Late effects of radioiodine (I-131) Effects on salivary glands • Doses from I-131 to the salivary (and lacrymal) glands can be high, up to 15 Gy • Sialadenitis and persistent xerostomia occur in up to 22% • Dry eyes and conjunctivitis are less frequent
What are the possible side effects of I-131?
]. Dry mouth is a complication which develops late after salivary gland swelling and dysfunction which might be even more frequent when patients are discharged from the hospital. More disturbing to the patients have been the nausea and vomiting which usually occur within 36 h after I-131 administration.
What happens after oral I-131 administration?
After oral I-131 administration, the patients were admitted and restricted in the purpose-built wards with specialized disposal facilities for radioactive waste over a seven-day period.
What are the signs and symptoms of I-131 therapy for thyroid cancer?
Salivary gland swelling, pain, and dysfunction have been the most notable symptoms due to their I-131 uptake and discretion [ 2 D. Van Nostrand, “The benefits and risks of I-131 therapy in patients with well-differentiated thyroid cancer,” Thyroid, vol. 19, no. 12, pp. 1381–1391, 2009. View at: Publisher Site | Google Scholar
How long does nausea and vomiting last after taking I-131?
More disturbing to the patients have been the nausea and vomiting which usually occur within 36 h after I-131 administration. Worth notice is that some patients came up with nausea as early as 2 h.
What are the after effects of radioactive iodine treatment?
What are the side effects of radioactive iodine?Neck tenderness and swelling.Nausea.Swollen salivary glands.Loss of taste or taste change.Dry mouth/insufficient salivary production.Dry eyes.Excessive tearing from the eyes.
How long does it take to feel better after radioactive iodine?
It usually gets better within 4 to 8 weeks. It can help to drink plenty of fluids after your treatment.
How long do side effects of radioactive iodine last?
Nausea: This usually subsides one to two days after treatment. Swollen salivary glands: This can last for a few weeks. It is caused by iodine absorbed by the salivary glands, though stimulating saliva flow a day after treatment (by sucking a lemon drop, for instance) is an effective remedy.
What are the long-term side effects of radioactive iodine?
NCI study finds long-term increased risk of cancer death following common treatment for hyperthyroidism. New study findings show an association between the dose of a common treatment for hyperthyroidism and risk of death from solid cancers.
Does radioactive iodine treatment make you tired?
Radioactive iodine treatment can make your neck swell up or hurt. Nausea or vomiting, which is usually mild. Constipation or diarrhea. Fatigue.
Will I gain weight after radioactive iodine treatment?
Treatment of hyperthyroidism with RAI or anti-thyroid medications is associated with an increased risk of gaining weight and even developing obesity. This risk is slightly higher with RAI therapy compared to medications.
How long does iodine 131 stay in the body?
Most of the radioiodine not collected by your thyroid gland will be eliminated during the first two days after your treatment. It leaves the body primarily through your urine, but very small amounts may leave in your saliva, sweat and during a bowel movement.
Does radioactive iodine affect immune system?
Treatment of Graves' disease patients with radioactive iodide (RAI) can induce two therapeutically important alterations in immune response to thyroid antigens. These may be characterized as a first response and a second phase response.
Can radioactive iodine cause other cancers?
This new analysis concluded that radioactive iodine was associated with an increased risk for mortality from overall cancer, breast cancer, and non-breast solid cancers.
For the Consumer
Along with its needed effects, sodium iodide-i-131 may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
For Healthcare Professionals
Cardiovascular side effects have included chest pain and tachycardia. [ Ref]
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
What happens if your thyroid is destroyed?
Once your thyroid is destroyed, it will no longer work exactly as it used to.
What happens if you destroy your thyroid gland?
And, if you destroy your thyroid gland, it turns out that that may have consequences on your metabolism. Anectodally, you've probably already heard stories about people gaining weight after their procedure.
How long does iodine affect sperm count?
Important to men is the fact that radioactive iodine can cause short-term reductions in sperm count for up to 2 years after your procedure (8).
How long can you live after iodine treatment?
You can expect to live a fairly normal life after radioactive iodine treatment but your life will probably not be exactly as it was before your procedure. For most people, this means that you can expect to live at 80-90% of your 'normal'.
How long does it take for a RAI to fade?
The good news is that this radioactivity does fade over a short period of time (usually 5 to 7 days) but the bad news is that you need to stay under certain precautions during this time.
What happens if you don't have thyroid?
