Treatment FAQ

why do endos recommend radioiodine treatment

by Jolie Adams Published 2 years ago Updated 2 years ago
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The point of the radio-iodine treatment is to destroy the thyroid tissue which is causing the over-production of thyroid hormones. This is especially important for patients with certain types of thyroid cancer who need to have all thyroid cells within their body destroyed in order to cure the cancer and to stop it from spreading.

Full Answer

What should I know about radio-iodine treatment?

First are some things to consider about having radio-iodine treatment, followed by some information aimed at dispelling some of the common fallacies that are found here on the internet. Radio-iodine treatment has become one of the most common treatments for hyperthyroidism and has been used for over 60 years.

Why is radioactive iodine therapy given more than once?

Historically, radioactive iodine therapy has been given to patients more than once, because for a long time, it was the only treatment available for thyroid cancer. We continue to offer more than one treatment in some patients, if the disease recurs or spreads to other parts of the body.

Why is radioiodine not used to treat Graves’s disease?

There is a school of thought that without adequate thyroid tissue, the antibodies that cause hyperthyroidism may go on to affect orbital or dermal tissue, causing Graves’ ophthalmology. For this reason some hospitals avoid using radio-iodine treatment for patients with Graves disease who already have Graves ophthalmology.

Can radioactive iodine be used to treat medullary thyroid carcinoma?

Radioactive iodine therapy cannot be used to treat anaplastic (undifferentiated) and medullary thyroid carcinomas because these types of cancer do not take up iodine. For RAI therapy to be most effective, patients must have high levels of thyroid-stimulating hormone (TSH or thyrotropin) in the blood.

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Why is radioactive iodine needed?

Radioactive iodine (RAI) is treatment for overactive thyroid (hyperthyroidism) and certain types of thyroid cancer. The term “radioactive” may sound frightening, but it is a safe, generally well-tolerated, and reliable treatment that targets thyroid cells so there is little exposure to the rest of your body's cells.

Why is radioactive iodine used after thyroidectomy?

Radioactive iodine therapy, which your doctor may refer to as radioactive iodine ablation, is used about 1 to 2 months after you have papillary thyroid cancer surgery. The goal of this treatment is to kill any cancer cells that may remain after surgery.

What is better 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.

What is the success rate of radioactive iodine treatment?

Conclusion: Radioactive iodine treatment is an effective modality for definitive treatment of hyperthyroidism with long-term cure approaching 80%. Response rate was not related to gender, etiology or RAI dosage. Pre-treatment with anti-thyroid medication reduces the response rate.

Is there an alternative to radioactive iodine?

These alternative therapies include two major categories: redifferentiation therapy and recent molecular target therapy. Several clinical trials have investigated these therapies. They demonstrated potential effects of the therapies, although the results have been somewhat limited so far.

Do you need RAI after total thyroidectomy?

Today, only approximately 20% of all papillary thyroid cancer patients undergo post-0perative RAI treatment. RAI treatment is primarily beneficial only when the patient has undergone a total thyroidectomy (complete removal of the thyroid gland) in the surgery for their papillary thyroid cancer.

Does radioactive iodine shorten your life?

Quality of life is worse at 6-10 years after radioactive iodine therapy of Graves' disease compared with treatment with antithyroid drugs or surgery. Quality of life is worse at 6-10 years after radioactive iodine therapy of Graves' disease compared with treatment with antithyroid drugs or surgery.

Can a thyroid grow back 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.

What are the long term side effects of radioactive iodine?

Possible long term side effects include:Ability to have children (fertility) Some women may have irregular periods after radioactive iodine treatment. ... Inflammation of the salivary glands (where spit is made) ... Tiredness. ... Dry or watery eyes. ... Lower levels of blood cells. ... Lung problems. ... Second cancers.

Who needs radioactive iodine?

Because of this, radioactive iodine (RAI, also called I-131) can be used to treat thyroid cancer. The RAI collects mainly in thyroid cells, where the radiation can destroy the thyroid gland and any other thyroid cells (including cancer cells) that take up iodine, with little effect on the rest of your body.

Can radioactive iodine cause other cancers?

Patients treated with radioactive iodine also have an increased risk of acute lymphocytic leukemia (ALL), stomach cancer, and salivary gland cancer.

How long is isolation after radioactive iodine?

Sleep alone for 7 days unless otherwise instructed by your doctor. Avoid kissing and physical contact with others, and maintain a distance of at least 3 feet from women who are pregnant and children under 18 years old.

What is the radiation used for thyroid cancer?

The radiation dose used here is much stronger than the one used in radioiodine scans, which are described in Tests for Thyroid Cancer. This treatment can be used to ablate (destroy) any thyroid tissue not removed by surgery or to treat some types of thyroid cancer that have spread to lymph nodes and other parts of the body.

How long after radiation therapy can you go home?

Depending on the dose of radioiodine used and where you are being treated, you might need to be in the hospital for a few days after treatment, staying in a special isolation room to prevent others from being exposed to radiation. Some people may not need to be hospitalized. Once you are allowed to go home after treatment, you will be given instructions on how to protect others from radiation exposure and how long you need to take these precautions. These instructions may vary slightly by treatment center. Be sure you understand the instructions before you leave the hospital.

