contamination, so try to use the toilet to urinate.
(3) Sleep alone as much as possible during this week. Avoid kissing and sexual intercourse during this week. Because sweat and body fluids contain small amounts of radioactive iodine.
(4) During this week, contact with children and pregnant women should be at least 1m, and close prolonged contact (sleeping) should be avoided. You can only hold the child for 15 minutes or less.
(5) This week, take buses, trains and trains at a distance of 1m or more from others. Try not to sit with others for more than 6 hours.
(3) Precautions for more than one week of treatment.
Please use contraception for 6 months until GD is stable. Most of the radioactive iodine is metabolized from the body after 1 month. The absolutely safe time for contraception is more than 6 months.
7: Treatment history
1) The course of radioactive iodine treatment is as follows.
(1) The effect of treatment appears after 1~2 months.
(2) After 3 to 4 months, hypothyroidism begins to appear. Temporary hypothyroidism may return to normal. Those that do not recover become permanently hypothyroid.
(3) In order to observe the effect of treatment, check every other month during the first 4 months.
(4) If the effect of one radioactive iodine treatment is not satisfactory, the treatment should be repeated after 3 to 12 months.
2). Application of thyroxine preparations after treatment.
In any case, hypothyroidism may occur in the future after radioactive iodine treatment. In case of hypothyroidism, one dose of thyroid hormone preparation once a day will ensure normal thyroid function. For permanent hypothyroidism, thyroid preparations must be taken for life without interruption. They are relatively inexpensive and have no side effects, so there is no cause for concern.