The thyroid gland is located in the front of the neck and is normally invisible and inaccessible. When it becomes enlarged and produces too much thyroid hormone, it is called hyperthyroidism (hyperthyroidism for short). Hyperthyroidism is a very common endocrine disease that can affect children, adults and the elderly alike, and is a serious threat to the physical and mental health of patients.
Its main manifestations include fear of heat, excessive sweating, insomnia, panic attacks, hand tremors, irritability, easy hunger, overeating, emaciation, weakness, protruding eyes and enlarged thyroid gland. It is now believed that the disease is not caused by iodine deficiency, but is related to thyroid autoimmune disorder, endocrine dysfunction, genetic defects and poor living environment.
There are three traditional treatments for hyperthyroidism, namely antithyroid drugs, surgery and nuclear iodine 131. These drugs mainly inhibit the synthesis of thyroid hormone, which is easy to use but ineffective, with a cure rate of only 20-40% and a long course of treatment.
Moreover, thyroid function, blood count, liver and kidney function should be reviewed regularly (usually 2-3 months); anti-thyroid drugs can easily lead to leukopenia and even granulocyte deficiency, septic sepsis, which can be life-threatening, and also damage liver and kidney function. Surgical removal of most of the thyroid gland is fast and effective, but it is risky. If the parathyroid glands are damaged or the blood flow is impaired, hypocalcemic tics may occur; accidental injury to the laryngeal nerve may cause hoarseness; local bleeding, wound infection, and anesthesia accidents are inevitable; and postoperative scarring of the wound may affect the aesthetic appearance.
Excessive removal of thyroid tissue can lead to hypothyroidism, and residual tissue can also lead to recurrence of hyperthyroidism after surgery (recurrence rate 10-15%). In addition, the cost of surgery is high and can add to the financial burden of the patient.
Indications for 131 iodine treatment.
1. Moderate hyperthyroidism, age 25 years or older.
2. Those who have allergic reactions to antithyroid drugs and cannot continue to use them, or whose long-term treatment is ineffective, or who relapse after treatment.
3, Combination of heart, liver and kidney diseases that are not suitable for surgery, or relapse after surgery, or those who do not want to operate.
4.Some high-functioning nodules.
5.Those with non-autoimmune familial toxic goiter.
Relative indications for 131 iodine therapy.
1.Adolescents and children under 25 years of age (over 10 years of age) with allergy or leukopenia treated with antithyroid drugs, or whose long-term treatment is ineffective.
2. Those with combined endocrine malignant proptosis.
Contraindications to 131 iodine therapy.
1.Pregnant and lactating women.
2.Severe heart, kidney or liver failure, or active tuberculosis.
3.Persons with peripheral leukocytes below 3w109/L, or neutrophils below 1.5w109/L.
4.Severe infiltrative proptosis.
5.Thyroid crisis.
6. Those whose thyroid gland is unable to take up iodine.
Preparation before 131 iodine treatment.
1. Stop using high iodine food such as seafood like kelp, nori, shrimp, etc. and various iodine agents and iodine-containing herbal medicines for more than one month.
2. Stop using anti-thyroid drugs for more than one week and other drugs that affect iodine absorption, such as thyroxine tablets, vitamin C, sulfonamides, anti-TB drugs, hormones, etc.
3.Low iodine diet.
4. Test thyroid hormone, blood count and sedimentation, liver and kidney function, electrocardiogram (cardiac ultrasound if necessary), iodine absorption rate and effective half-life, thyroid scan (or ultrasound), etc.