If you don't have thyroid hormone at all then you risk the chance of coma and death.
How long does it take for radioactivity to fade?
The good news is that this radioactivity does fade over a short period of time (usually 5 to 7 days) but the bad news is that you need to stay under certain precautions during this time.
How long before I-131 therapy?
Before I-131 therapy, all patients followed a standard protocol including the lower iodine diet and avoiding radiological contrast, withdrawing thyroid hormone medication 3-4 weeks to stimulate serum TSH values to high levels. One day ahead of the I-131 therapy, only five patients failed to achieve the serum TSH levels > 30 mIU/L. Other lab tests and medical examinations consisted of the following: serum FT3, FT4, Tg, TgAb, PTH, neck ultrasonography, neck and chest X-CT scan, and MRI.
How long does it take for a neck to swell after I-131?
Of these 55 patients, 5 patients had pain or swelling of neck at 2 h, 31 at 24 h, 15 at 48 h, 2 at 72 h, and 2 at 96 h, respectively. 51 patients (51/55, 92.8%) developed pain or swelling of neck within 48 h of treatment, mainly from 24 h to 48 h (Figure 1 ), only 4 patients (4/55, 7.2%) developed the symptom after 48 h, and the symptom did not become apparent until 72 h after therapy. And 55 patients accumulated a great deal of I-131 activities in the thyroid region throughout I-131 whole body scan (Figure 2 (a) ).
How much GBq is I-131?
The dose of 3.7 GBq (100 mCi) of I-131 was used to ablate the thyroid remnants, 5.5 GBq (150 mCi) for patients with lymph node metastasis and 7.4 GBq–9.25 GBq (200–250 mCi) for distant metastases.
How many patients develop insomnia during hospitalization?
We also noticed that 7.7% of patients developed insomnia during hospitalization. Those patients may worry much about their conditions while anxiously waiting for the posttreatment I-131 whole body scan.
What are the complications of radioiodine therapy?
These complications include cerebrovascular events (i.e., strokes) and the premature exacerbation of pre-existing kidney disease. Luckily these risks will diminish in time following successful radioiodine therapy and a return to a persistently normal thyroid level.
What is the risk of radioiodine?
1.) Risk to the patient: The radioiodine (I -131) used to treat thyroid disease in people and animals emits both gamma rays and beta particles. The beta particles, which are much more potent forms of radiation, travel an average distance of less than 1 mm. Because of the short distances they travel they never exit the patient ...
What happens when X-rays pass through the body?
When x-rays, or any ionizing radiation, pass through the body they cause electrons to be ejected from atoms, leaving behind positive ions. These positive ions, or free radicals, can cause damage to DNA. DNA can also be damaged directly by radiation. If DNA is damaged, there are three possible outcomes:
Can iodine cause thyroid cancer?
The risks associated with low level ingestion of radioactive iodine relate to an increased risk of developing thyroid cancer. When the dose of radiation to the thyroid is very low, like might occur by accidental ingestion of litter box contents, then mutations leading to cancer can ensue. Interestingly, when higher doses are given, like those received by the patient treated for hyperthyroidism or thyroid cancer, then the injury to the cells is terminal and hence the cells do not survive to go on to become malignant.
How long before I-131 injections?
You may receive injections of a medication called Thyrogen over two days prior to your I-131 therapy. Thyrogen is recombinant TSH and these injections will elevate the TSH level in your blood, which in turn stimulates the thyroid cells to take up the I-131.
How long does I-131 stay in your system?
I-131 remains in your system for up to a few weeks and excess not taken up by the thyroid is excreted in urine, stool, saliva and perspiration over the first 1-2 days following treatment. As the radioactivity of the I-131 in your system is a concern for those around you, you need to follow radiation safety precautions after receiving I-131. The length of time one has to follow these precautions is partly dependent on the dose of I-131, so the following recommendations need to be individualized. To keep those around you safe, in general, you should stay 6 feet away from them for the first few days (10 feet away for the first 24 hours) In addition your team will provide you with detailed precautions for the first week after treatment, which may include:
How long does it take to stop taking thyroid hormone?
Alternatively, you may be told to stop taking your thyroid hormone pill for about 2-3 weeks. Your body will sense that your thyroid hormone levels are low and will try to stimulate thyroid hormone production by producing large amounts of TSH (your body does not know that your thyroid gland has been removed!). During the time that you are not taking any thyroid hormone, you will experience some hypothyroid (low thyroid levels) symptoms. These may include: difficulty concentrating, fatigue, blue or sad mood, puffiness around the eyes, dry skin, water retention, weight gain, constipation and fatigue. Once you restart your thyroid hormone after the I-131 therapy, it may take several weeks for these symptoms to completely resolve.