How long should I take thyrotropin before RAI?

Another way is to get an injection (shot) of thyrotropin (Thyrogen), which can make withholding thyroid hormone for a long period of time unnecessary. This drug is given daily for 2 days, followed by RAI on the 3 rd day. Most doctors also recommend that you follow a low iodine diet for 1 or 2 weeks before treatment.

How to treat RAI?

For RAI therapy to be most effective, you must have a high level of thyroid-stimulating hormone (TSH or thyrotropin) in the blood. This hormone is what makes thyroid tissue (and cancer cells) take up radioactive iodine. If your thyroid has been removed, there are a couple of ways to raise TSH levels before being treated with RAI: 1 One way is to stop taking thyroid hormone pills for several weeks. This causes very low thyroid hormone levels (hypothyroidism), which makes the pituitary gland to release more TSH. This intentional hypothyroidism is temporary, but it often causes symptoms like tiredness, depression, weight gain, constipation, muscle aches, and reduced concentration. 2 Another way is to get an injection (shot) of thyrotropin (Thyrogen), which can make withholding thyroid hormone for a long period of time unnecessary. This drug is given daily for 2 days, followed by RAI on the 3 rd day.

Can you use rai for thyroid cancer?

Discuss your risks and benefits of RAI therapy with your doctor. Radioactive iodine therapy cannot be used to treat anaplastic (undifferentiated) and medullary thyroid carcinomas because these types of cancer do not take up iodine.

Can radiation cause irregular periods?

Radioactive iodine may also affect a woman’ s ovaries, and some women may have irregular periods for up to a year after treatment.

Does radioactive iodine help with thyroid cancer?

Radioactive iodine therapy helps people live longer if they have papillary or follicular thyroid cancer (differentiated thyroid cancer) that has spread to the neck or other body parts, and it is now standard practice in such cases. But the benefits of RAI therapy are less clear for people with small cancers of the thyroid gland ...

What is the treatment for thyroid cancer?

The most common types of thyroid cancer (papillary and follicular) can usually be treated with large doses of radioactive iodine. (The dosages of RAI are much higher than with hyperthyroidism treatment.) The therapy is usually given after removal of the thyroid gland to destroy any remaining thyroid tissue. A “tracer” dose of radioactive iodine can ...

How long does it take for iodine to flush out of the body?

Most patients need only one dose before their hyperthyroidism is resolved, which may take a few weeks to several months.

Is radioactive thyroid medicine safe?

The term “radioactive” may sound frightening, but it is a safe, generally well-tolerated, and reliable treatment that targets thyroid cells so there is little exposure to the rest of your body’s cells . Cleveland Clinic is a non-profit academic medical center.

Can RAI cause hypothyroidism?

Permanent hypothy roidism (or underactive thyroid, when the thyroid does not produce enough hormones) is an expected side effect of RAI treatment for hyperthyroidism. Fortunately, hypothyroidism is much easier to treat than hyperthyroidism using hormone replacement therapy.

Why is radio iodine so effective?

One of the reasons that radio-iodine treatment is so effective is because the thyroid readily takes up iodine, which is used in thyroid hormone production. To ensure that the treatment is maximised you will be asked to avoid any foods and medicines ...

What is the purpose of radioactive iodine?

The aim of the treatment is to damage and kill the cells responsible for the hyperthyroidism. Radioactive iodine and some other radioisotopes used in Nuclear Medicine are produced during the production of nuclear energy. They are a by-product or, if you like, a useful waste product.

How long do you have to stay in hospital after ablative thyroid?

Patients who have what is called an ablative dose (usually for treatment of thyroid cancer) are asked to stay in hospital for three days following the treatment. This is to reduce the doses to other members of the public.

How long does it take to stop taking anti-thyroid medication?

This is usually prescribed in the beginning, for all patients, and approximately half of all patients are successfully treated with this method and can cease taking the medication after six months.

Why is lead used in medicine?

The lead captures the emitted radiation, preventing it from resulting in a dose to anybody. It also helps to reduce the amount of time staff spend in contact with radiation, making it possible for us to prepare injections and transport doses without exposing ourselves to an unnecessary dose of radiation.

Why can't you get pregnant after radiotherapy?

Patients are advised not to become pregnant for 6 months following radio-iodine treatment. This is because the radiation that is used could potentially affect the DNA in human cells.

What are the three types of radiation?

Nuclear Medicine concerns three types of radiation: Alpha particles, which are made up of two protons and two neutrons (the material that makes up the nucleus of any atom), Beta, which is either an electron or a positron (smaller particles that form part of an atom) and Gamma, which is basically an energy wave.

What is radioiodine used for?

What is radioiodine? Radioiodine (sodium I-131) is a form of radiation therapy that has been used for many years to treat thyroid conditions. It is safe and effective but requires you to observe certain precautions to decrease the small amount of radiation that other people may receive from your body and bodily fluids.

