Although hyperthyroidism is an incurable and recurring disease, and no method has been found to prevent its onset, it is not an incurable disease and can be completely cured if an effective method is chosen for timely treatment. At present, there are three recognized treatments for hyperthyroidism in the world: iodine-131 therapy, internal antithyroid drug therapy and surgical treatment. 1: Internal treatment: Internal antithyroid drugs (ATD): The mechanism of treatment is to inhibit the activity of thyroid hormone synthesizing enzymes, thus reducing the synthesis of thyroid hormones. It is mainly suitable for patients under 20 years of age and patients with mild hyperthyroidism. The disadvantage is that the course of treatment is long, at least 2-3 years, or even longer, and the relapse rate is high, up to 50-60%, after stopping the medication. 2: Surgical treatment, mainly for ectopic goiter, nodular goiter with hyperthyroidism, severe enlargement of the thyroid gland with pressure symptoms and hyperthyroidism with “cold” nodules, with a cure rate of 50-70% and a recurrence rate of about 10%, with the disadvantage of damage to the parathyroid glands and the laryngeal nerve. 3: Iodine-131 treatment. Iodine-131 one-time oral treatment for hyperthyroidism is regarded as the oldest, most mature and most widely used exemplary treatment method in radionuclide therapy. Since the beginning of this method in 1942, about ten million cases of hyperthyroidism have been treated with iodine-131 at home and abroad. With the long-term and in-depth research on the treatment of hyperthyroidism with iodine-131 and the new understanding of its advantages and disadvantages, the treatment of hyperthyroidism with iodine-131 has been accepted by more and more doctors and patients. In developed countries in Europe and America, iodine-131 has been adopted as the first choice for the treatment of hyperthyroidism, among which the application of iodine-131 in the United States is the most popular, with more than 80% of hyperthyroid patients treated with iodine-131. When former US President George W. Bush was suffering from hyperthyroidism during his administration, he was finally treated with this method after consultation and discussion by many world-class authoritative medical experts, and received good results. After the 1980s, with the improvement of medical technology and equipment as well as the increase of international medical technology exchange, more and more hyperthyroidism patients have been treated with iodine-131, with an efficiency rate of
The efficiency rate is over 98%, and the cure rate is as high as 70-80%. The few patients who have not been cured once by radioactive iodine-131 can repeat the treatment and will not be affected by other treatment methods in the future. Why is isotope therapy so effective? Radioactive iodine-131 has the same physiological and biochemical properties as stable iodine, and the thyroid tissue has the same high absorption and concentration capacity. A large concentration of radioactive 131 iodine exposes the thyroid gland to radiation and destroys part of the thyroid tissue, in a similar way to surgery, resulting in a reduction in thyroid hormone production and the remission or cure of hyperthyroidism. Iodine-131 is an unstable radionuclide that emits gamma and beta rays during the decay process, with beta rays accounting for 99% of the therapeutic effect. Since the range of beta rays in the thyroid tissue is only 2mm to 3mm, they are basically absorbed by the thyroid tissue and have no significant adverse effects on the surrounding tissues, not to mention affecting fertility and causing cancer, etc. This has been confirmed by the scientific research conducted by the World Health Organization worldwide.
It is a biological missile treatment method, which is known as “no surgery, no bloodshed, no pain”. Only a few patients have early reactions within 2 weeks after taking the drug, mainly nausea, vomiting, dizziness and weakness; a few other patients have rash and itching, which are generally mild and can disappear on their own; some patients may have transient exacerbation of hyperthyroidism, which is usually temporary, and very few serious cases have to be hospitalized for observation. Late complications are mainly hypothyroidism, one is transient hypothyroidism caused by iodine-131 treatment, which is mild and can disappear on its own after 6-9 months. The other is permanent hypothyroidism, the incidence of which is reported to be 2% to 5% in the first year in China, and increases by 2% to 3% year by year as time goes on. As long as the appropriate amount of thyroxine is supplemented, normal thyroid function can be maintained and the patient will have no adverse reactions as normal people; just as we have to eat every day, taking thyroid hormone for patients with low thyroid is like supplementing nutrition.
Some scholars believe that hypothyroidism is a natural history of hyperthyroidism and can occur after various treatments, and is not unique to iodine-131 treatment. Of course, there are contraindications to radioactive iodine-131 treatment for hyperthyroidism. Pregnant and lactating patients are absolutely contraindicated, while others are relatively contraindicated, such as children and adolescents; patients with significant enlargement of the thyroid gland with symptoms of compression; patients with hyperthyroidism with recent myocardial infarction; patients with severe liver and kidney insufficiency; patients with severe infiltrative proptosis; patients with thyroid crisis; and patients with a thyroid gland unable to take up iodine. In summary, several methods of treating hyperthyroidism have their own characteristics. Relatively speaking, radioactive iodine-131 treatment for hyperthyroidism has the following advantages.
It has the following advantages: wide scope of application, simple method, safe and effective, few and mild side effects, low price, low number of doses, high cure rate and low recurrence rate.