Taking radioactive 131 iodine to treat hyperthyroidism is easy to use, has a high one-time cure rate and low cost, so it is popular among patients. However, some people are concerned that radiation is harmful, that it can harm the “vitality” of the body, that it can cause infertility, and so on. What are the facts? We should have a proper understanding of it.
Hyperthyroidism (hyperthyroidism) is a very common endocrine disease with many causes and types, but the common feature is excessive secretion of thyroid hormones. Zheng Songstop, Department of Nuclear Medicine, Siping First People’s Hospital
The common self-conscious symptoms of hyperthyroidism include panic, rapid heartbeat, fear of heat, excessive sweating, short temper, weakness, weight loss, hyperphagia, and increased stool. Some patients may also find themselves with thickening of the neck and protruding eyes. If the above symptoms and signs appear, you should go to the hospital for relevant examination in time.
Patients suffering from hyperthyroidism need not panic, as the disease is completely curable. However, it is different from a cold or flu that will be cured within a few days, there is a process. At present, there are four kinds of treatment methods in common use: internal anti-hyperthyroidism medication, surgery, radioactive iodine treatment and Chinese herbal medicine.
The treatment of hyperthyroidism with radioactive 131 iodine is one of the most recognized and effective methods in the world. When former U.S. 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. Currently, this is included in the preferred method in some western countries. Why is isotope therapy so effective? Radioactive 131 iodine has the same physiological and biochemical properties as stable iodine, and the thyroid tissue has the same high absorption and concentration capacity. A large amount of concentrated radioactive 131 iodine exposes the thyroid gland to radiation, destroys part of the thyroid tissue, reduces the production of thyroid hormones, and relieves or cures hyperthyroidism. 131 iodine is an unstable radionuclide that emits γ and β rays during the decay process, with β rays accounting for 99% of the therapeutic effect. Because of the short range of β-rays, 1 mm on average and 2.2 mm on the longest, they have little or no effect on the tissues and organs surrounding the thyroid gland. This shows that radioactive 131 iodine is a safe and easy way to treat hyperthyroidism.
Which patients with hyperthyroidism are suitable for radioactive iodine therapy? It is generally accepted that radioactive iodine therapy is suitable for adult patients of both sexes. There is some debate about the treatment of women of childbearing age and children. In the early days of using 131 iodine to treat hyperthyroidism, there were concerns about the risk of cancer and leukemia and congenital abnormalities in fetuses. After half a century of clinical practice, these fears have been eliminated. Statistics on more than 2 million patients at home and abroad show that no increase in the incidence of leukemia or thyroid malignancies has been found, fetal malformations do not exceed the natural incidence, and there is no effect on fertility or offspring development. It is unanimously accepted that treatment with 131 iodine is contraindicated in patients with hyperthyroidism during pregnancy and lactation because it can cause hypothyroidism in the fetus or infant. Therefore, we believe that 131 iodine is a safe treatment for patients of all ages (including women of childbearing age and children), except for pregnant and lactating women.
Treatment of hyperthyroidism with radioactive 131 iodine is usually performed in nuclear medicine departments. Most patients can have their disease controlled after treatment and can be cured with a single dose of the drug. A small number of patients require a second treatment. It takes more than 3 weeks after 131 iodine administration for the treatment to begin to take effect, and within 3 months the symptoms gradually improve, the thyroid gland shrinks, and some patients’ proptosis is reduced. If a second treatment is needed, it should be done after 6 months, preferably 8 to 10 months apart.
Some patients with hyperthyroidism have protruding eyes. The reasons for this are complex and may be related to certain immune disorders in the body, or the presence of a substance in the patient’s serum that is associated with the development of protruding eyes. Only a few cases of proptosis may be aggravated by 131 iodine treatment, and this should be properly understood.
Only a few patients have early reactions within 2 weeks after taking 131 iodine, mainly nausea, vomiting, dizziness and weakness; a few patients have skin rash and itching, which are generally mild and can disappear on their own. Some patients may experience transient exacerbation of hyperthyroidism, which is usually temporary, and very few severe cases require hospitalization for observation. Late complications are mainly hypothyroidism, which is caused by insufficient synthesis and secretion or physiological effects of thyroid hormones. 131 iodine treatment causes transient hypothyroidism, which is mild and can disappear on its own after 6 to 9 months. Another type of hypothyroidism 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. Hypothyroidism is not scary, as long as the right amount of thyroxine is supplemented, normal thyroid function can be maintained. Some scholars believe that hypothyroidism is a natural history of hyperthyroidism and can occur after various treatments and is not unique to 131 iodine therapy.
Several methods of treating hyperthyroidism have their own characteristics. Relatively speaking, radioactive 131 iodine treatment for hyperthyroidism has the advantages of wide range of adaptation, simple method, safety and effectiveness, less number of doses and high cure rate at one time.