Bad ecology, stress and other adverse conditions often lead to thyroid disease. Its increase harms the body. Thyrotoxicosis can take many different forms, including diffuse toxic goiter, also called Graved's disease or Graves' disease. Sometimes it comes to thyroid cancer. To destroy the overgrown tissue of the gland and radioactive iodine is intended.
Thyroid disease
Thyrotoxicosis, which is hyperthyroidism, can take various forms. These include diffuse and nodular toxic goiter, Plummer's disease, Hashimoto's goiter and some other ailments. Treatment with radioactive iodine is successfully coping with these diseases (in Moscow, for example, it is carried out at the Central Research Institute of Radiotherapy and some other clinics). This method complements the treatment of many types of cancer and other thyroid tumors, including Hashimoto's lymphoma and thyroiditis.
The opposite of thyrotoxicosis is hypothyroidism, which does not pose a serious threat and is adjusted by drugs. In addition to diseases of the thyroid gland itself, sometimes there is insufficiency or hyperfunction of the parathyroid glands, i.e. hypoparathyroidism and hyperparathyroidism. Insufficiency is treated with medication, but hyperfunction requires surgery.
Therapy of thyrotoxicosis and cancer
Most of these diseases effectively eliminate the treatment of radioactive iodine. In Moscow, this type of therapy is also carried out. Of course, the conservative treatment of, say, toxic adenoma or diffuse toxic goiter with medication is prescribed first. But efficiency rarely exceeds 40%, and often almost half as much. If such treatment does not bring results or relapse is observed, then the optimal solution would be to prescribe therapy with radioactive iodine I 131. You can also use radiation, but it increases the risk of cancer of the gland, and iodine remains harmless.
Cancer is removed promptly. But even in this case, treatment with radioactive iodine in Moscow, as well as throughout the world, is carried out as an additional method of therapy. It is important to maintain the established time after thyroidectomy and treat according to the protocol, then the risk of metastases can be minimized.
Why not an operation?
Sometimes an alternative to thyrotoxicosis therapy is surgery. Of course, the operation is always fraught with great risk, not to mention the fact that a scar on the skin is not a very aesthetic thing. Anesthesia itself, the risk of bleeding, the possibility of damage to the recurrent nerve - all these are factors that speak out against surgery in favor of a more gentle, but effective radioiodine therapy. Of course, in some cases, emergency measures simply cannot be dispensed with, as is the case with cancer.
In the surgical method, part of the tissue was often retained in order to prevent hypothyroidism. However, this approach is fraught with relapses of the disease. Thyroid stimulating autoimmune antibodies attack the remaining glands again, leading to a new round of disease. Therefore, now they prefer to get a full therapeutic effect instead of a temporary one. Yes, and treatment with radioactive iodine, the cost is more acceptable.
World practice
Mild forms of the disease are preferred to be treated with medication. Also, with this method they start when problems occur in adolescents and children. In other cases, it is better to treat thyrotoxicosis with radioactive iodine. The drug has the form of a capsule or an aqueous solution.
By the way, in Europe, doctors in general trust more precisely various antithyroid drugs than treatment with radioactive iodine. But in the US, radioiodine therapy is preferred as more effective. Of course, after it is necessary to undergo a rehabilitation program, but after all, taking medications also requires further recovery of the body.
The radioisotopes of iodine were first introduced in 1941 in the USA. And since 1960, the method has been widely used in medicine. Over the past period, convinced of its benefits, reliability and safety. And the price for treatment with radioactive iodine has become more affordable. In some clinics in America and Europe, treatment with small doses of iodine is already on an outpatient basis. We also allow such a regimen, but only for doses within 10.4 mCi in activity. Abroad, the norms are slightly different, allowing a stronger effect, which also has a positive effect on treatment.
The basis of the method
Isotopes I 123 and I 131 are used in medicine. The first is for diagnosis, since it has no cytotoxic effect. But the second isotope just allows treatment. It emits Γ and particles. Γ-radiation gives an irradiating effect, localized in the tissues of the thyroid gland. Ι£-radiation allows you to control the dose and distribution of the drug. The thyroid gland accumulates this radioisotope of iodine I 131, and it, in turn, damages the thyroid tissue, which is the therapy of thyrotoxicosis.
Safety for other tissues is explained by the fact that the thyroid gland binds iodine isotopes and attracts them to itself. In addition, its half-life is only 8 days. The intestinal and urinary systems, as a rule, capture a minimum of the isotope, not exceeding the permissible limits. The cytotoxic effect is localized, it destroys only thyrocytes, which leads to a decrease in the thyroid gland in volume and the transition to hypothyroidism without surgical intervention.
Hypothyroidism, in turn, is corrected medically. L-thyroxine preparations are prescribed, which compensates for the necessary hormones, in the usual case produced by the thyroid gland. This hormone, although it is synthetic, is practically inferior to endogenous. Control over the level of hormones is no doubt necessary, sometimes the dosage must be changed, but otherwise the patients return to their usual way of life.
Treatment appointment
Now even our experts are inclined to believe that it is necessary to conduct a single treatment with radioactive iodine in Moscow or other cities in order to cause the development of hypothyroidism. Low-dose treatment simply reduces symptoms, removes the problem only for a while, which is not as effective as the complete elimination. The dosage of the drug is calculated individually for each patient. This indicator depends on the volume of the gland, the severity of the disease, its stage, absorption test and routine scintigraphy.
First, an examination is performed, associated pathologies are clarified, calculations are made. Sometimes a decision is made to nevertheless perform two injections of the drug to achieve the desired result. But there are cases when surgery is more appropriate.
Also, cancer is treated with radioactive iodine, but already as a second stage of therapy. Dosages are higher, aimed at eliminating the risk of metastases. The amount of the drug depends on the severity of the case and the prevalence of the process. This procedure is not performed on an outpatient basis, preferring to leave the patient for two to three days in the clinic.
The consequences of taking the drug
You should be prepared for what will happen after treatment with radioactive iodine. A few days after taking the drug, radioactive iodine will leave the body through saliva and urine. These symptoms can last a different period of time, depending on age and the prescribed dose. At the same time, the elimination process is accelerated in young people, compared with the situation in older people.
It practically does not affect well-being. Only some sensitive people who have been treated with radioactive iodine leave reviews about nausea during this period. Dry mouth or sore neck and throat may also occur. Increased fatigue and a metallic taste in the mouth are noted. Sometimes it can affect the occurrence of constipation or diarrhea.
Restrictions after treatment
But there are a number of limitations that are instructions for action. So, a certain period of time will need to avoid close contact with other people, so as not to irradiate them. Youβll have to sleep alone, refuse kisses and hugs, avoid exchanging dishes and observe similar measures. In this regard, a number of prescriptions for patient behavior can be distinguished.
Key recommendations
For patients undergoing treatment with radioactive iodine, reviews confirm this, for some time more attention should be paid to hygiene. So, it is better to flush the toilet twice, wash your hands after visiting it especially carefully in plenty of water and soap. Separate dishes, towels, bed linen, which no one else will use, will be needed. Naturally, linen and clothes should also be washed separately from the things of relatives. Do not cook for households.
Even it is better to collect garbage in a separate basket, and then give it to a medical institution for disposal (if such a service is provided). Otherwise, you can throw it into an ordinary trash can after 8 days. Dishes should not be washed with other people's items, it is better to wash them by hand without a dishwasher. Disposable plates and appliances are all placed in the same separate garbage bag.