With the development of science and technology, the means of disease treatment are constantly being updated. In our clinical work, we often encounter the problem of how to choose a treatment, and here we present the problem of choosing a treatment for a common disease in nuclear medicine: hyperthyroidism.
Any disease treatment will have certain side effects, but the number, chance and severity of side effects and prognosis are what we must consider when choosing. Du Jianqiang, Department of Internal Medicine, Guangdong Provincial Hospital of Traditional Chinese Medicine
The main treatments for hyperthyroidism (Grave’s disease, GD) are: medical medication, surgical treatment and nuclear medicine radioactive iodine treatment.
Method
Medication
Iodine therapy
Surgical treatment
Problems that may occur
1. Recurrence
2. Hypothyroidism
3. Allergy
4. impaired liver function
5. low white blood cells
1. relapse
2. hypothyroidism
3. thyroid crisis (very low, only possible in patients with very severe disease who have been untreated for a long time)
1. scarring
2. relapse
3. hypothyroidism
4. damaged parathyroid glands: twitching of the hands and feet
5. damage to the recurrent laryngeal nerve: hoarseness or even loss of voice
6. damage to the superior laryngeal nerve: choking and coughing
7. edema of the larynx
8. thyroid crisis
9. Infection
The above table shows that 131 iodine treatment is undoubtedly the best choice. Some countries in Europe and the United States have now made 131 iodine therapy the preferred method of treatment for hyperthyroidism, and it is also listed as the first choice in important monographs such as “Hitchcock’s Internal Medicine”.
Special problems encountered with iodine therapy.
The widespread knowledge of nuclear physics and the exaggeration of some literature have made many people talk about nuclear. Many patients often have some questions: Will it cause cancer? Will there be any bad genetic problems? Can they have children? Will they get leukemia?
We say that because iodine only aggregates in the thyroid gland and at a very low dose, just treating the disease of the thyroid gland itself, according to the history of nuclear medicine carried out for more than 60 years and the follow-up of many cases, it is believed that
Patients who received the treatment have problems in their future life with cancer, fertility and heredity, leukemia, etc.: no difference from the general population.
Concerning the possible problems of hypothyroidism after treatment.
1. natural regression.
2. Possible with any means of treatment.
3. Treatment is simple and easy, just take thyroxine.
Some patients ask: Is there a lot of side effects of taking hormones for hypothyroidism?
In fact, thyroxine is an essential hormone in the body, not adrenal glucocorticoid hormone as it is usually said. As long as the medication is taken under the guidance of a doctor, it will not produce any abnormalities.
Other patients ask if taking 131 iodine will aggravate the protrusion of eyes.
The problem of proptosis is a complication of hyperthyroidism. In some patients, proptosis can be reduced with the reduction of symptoms after hyperthyroidism treatment, but in some patients, it is not the case and shows no parallel progression with the symptoms of thyroid disease, and then it is necessary to work with the relevant departments such as ophthalmology to deal with this problem.