How long should you wait to breastfeed after radioiodine?

You must stop breastfeeding before you can be treated with radioiodine. If possible, you should stop breastfeeding for 6 weeks prior to treatment. You should not resume breastfeeding after treatment for your current child, but you may safely breastfeed babies you may have in the future.

How long does radioiodine stay in your system?

Radioiodine stays in your body for only a short time. Most of the radioiodine that does not go to thyroid tissue will be eliminated from your body during the first few days after treatment. Radioiodine leaves your body primarily through your urine, but very small amounts can be found in your saliva, sweat and bowel movements.

How can radiation exposure be reduced?

Radiation exposure to other people can be reduced by keeping a reasonable distance between yourself and others and keeping the time you are close to others to a minimum. Your doctor should review the following instructions with you and answer all of your questions.

How to minimize radiation risks?

Keep Your Distance. Here are some ways to minimize radiation risks to other people (and pets) after you have had RAI treatment: Stay at least six feet away from other people, including members of the public, family members, and co-workers, for three to 11 days. This means avoiding public transportation, hotels, carpools, and in some cases, ...

How to avoid radiation?

Here are some ways to minimize radiation risks to other people (and pets) after you have had RAI treatment: 1 Stay at least six feet away from other people, including members of the public, family members, and co-workers, for three to 11 days. This means avoiding public transportation, hotels, carpools, and in some cases, your workplace. 2 Sleep apart from adults by at least six feet (a separate bedroom is recommended) and avoid sexual activity. 3 Avoid sleeping in the same bed with a pregnant woman, infant, or child for a period of six to 23 days. According to the Nuclear Regulatory Commission, infants and children should ideally stay outside the home for the recommended period. 1  4 To protect family pets, do not sleep with them for up to 21 days.

Does iodine affect thyroid?

Because the radioactive iodine used (known as iodine 131) may expose those around you to the effects of radiation (and theoretically negatively affect their thyroid glands), you will be given guidelines on how to prevent such exposure. Laura Porter / Verywell.

Can you hospitalize after a RAI?

It is not common in the United States to hospitalize patients after RAI, but if you are receiving a particularly high dosage of iodine 131 and have no way to protect children or babies, it may be an option. A Low-Iodine Diet Can Make Radioactive Iodine Treatment More Effective.

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 radioactive 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). This may or may not be important to you based on your age, your gender, and whether or not fertility is something you are interested in but, again, it's worth knowing about.

How to avoid weight gain after RAI?

Your best bet to AVOID weight gain after RAI is to go into your procedure with a normal weight and to maintain a healthy lifestyle both before and after. Just realize that you will always be in a 'sensitive' category and you will be more likely to gain weight compared to people with their thyroid intact. #3.

Can you take a thyroid pill every day?

There's no way for doctors to give you a pill once a day and for that pill to perform the exact same function that your thyroid gland does every minute of every day. Because of this, people may experience symptoms which may lead them to want to restore whatever thyroid function they can.

Can beta cells take up iodine?

But you probably at least know a little bit about RAI or you wouldn't be here.

Can you gain weight after radioactive iodine treatment?

You may gain weight. This is probably not what you want to hear, especially if this is a procedure that is necessary for your health, but it's still important to know about it. You may gain weight after you undergo radioactive iodine treatment.

How does radioiodine work?

In short, radioiodine is administered as a salt pill or solution. Instead of being normal salt, sodium chloride (NaCl), it is sodium iodide (NaI). Once you swallow the treatment dose, iodine-131 ( 131 I) is rapidly absorbed into the circulation.

When was radioiodine first used?

Radioiodine therapy has been remarkably effective for patients and was first used for medical treatment in 1941. In the 75-plus years since its first use, hundreds of thousands, if not millions of people have benefited from radioiodine therapy.

How long does it take for iodine to be excreted?

Excretion is so rapid that as long as you have reasonable kidney function, 50% of the administered iodine is gone within eight hours. Another 50% of the remaining circulating iodine is excreted during the second eight hours and so on.

What percentage of iodine is fixed in thyroid?

The remaining 1.6% of the iodine at this point is primarily fixed in any residual thyroid tissues and no longer circulating. It's this residual fixed iodine that achieves the therapeutic effect of the treatment. You should first understand that you don't need to place yourself in an isolation room.

How long should you wash your clothes after a radioactive reaction?

Personal clothing, sheets, bedding, washcloths, and towels should be collected and washed separately for the first 48 hours. After washing, run the washing machine through an extra wash cycle to clear out any residual radioiodine before using it for others.

How long after iodine is taken to go away?

After the first two days post-administration, 98% of the iodine will be gone and you can begin to ease up on these instructions. However, many providers will recommend that you try to keep it up for the first week post-administration, just to be overly cautious.

How long should you sleep with radioiodine?

You should also make separate sleeping arrangements for the first 48 hours to maintain this distance. Since the radioiodine is administered as a salt, is can pass through the skin barrier with perspiration, so you shouldn't exercise or swim in pools during the first 48 hours.

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