Why can Iodine 131 cure hyperthyroidism?
The thyroid gland is the only organ in the body that uses iodine as its main “food”. The iodine we consume from our diet is partially consumed by the thyroid gland, while the unconsumed part is excreted in our urine and stool. Hyperthyroidism is a disease caused by an increase in the synthesis of thyroid hormones by the thyroid gland. In hyperthyroidism, the thyroid gland eats a lot and most of the iodine that enters the body is eaten by it. Iodine 131 is the twin of the iodine that we normally encounter in our lives, and it looks almost the same. These rays will dry out the thyroid cells and make them lose their ability to produce thyroid hormone. The number of cells that can produce thyroid hormone will be greatly reduced, and the thyroid gland will produce less thyroid hormone, and the amount of thyroid hormone released into the blood will be reduced accordingly. Some people say that Iodine 131 treatment is a non-invasive surgery, others say it is a “liquid knife”, and some say it is a “miracle water”.
Who can choose Iodine 131 treatment?
All patients with hyperthyroidism, except those who are pregnant or breastfeeding, can choose Iodine 131 treatment as long as their thyroid gland is able to eat iodine well and the iodine can stay in the thyroid gland for a certain period of time.
Patients with significant neck enlargement, where the effect of drug therapy is often unsatisfactory, can be the first choice. Male patients with hyperthyroidism, often accompanied by hypothyroidism and periodic paralysis (during the attack, the milder ones show weakness of limbs and inability to stand, and the severe ones have difficulty in breathing due to respiratory muscle paralysis, which can be restored to normal after intravenous potassium chloride supplementation), can be the first choice. Patients with hyperthyroidism with impaired liver function, impaired heart and prominent neuropsychiatric symptom expression can be preferred along with effective liver protection, heart protection and antipsychotic treatment. Diabetic patients with good glycemic control can be preferred. Of course, women of childbearing age who wish to have a baby as soon as possible can also be preferred.
In case of significant side effects during antithyroid drug treatment, such as liver function impairment, severe allergy, granulocytopenia, treatment should be changed to iodine 131. Patients who do not have good results with anti-thyroid medication, have a significantly enlarged neck, or have a relapse upon discontinuation of medication should also be promptly switched to iodine 131 treatment.
Why should I avoid iodine before taking Iodine 131?
If the intake of iodine is too much, the thyroid gland is already full, and then given iodine 131 it will not be able to eat in, and it will be ineffective with iodine 131. Therefore, the first thing to do before iodine 131 treatment is to avoid eating high-canon foods and avoid using iodine preparations, which will cause iodine starvation in the thyroid gland, and the truth that hunger does not choose food applies here.
Highly iodized foods are mainly kelp, nori, seafood, iodized salt, etc.
Iodine preparations, such as iodine wine for disinfection, iodine tincture, Lugol’s liquid, the drug Amiodarone, enhancement drugs used in hospital radiology departments for CT enhancement examinations, contrast agents for contrast examinations, etc. If you use these, it may take 3 to 4 months before you can have iodine 131 treatment oh!
What are the possible side effects after Iodine 131 treatment?
Iodine 131 treatment for hyperthyroidism is safe and effective as long as you are well prepared and strictly follow your doctor’s instructions. There may be some side effects after taking Iodine 131, but most of them are not serious and very few of them are.
Possible side effects can be localized in the neck and systemic manifestations. Neck manifestations are mainly caused by radioactive thyroiditis, which may occur 3-7 days after taking iodine 131, manifested as neck swelling, neck pain, neck discomfort and foreign body sensation in swallowing, etc. Most people have mild manifestations and no special treatment is needed. The systemic manifestations may be related to the stimulation of the gastrointestinal tract by iodine 131 and the destruction of the thyroid, the massive release of thyroid hormones from the thyroid into the blood, the formation of temporary hyperthyroidism, and the aggravation of hyperthyroidism. The former mostly occurs 1~3 days after taking the drug, mainly manifested as loss of appetite, nausea, vomiting, etc. Most of them do not need to be treated, and will disappear naturally after a few days, while serious cases can be treated with gastrointestinal drugs. Generally speaking, as long as you follow the doctor’s instructions and take the medication prescribed by the doctor, most of the symptoms will be well controlled. One of them was induced by heat stroke and was discharged after emergency hospitalization. The other was a patient with diabetes mellitus who died of ketoacidosis due to poor glycemic control and induced hyperthyroidism crisis.
