Is radioactive iodine safe for hyperthyroidism?
This thyroid treatment is much safer than it sounds; in fact, it is the most commonly used hyperthyroid treatment in the US. Unlike antithyroid medications, radioactive iodine is a permanent and more reliable cure for hyperthyroidism. Radioactive iodine therapy can destroy all or part of the thyroid gland, depending on need.
How is hypothyroidism treated in older adults?
Treatment of an underactive thyroid condition (hypothyroidism) is usually more straightforward than the problem of recurrent hyperthyroidism in the older patient, because of the effect hyperthyroidism can have on the heart, as indicated above. A frequent clinical concern is the treatment of patients with normal T4 and T3 with suppressed TSH.
What is the role of iodine in hyperthyroidism?
Iodine has several effects on thyroid function. (See "Iodine-induced thyroid dysfunction" and "Thyroid hormone synthesis and physiology" .) In hyperthyroid patients, iodine acutely inhibits hormonal secretion [ 1 ], but the responsible mechanisms are uncertain.
Is radioiodine the same as radioactive iodine threapy?
Radioiodine, or RAI, is given as a pill, to treat hyperthyroidism by gradually shrinking your thyroid —ultimately destroying the gland. Yes, RAI is the same as radioactive iodine threapy, which was the formal medical term. It has been changed to lessen the scariness of sound of this therapy.
When Should radioactive iodine be administered?
The therapy is usually given after removal of the thyroid gland to destroy any remaining thyroid tissue. A “tracer” dose of radioactive iodine can also be used to track remaining thyroid tissue and/or cancer that could have spread to other parts of the body.
For which client with hyperthyroidism is radioactive iodine therapy contraindicated?
Contraindications (RAI therapy is not appropriate): moderate to severe eye disease, suspicious thyroid nodule (s), pregnancy or desire to become pregnant in next 12 months, need for quick control of hyperthyroidism.
Who needs radioactive iodine treatment?
Radioiodine therapy is a nuclear medicine treatment. Doctors use it to treat an overactive thyroid, a condition called hyperthyroidism. They also may use it to treat thyroid cancer.
Is hyperthyroidism a risk factor for osteoporosis?
Overt hyperthyroidism is associated with accelerated bone remodeling, reduced bone density, osteoporosis, and an increase in fracture rate. The bone density changes may or may not be reversible with therapy.
Which cases are radioactive iodine contraindicated?
RAI and pregnancy RAI treatment is absolutely contraindicated in pregnancy, because it is readily transferred across the placenta. The damage to the foetal thyroid gland results in hypothyroidism and irreversible mental retardation (44,45).
Why is iodine contraindicated in hyperthyroidism?
Iodine: Yes. Avoid it as a supplement whether you have hyperthyroidism or hypothyroidism. The effect of iodine supplements can vary by person, causing the thyroid to produce either too much or too little hormone. Certain alternative medicine websites or doctors tell patients that iodine is good for your thyroid, Dr.
Which is better thyroid surgery or radioactive iodine?
Surgery for hyperthyroidism was associated with a lower risk of all-cause and cardiovascular death as compared to radioactive iodine therapy during long-term follow-up, particularly in men.
How successful is radioactive iodine treatment?
Conclusion: Radioactive iodine treatment is an effective modality for definitive treatment of hyperthyroidism with long-term cure approaching 80%.
Can hyperthyroidism return after radioactive iodine?
Once hypothyroidism has been achieved, it is usually irreversible with the patient requiring lifelong thyroid replacement. Recurrence of hyperthyroidism after RAI therapy may be due to inadequate dosing or early Marine Lenhart syndrome.
Can osteoporosis caused by hyperthyroidism be reversed?
The association between a hyperactive thyroid, high-turnover bone loss, and increased risk for fractures is well-established, and reversal of osteoporosis after thyreostatic treatment has been documented previously [10–12].
Is there a connection between osteoporosis and thyroid?
What is the link between thyroid disease and osteoporosis? Thyroid hormone affects the rate of bone replacement. Too much thyroid hormone (i.e. thyroxine) in your body speeds the rate at which bone is lost. If this happens too fast the osteoblasts may not be able to replace the bone loss quickly enough.
Can too much thyroid medication cause osteoporosis?
Too much thyroid medicine increases the activity of the osteoclasts (the bones that break down bone) and put you at an increased risk for breaking a bone.
