What Can I Expect During Radioactive Iodine Therapy?

In 1942, radioactive 131 iodine was used for the first time as a treatment for hyperthyroidism. It is an effective antithyroid drug. Thyroid cells have a special affinity for iodide. After oral administration of a certain amount of 131 iodine, it can be absorbed by the thyroid gland in large quantities. The 131 iodine with harmful effects can be implanted into thyroid tissue. When 131 iodine decays into 131 xenon, it can emit Beta rays (99%) and gamma rays (1%). The former has an effective range of only 0.5 to 2 mm, which can selectively destroy the thyroid acinar epithelium without affecting adjacent tissues. The thyroid tissue can be exposed to concentrated light for a long time. After the glands are destroyed, they gradually die and become non-functional. Connective tissue, thereby reducing the secretory function of the thyroid gland, so that hyperthyroidism can be cured, achieving the purpose similar to subtotal thyroidectomy. So some people call 131 iodine the treatment of hyperthyroidism as "medical thyroid surgery."

In 1942, radioactive 131 iodine was used for the first time as a treatment for hyperthyroidism. It is an effective antithyroid drug. Thyroid cells have a special affinity for iodide. After oral administration of a certain amount of 131 iodine, it can be absorbed by the thyroid gland in large quantities. The 131 iodine with harmful effects can be implanted into thyroid tissue. When 131 iodine decays into 131 xenon, it can emit Beta rays (99%) and gamma rays (1%). The former has an effective range of only 0.5 to 2 mm, which can selectively destroy the thyroid acinar epithelium without affecting adjacent tissues. The thyroid tissue can be exposed to concentrated light for a long time. After the glands are destroyed, they gradually die and become non-functional. Connective tissue, thereby reducing the secretory function of the thyroid gland, so that hyperthyroidism can be cured, achieving the purpose similar to subtotal thyroidectomy. So some people call 131 iodine the treatment of hyperthyroidism as "medical thyroid surgery."

Chinese name

Hyperthyroidism Radioactive Iodine Treatment

131 Iodine

An effective antithyroid drug

1942

First use of 131 Iodine as a treatment for hyperthyroidism

Scope of application

Heart disease, chronic nephritis, hypertension

Application of radioactive iodine treatment for hyperthyroidism

Patients with hyperthyroidism who meet one of the following conditions can be treated with radioactive 131 iodine:

Diffuse goiter and hyperfunction.

Complicated with serious organic diseases such as heart disease, chronic nephritis, hypertension, cirrhosis, chronic bronchitis,

Patients with severe diabetes, mental disorders, and organic disorders of the nervous system.

People who have undergone thyroidectomy and have relapsed; because they will be more likely to damage the recurrent laryngeal nerve or parathyroid glands when they undergo another operation,

The use of 131 iodine is safer, or is unwilling or unsuitable for surgery.

The long-term application of antithyroid drugs has poor therapeutic effects, repeated relapses, or is unsuitable for drug allergies.

Patients with severe exophthalmopathy (the extent of most exophthalmos is reduced after 131 iodine treatment).

Patients with hyperthyroidism and chronic lymphocytic thyroiditis with increased I131 rate.

Patients with hyperthyroidism with leukocytes or thrombocytopenia.

Patients with hyperthyroidism with atrial fibrillation.

Preparation for radioactive iodine treatment of hyperthyroidism

The treatment of hyperthyroidism with radioactive iodine should be prepared in advance as follows:

Avoid using iodine and other iodine-containing food or drugs 2 to 4 weeks before taking 131 Iodine.

131 iodine treatment is serious before heart rate exceeds 160 beats / minute. For severe cases, antithyroid drugs should be used first.

Or propranolol and other treatments, 131 iodine can be used until the symptoms have eased.

Patients who use antithyroid drugs need to stop taking the drug, tabazole should be stopped for about 3-5 days, and propylthiouracil should be stopped for 2 weeks.

Then take a 131 iodine rate measurement, and then 131 iodine treatment can be used.

Make routine checks of blood and urine to understand the main organ functions.

Make a thyroid 131 iodine rate or thyroid scan to calculate the drug dose.

Explain to the patient the relevant precautions for 131 iodine treatment.

Before and after taking 131 Iodine, patients should stay in bed to avoid strenuous activities.

Therapeutic effect of hyperthyroidism radioactive iodine treatment

With 131 iodine to treat hyperthyroidism, if the patient and the doctor cooperate with each other, the effective rate is more than 90%. After taking the drug, the effect appeared in 3 to 4 weeks, and then the symptoms were reduced month by month, the thyroid gland shrank, and the weight increased. In 3 to 4 months, most patients could reach normal thyroid function level, and the effect of 131 iodine in a few patients Slowly, symptoms gradually improved even after 6 months of taking the medicine. Some cases take 6 months to a year to resolve, about 2/3 of the cases can be cured at once, and 1/3 of the cases need to be treated with 2 or more courses. Generally, about 50% to 80% are cured in one course, and about 20% to 40% are cured in two courses. Few patients need a third course of treatment. Therefore, patients with hyperthyroidism treated with 131 iodine should not go away after drinking the medicine, but should return to the doctor for treatment, follow up, observe, adjust or decide the next treatment plan at regular intervals.

Precautions for radioactive iodine treatment of hyperthyroidism

In order to obtain the best effect, you must pay attention to the following aspects after taking the medicine:

Take 131 iodine on an empty stomach for 2 hours before eating, so as not to affect the absorption of iodine.

After taking 131 iodine, the effect usually begins to appear after 3 weeks, a period before the clinical symptoms have not started to improve,

It is not advisable to use iodine, bromine and antithyroid drugs arbitrarily, so as not to affect the reabsorption of 131 iodine and reduce the curative effect. One after treatment

Low-iodine diet for a month, do not eat kelp, seaweed and other marine plants.

Patients should pay attention to rest within two weeks after taking the medicine, avoid strenuous activities and mental stimulation, and prevent infection.

Because of the symptoms of radiation thyroid inflammation such as neck itching and pain in the early stage of 131 iodine treatment,

Avoiding percussion or squeezing the thyroid should be avoided.

Make a note of the contact phone number of the treating doctor. If you have any questions, please feel free to contact.

Follow the doctor's order and return to the hospital regularly.

Exophthalmos aggravates after radiothyroid iodine treatment for hyperthyroidism

Severe progressive exophthalmos can occur spontaneously or after a subtotal thyroidectomy, and fewer exophthalmos occur after 131 iodine treatment. 131 iodine can improve exophthalmos in most patients (about 70% reported), and only a few cases exacerbate exophthalmos. It is generally believed that 131 iodine can gradually reduce thyroid function, so the pituitary gland thyroid stimulating hormone or exophthalmic substances do not increase suddenly, so some scholars believe that patients with hyperthyroidism with obvious exophthalmos are the indication for treatment with 131 iodine.