Hypothyroidism is very common with iodine 131 treatment, and can occur early after iodine 131 treatment, with some becoming hypothyroid after 2 months of taking iodine, or after several years.
We have seen cases of hyperthyroidism cured by iodine 131, but the eye protrudes, or the eye protrudes before treatment, but after iodine 131 treatment the eye protrusion is aggravated. This is not a rare case. I have treated more than 10,000 patients, but there are less than 50 cases of this kind, mostly patients whose eyes were already protruding before taking Iodine 131.
What should I pay attention to after taking Iodine 131?
Precautions after taking iodine 131 can be summarized as follows: avoid iodine, take medication on time, be lazy, prevent and cure diseases, radiation protection and review on time.
After taking Iodine 131, you should continue to avoid iodine and eat less iodine-rich food.
The effect of iodine 131 treatment is a slow process, most patients may feel the significant effect only after 1~1.5 months. Before that, hyperthyroidism symptoms still exist, meanwhile, due to the destruction of the thyroid gland, a large amount of thyroxine enters the blood, and the performance of hyperthyroidism may be more serious. For these situations, doctors will routinely prescribe some symptomatic treatment drugs, such as insulin, glutathione, creatinine, B vitamins, etc., which are usually taken for one month. After one month, the effect of iodine 131 treatment has been shown, there is no need to take these drugs.
Good food and lazy work means that you should pay attention to rest and strengthen nutrition after taking iodine 131. Within one month after taking iodine, hyperthyroidism is not yet cured, and the body’s metabolic consumption will be even more harmful. It is necessary to strengthen nutrition to meet the body’s needs and enhance resistance to disease. It is recommended to eat more fruits, vegetables and meat for one month after taking iodine, and to refrain from heavy work for one month and to ensure sufficient sleep to prevent complications and ensure the efficacy of treatment.
During the treatment period, attention should be paid to the prevention and treatment of concomitant diseases, such as heavy colds, fever, diarrhea, diabetes, etc. Good prevention and treatment of concomitant diseases is important to reduce the chance of serious complications and to ensure the safety of iodine 131 treatment.
Because iodine 131 is a radioactive substance, the body contains radioactivity after eating iodine 131, which is a mobile radioactive source that shines wherever you go. In China, most people are treated on an outpatient basis, therefore, when you go home, you should minimize the exposure to family members, preferably in a room by yourself, and avoid close contact with children, pregnant women and other people who are highly sensitive to radiation. Since iodine 131 not absorbed by the thyroid gland is mainly excreted through urine and faeces, you should flush more after urination and faeces to prevent spillage on the bathroom floor and avoid indoor radioactive contamination.
After 3 months of iodine 131 treatment, most patients’ hyperthyroidism symptoms will be reduced or disappear, some may become hypothyroid. This is the first review after iodine 131 treatment, the purpose is to see if the hyperthyroidism is cured, to determine whether a second treatment is needed, and more importantly, to detect hypothyroidism early so that it can be treated early. Remember to come back to the hospital on time for follow-up checkups!
What is the effectiveness of Iodine 131 treatment for hyperthyroidism?
The efficacy of iodine 131 in treating hyperthyroidism is certain, with an overall efficiency rate of over 90%. However, whether hyperthyroidism can be cured depends on the patient’s condition, the sensitivity of the thyroid gland to radiation, and sometimes more so on the doctor, which varies significantly from hospital to hospital and from doctor to doctor. The amount of iodine 131 taken is the key to determine the efficacy and cure rate, but there is no unified standard for how much should be taken, either calculated by a formula, or given in a fixed dose, or the dose is determined by other methods. If the doctor is experienced and has a more positive attitude towards the treatment of hyperthyroidism, the dosage will be larger and the chance of curing hyperthyroidism will be higher, and of course the chance of becoming hypothyroidism will also be higher. Although the chance of hypothyroidism is reduced, the chance of curing hyperthyroidism is also reduced, and even the cure is not good.