How long does it take for thyroid to return to normal after iodine?
For most people, one dose of radioactive iodine treatment will cure hyperthyroidism. Usually, thyroid hormone levels return to normal in 8 to 12 weeks. In rare cases, the person needs a second or third dose of radioactive iodine. Risks. Some side effects from radioactive iodine treatment include:
How long does it take for iodine to leave your body?
Most people don't feel different after treatment. But a few people may have nausea. Within a few days after treatment, the radioactive iodine will leave your body in your urine and saliva. How long it takes will depend on your age and on the dose you received.
Does radioactive iodine harm thyroid?
After you swallow it, it is taken up by your thyroid gland. Depending on the dosage used, the radioactivity in the iodine destroys most or all of the tissue in your thyroid gland, but it does not harm any other parts of your body.
When was iodine used for hyperthyroidism?
They returned to favor in the 1920s as preoperative treatment for hyperthyroidism and were used in the 1930s as the sole therapy for mild hyperthyroidism prior to the introduction of the thionamides. Today, iodine continues to have a minor role in the treatment of hyperthyroidism. The role of iodine in the treatment of hyperthyroidism will be ...
What is iodine solution?
Iodine solutions, such as saturated solutions of potassium iodide (SSKI) or potassium iodide-iodine (Lugol's solution), replaced burnt sponge extract in the 19 th century as treatment for endemic goiter. By extension, they were sometimes used to treat Graves' disease, but by the end of the century, they were considered to be a dangerous form of therapy. They returned to favor in the 1920s as preoperative treatment for hyperthyroidism and were used in the 1930s as the sole therapy for mild hyperthyroidism prior to the introduction of the thionamides. Today, iodine continues to have a minor role in the treatment of hyperthyroidism.
Does iodine affect thyroid?
In hyperthyroid patients, iodine acutely inhibits hormonal secretion [ 1 ], but the responsible mechanisms are uncertain. This is the most acute effect of iodine on thyroid status, occurring within hours of the start of therapy.
What is the treatment for hyperthyroidism in older patients?
As with younger patients, treatment of hyperthyroidism in the older patient includes antithyroid drugs and radioactive iodine (see Hyperthyroidism brochure ). Surgery is rarely recommended due to increased operative risks in the older patient. While Graves’ disease is still a common cause of hyperthyroidism, toxic nodular goiter is seen more frequently in the older patient. During therapy, the effects of change in thyroid function on other body systems must be closely monitored, due to an increased likelihood of co-existing cardiac, central nervous system and thyroid disease in older patients. Most often, thyroid function is brought under control first with antithyroid drugs (propylthiouracil or methimazole (Tapazole®)) before definitive treatment with radioactive iodine.
How common is hypothyroidism in nursing homes?
Hypothyroidism is very common in patients over 60 years of age and steadily increases with age (see Hypothyroidism brochure ). Up to 1 in 4 patients in nursing homes may have undiagnosed hypothy roidism. Unlike symptoms of hyperthyroidism, the symptoms of hypothyroidism are very non-specific in all patients, even more so in the older patient.
What determines the dose of thyroid hormone replacement?
The presence or absence, and severity, of thyroid-related symptoms and co-existing diseases such as coronary artery disease or heart failure will determine the dose of thyroid hormone replacement that is given.
How old is a woman who has lost strength in her legs?
A 65 year old woman who has lost strength in her legs, causing difficulty in climbing stairs;she has recently lost 15 lbs in spite of a very good appetite. A 75 year old woman who has developed difficulty swallowing and a dry cough, accompanied by hoarseness, weight gain, and dry, itchy skin. A 78 year old man with hearing loss.
Can hypothyroidism cause constipation?
For example, memory loss or a decrease in cognitive functioning, often attributed to advancing age, may be the only symptoms of hypothyroidism present. Symptoms and signs of hypothyroidism may include weight gain, sleepiness, dry skin, and constipation, but lack of these symptoms does not rule out the diagnosis.
Is TSH normal for elderly?
There is some controversy about what the normal level of TSH is for elderly patients. In general, an attempt is made to render thyroid function either normal or low in an elderly patient treated with radioactive iodine.
Does L-T4 work for thyroid?
As with the younger patient, pure synthetic thyroxine (L-T 4), taken once daily by mouth , fully replaces the function of the thyroid gland and successfully treats the symptoms of hypothyroidism in most patients (see Thyroid Hormone Treatment brochure).