Clinical experience and research at home and abroad for many years have shown that iodine-131 treatment for hyperthyroidism is the preferred option. In Europe and the United States, iodine-131 treatment has become the main treatment method for hyperthyroidism. Experts at home and abroad have proven through a large number of follow-up studies that the incidence of leukemia and malignant tumors in patients treated with iodine-131 for hyperthyroidism and their fertility are no different from those of normal people.
1. What is hyperthyroidism?
Hyperthyroidism is the abbreviation of hyperthyroidism, which is a common endocrine disorder caused by an increase in the function of the thyroid gland, an increase in the secretion of hormones, or an increase in the level of thyroid hormones in the blood circulation. Clinically, it is characterized by enlargement of the thyroid gland, hypermetabolic syndrome and malfunction of the nervous and cardiovascular systems. The symptoms include fear of heat, excessive sweating, strong appetite, weight loss, tachycardia, emotional stress, short temper, enlarged thyroid gland and protruding eyes.
2. Why does hyperthyroidism occur?
The cause and pathogenesis of hyperthyroidism have not yet been fully elucidated. According to the research in the past 20 to 30 years, the disease is mainly caused by autoimmune reaction induced by mental stimulation and other stress factors on a genetic basis. However, the pathogenesis is still speculative, especially the cause of the initiation is unknown. According to the current understanding, it may be due to a genetic defect in the immune guardianship and regulation of the Ts cells of the patient. When stress such as mental stimulation or infection occurs, the immune stability of the body is destroyed and the “forbidden” cells lose control, resulting in the proliferation of TSI-producing B cells and the secretion of a large number of autoantibodies to TSI with the assistance of Th cells.
3.What are the treatments for hyperthyroidism?
At present, there are three main treatments for hyperthyroidism: internal medicine, surgery and iodine-131 therapy.
4.Why can radioactive iodine-131 treat hyperthyroidism?
Iodine is the main raw material for thyroid gland to synthesize thyroid hormone. Radioactive iodine for treatment has the same physical and chemical properties as stable iodine, so the thyroid gland also has the ability to selectively and highly absorb and concentrate radioactive iodine. Normally, the concentration of iodine in the thyroid gland can reach 25 times of the plasma concentration, and in case of insufficient iodine supply, the concentration can reach 500 times of the plasma concentration. Due to the increased rate and amount of thyroid hormone synthesis in hyperthyroidism, the thyroid gland is relatively iodine-deficient and has a particularly strong ability to concentrate radioactive iodine, which can reach 80% to 90% of the internal concentration. Radioactive iodine-131 stays in the thyroid gland for a long time, with an effective half-life of up to 3.5-4.5 days. Iodine-131 mainly releases beta rays (99%) and gamma rays (1%) when it decays.
5. Which patients are suitable for iodine-131 treatment of hyperthyroidism
Clinical experience and research at home and abroad over the years have shown that iodine-131 treatment for hyperthyroidism is the preferred option, without the risk of leukemia and thyroid tumors. The indications that are generally considered to be suitable for iodine-131 treatment of hyperthyroidism are
(1) Patients with diffuse hyperthyroidism who are 20 years of age or older.
(2) Patients who have been treated with long-term antithyroid drugs with poor results, relapse after treatment with allergy to antithyroid drugs and other serious side effects and cannot continue to apply antithyroid drugs or cannot adhere to long-term medication are prohibited.
6.The effect of iodine-131 treatment for hyperthyroidism
The efficacy of iodine-131 in the treatment of hyperthyroidism has been confirmed at home and abroad, and the total efficacy is over 90%. Generally, patients’ symptoms gradually improve within 3 months after iodine treatment, and all symptoms disappear within 6 months to 2 years, but in some patients, some symptoms may disappear only after several years. Due to the inconsistent treatment methods at home and abroad, the cure rate of a course of treatment varies from 70% to 90%, and the recurrence rate is about 1% to 4%. If the goiter shrinks after iodine treatment, but the symptoms still exist, it is not advisable to treat it with iodine immediately.
If the thyroid gland does not shrink or continues to increase in size and clinical symptoms are evident, the next course of treatment may be administered 3 to 6 months after the first course of treatment. A common complication or side effect of iodine-131 therapy is the possibility of hypothyroidism in a small number of patients. In order to detect the occurrence of hypothyroidism and treat it effectively, all patients receiving iodine-131 treatment for hyperthyroidism should be followed up regularly to monitor changes in TSH levels.
7. Precautions for iodine-131 treatment of hyperthyroidism
In order not to affect the absorption of iodine-131, patients should take iodine-131 on an empty stomach before taking it and eat only 2-3 hours after taking it. Iodine, australia and anti-thyroid drugs should not be used within 2 weeks after taking iodine-131. Because of the destruction of the thyroid follicles after iodine-131 treatment, a large amount of thyroid hormone enters the bloodstream and may aggravate the symptoms of hyperthyroidism in the short term, so for the first week after iodine-131 treatment, patients should pay more attention to rest and avoid strenuous activities. In severe cases, anti-thyroid drugs may be considered three days after iodine-131 treatment to reduce symptoms. Special attention should be paid to avoid mental stimulation and prevention of infection, both of which can easily trigger hyperthyroid crisis.
8. What to pay attention to in the diet of hyperthyroidism patients
In hyperthyroidism, thyroid hormone secretion is excessive, which promotes the metabolism of three major nutrients, namely essence, fat and protein, and accelerates oxidation. The body’s heat production and heat dissipation increase significantly, and the basal metabolic rate increases abnormally, so the energy must be increased every day to correct the energy consumption in the body. Based on the above reasons, the diet of hyperthyroid patients must pay attention to high calorie, high protein, high vitamin and supplementation of calcium, phosphorus, potassium, zinc and magnesium to correct the consumption caused by hyper-metabolism. Improve the general condition. Avoid iodine-containing foods, such as kelp, nori, hairy vegetables, seafood, etc. Chinese herbs such as mushroom kun-shi, seaweed, summer cucumber, salvia, genistein, aromatic herbs, zhebei, etc. are also used by the Bureau.