Iodine-131 has been used to treat hyperthyroidism for more than 60 years and is now the treatment of choice for adults in the United States and western countries. Since 1958, China has been treating hundreds of thousands of cases of hyperthyroidism with iodine-131, and has accumulated rich experience in treating refractory severe hyperthyroidism with iodine-131, but the frequency of use is significantly higher in Europe and America than in China and Asian countries.
It is now clear that.
1. This method is safe, simple, inexpensive and highly effective, with an overall efficiency of 95%, a clinical cure rate of over 85% and a relapse rate of less than 1%. After 3-6 months after the first iodine-131 treatment, some patients can have the second iodine-131 treatment if their condition requires.
2. Iodine-131 mainly accumulates in the thyroid gland in the body and does not cause acute radiation damage to organs other than the thyroid gland, such as the heart, liver and blood system, so it can be safely used to treat patients with severe hyperthyroidism who are suffering from comorbidities of these organs.
3. Our experts are more cautious about the indications for age. In the United States and other North American countries, treatment of hyperthyroidism in patients under 20 years of age has been repeatedly reported. In the UK, Iodine-131 is also used for children over 10 years of age with hyperthyroidism, especially for those with goiter and/or poor compliance with ATD therapy.
Indications.
1. Adult Graves’ hyperthyroidism with goiter degree II or higher.
2. Failure of ATD therapy or allergy.
3, recurrence of hyperthyroidism after surgery.
4, hyperthyroid heart disease or hyperthyroidism with other causes of heart disease.
5, hyperthyroidism combined with leukocytopenia and/or thrombocytopenia or allohemocytopenia.
6, hyperthyroidism in the elderly.
7, hyperthyroidism with diabetes mellitus.
8. toxic multinodular goiter.
9, Autonomous functional thyroid nodules combined with hyperthyroidism.
Relative indications.
1, adolescents and children with hyperthyroidism who have failed treatment with ATD, refused surgery or have contraindications to surgery.
2, hyperthyroidism combined with impairment of liver, kidney and other organ functions.
3, infiltrative proptosis. Iodine-131 alone can be used to treat mild and stable moderate to severe infiltrative synostosis, while prednisone can be added before and after iodine-131 treatment for patients in progressive stage.
Contraindications: Pregnant and lactating women.
The main complication after iodine-131 treatment of hyperthyroidism is hypothyroidism. The incidence of hypothyroidism has been reported to increase by 5% annually, reaching 30% in 5 years and 40% – 70% in 10 years. In China, the incidence of hypothyroidism is reported to be about 10% in early stages and 59.8% in late stages. Nuclear medicine and endocrinology experts agree that hypothyroidism is an unavoidable consequence of hyperthyroidism treated with iodine-131, and that the choice of iodine-131 therapy is mainly a matter of weighing the pros and cons of the consequences of hyperthyroidism and hypothyroidism. After the onset of hypothyroidism, L-T4 replacement therapy can be used to maintain normal thyroid function, allowing patients to live, work and study normally, and women of childbearing age to have pregnancies and give birth.