How do you think about hypothyroidism caused by hyperthyroidism treated with iodine 131?
The fear of becoming hypothyroid after Iodine 131 treatment and the fear of taking hypothyroidism medication for life are among the main reasons why patients do not choose Iodine 131 treatment.
It is very common for hypothyroidism to occur in patients with hyperthyroidism treated with Iodine 131. It can be said that as long as treatment with Iodine 131 is used, it is possible to become hypothyroid, and it can also be said that hypothyroidism is inevitable as a result of aggressive treatment of hyperthyroidism.
Both hypothyroidism and hyperthyroidism are diseases, and both can have serious consequences if not treated aggressively. There are three main methods of treatment for hyperthyroidism, anti-thyroid medication, surgery and iodine 131, and of course, we have Chinese medicine. The fact that none of the treatments in use can perfectly cure hyperthyroidism shows that hyperthyroidism treatment is complex and difficult. However, the treatment of hypothyroidism is obviously much simpler, and the majority of patients will not show signs of hypothyroidism as long as they take Eugenol orally. There is a saying among our doctors that “we would rather have hypothyroidism than hyperthyroidism”, and some people say that “if we don’t cure hypothyroidism, hyperthyroidism is not cured”, and some people even say that “to cure hyperthyroidism into hypothyroidism is the goal of hyperthyroidism treatment. Some people even say that “the goal of hyperthyroidism treatment is to cure hypothyroidism.
Hypothyroidism is a disease in which the thyroid gland’s ability to synthesize thyroid hormones decreases, resulting in a lack of thyroid hormones in the human body. The current treatment for hypothyroidism is to take oral thyroxine medication to supplement the lack of thyroid hormones in the body to meet normal human needs, just like buying food to eat when we cannot produce food ourselves.
Eugenol is the most commonly used medication for hypothyroidism treatment, with no significant side effects when taken in normal amounts, just like vitamins, it is very safe and we can think of it as a special nutrient. Eugenol has no effect on the fetus and can be used normally by hypothyroid patients during pregnancy. The effect of Eugenol treatment is also very stable, except for pregnant women with hypothyroidism who need monthly thyroid function tests, other patients with hypothyroidism can be rechecked once every 6-12 months. In our country, Eugenol is available in hospitals at the county level and above.
What is the effect of iodine 131 treatment for hyperthyroidism on fertility?
The reason why female hyperthyroidism patients of childbearing age do not choose Iodine 131 treatment is not only because they are worried about hypothyroidism, but also because they are afraid that they will not be able to have children after taking Iodine 131, or that their offspring will have deformities.
After iodine 131 enters the human body, the ovaries do not have the function of eating iodine, iodine 131 will not stay in the ovaries and will not destroy it, and its function of secreting female hormones and producing eggs will not be affected, so it will not affect childbirth or produce deformed state children. In fact, up to now, more than one million cases of hyperthyroidism have been treated with iodine 131 worldwide, and there have been no reports of fertility or offspring malformations. Even studies of patients with thyroid cancer treated with high doses of iodine 131 (usually 5-10 times the dose for hyperthyroidism) have shown no such effects. On the contrary, it is a well established fact that hyperthyroidism causes infertility, miscarriage, premature birth and birth. In our work, we have seen many cases of patients who were infertile due to hyperthyroidism and became pregnant soon after treatment with iodine 131. Almost all patients who come to our fertility center for infertility (treatment of infertility and IVF) have not been treated with iodine 131.
As anti-thyroid medications have long treatment cycles and unpredictable treatment effects, we recommend that female hyperthyroid patients of childbearing age who wish to conceive a baby early can make iodine 131 treatment their first choice.