How long after I-131 treatment can I go home?
After the whole body scan is completed, you will then receive the oral I-131 treatment pill. After taking the I-131, you will be sent home or, rarely, you may be required to remain in the hospital for a few days . You will be asked to return to the nuclear medicine department 7-10 days later to have another whole body scan, also known as the "post-therapy scan," that will show where the I-131 was deposited in your body. This scan may also identify any new sites of iodine-avid thyroid cancer not seen on the first whole body scan.
How long does it take for I-131 to work?
To prepare you for I-131 therapy and to maximize the effects I-131, there are two things that must happen. First, you must follow a low iodine diet for 1-2 weeks to deplete your body of iodine. Iodine is found in many foods that we eat. This will make your thyroid cells "hungry" for the I-131 and help to increase the amount ...
What happens after a body scan?
After the whole body scan is completed, you will then receive the oral I-131 treatment pill. After taking the I-131, you will be sent home or, rarely, you may be required to remain in the hospital for a few days.
Can RAI cause thyroglobulin to be produced?
However, after the thyroid remnant is destroyed by RAI, these normal cells are no longer contributing to thyroglobulin production. In the future, if thyroglobulin is detected in your blood, your physician knows that it must be produced by residual or recurrent thyroid cancer.
What is the radiation from I-131?
Radioactive I-131 emits both gamma and beta radiation. The gamma radiation allows it to be easily detected and located with radiation survey meters and imaged by nuclear medicine imaging techniques. The gamma radiation from I-131 in the patients is the major source of external radiation to others after an I-131 procedure.
What is the basic radiation safety associated with radioactive I-131?
Basic radiation safety associated with radioactive I-131 involves using the principles of time and distance to reduce exposure to others as the basis for precautions to take after treatment.
Does thyroid carcinoma have radioactive 131?
Thyroid carcinoma patients, receiving radioactive I-131, have already had surgery to remove their thyroid gland but some "thyroid tissue" may remain. Therefore, they have less thyroid tissue to use the radioactive 1-131 and most of the radioactive I-131 remains in circulation as the body processes it and gets rid of it. It is processed by the parts of the body that produce fluids, such as the kidneys that produce urine, the sweat glands that produce sweat, and the salivary glands that produce saliva, and the mammary glands that produce milk if the person is lactating. Radioactive I-131 is also volatile so it may be released as a gas during normal breathing. If the person's kidney function is normal (and they are not lactating), removal of most of the free radioactive I-131 occurs within the first few days through the production of urine.
Is rai safe to use?
This radioactive iodine is used in the form of sodium iodide and because of the extremely small amounts used for imaging or destroying cells, RAI is safe to use in individuals who have had allergic reactions to seafood or X-ray contrast agents. RAI is given by mouth in pill or liquid form.
Does I-131 emit beta radiation?
Radioactive I-131 emits both gamma and beta radiation and a person receiving an I-131 procedure will continue to emit both gamma and beta radiation until the I-131 is gone. The amount of I-131 will decrease over time as the unstable I-131 decays or as the body processes the iodine and eliminates the I-131 from the body.
Is iodine safe to use in thyroid disease?
Two unstable forms of iodine, i.e., the radioactive isotopes I-123 (13 hour half-life and photon (x-ray) emitter is good for imaging the location of iodine in the body and harmless to thyroid cells) and I-131 (8 day half-life and both photon (gamma) and beta particle emitter can both image where iodine is in the body and destroy thyroid cells) are used in the diagnosis and treatment of thyroid disease. This radioactive iodine is used in the form of sodium iodide and because of the extremely small amounts used for imaging or destroying cells, RAI is safe to use in individuals who have had allergic reactions to seafood or X-ray contrast agents. RAI is given by mouth in pill or liquid form.
After Treatment of Overactive Thyroid
Rare
- Excessive sweating
- fast, irregular, pounding, or racing heartbeat or pulse
- fever
- unusual irritability
Incidence Not Known
- Chest pain
- fast, pounding, or irregular heartbeat or pulse
- hives, itching, and rash
- nervousness
Less Common
- Neck tenderness or swelling
- sore throat