WHAT IS RADIOACTIVE IODINE THERAPY?
Radioactive iodine (RAI) therapy I-131, also known as radioiodine therapy, is a treatment that uses radioactive iodine. The material circulates throughout the body and is concentrated in the thyroid gland, where the radioiodine destroys the thyroid cells.
WHAT ARE THE USES OF RADIOIODINE THERAPY?
Radioactive iodine is mainly absorbed by the thyroid cells with little effect on other cells. Hence, it can be used as a treatment for thyroid cancer and hyperthyroidism (an overactive thyroid gland).
This therapy can also be used after a thyroidectomy to destroy any cancer cells that remain after surgery, treat thyroid cancer that has spread, or treat recurring thyroid cancer.
You may need to have the treatment only once but, if needed, it can be repeated every three months until there is no sign of thyroid cancer.
WHAT ARE THE PREPARATIONS TO BE DONE BEFORE STARTING ON RADIOIODINE THERAPY?
Before starting on this treatment, you’ll need to do some preparation.
• Low-iodine diet: Following a low-iodine diet for at least two weeks before getting your treatment makes your thyroid more receptive to the medication. This will increase the effectiveness of the treatment. For low iodine diet, you will need to eliminate certain things in diet like iodized salt, seafood and fish, supplements containing iodine, dairy products, eggs, milk chocolate and soy products. This should be started one or two weeks before starting the treatment. When you are given the therapy, the iodine-starved thyroid cells will absorb the radioactive iodine and hence destroy the cells.
• Raise the Thyroid stimulating hormone (TSH) level in blood:Your thyroid gland absorbs iodine best when there are high levels of thyroid-stimulating hormone (TSH) in your blood. This is accomplished either through injections of a medication called thyrogen (thyrotropin alfa) or through withholding of levothyroxine.
WHAT IS THE PROCEDURE INVOLVED IN RADIOACTIVE IODINE THERAPY?
The procedure takes place in a hospital setting. Radioactive iodine is ingested in either as oral solution or as a capsule in a single dose. You will need to refrain from eating so that your body can absorb the iodine. You will be able to eat and drink normally afterward and you will need to drink plenty of liquids to flush the radioactive iodine out of your system. Once your body’s level of radioactivity falls to a safe level, you will be sent home with post care instructions. You will need to avoid contact with small children and pregnant or breastfeeding women for a period of time because the treatment will make you to become slightly radioactive.
WHAT ARE THE SIDE EFFECTS OF RADIOACTIVE IODINE THERAPY?
Depending on your age, overall health and the amount of radioactive iodine you received, you may have one or more of the following short-term side effects:
• Swelling and inflammation of the salivary glands
• Dry mouth and dry eye
• Changes in taste and sense of smell
• Nausea
• Neck swelling
• Constipation or diarrhea
Possible long-term side effects are:
• Lower sperm counts in men
• Irregular menstrual cycles in women
• Reduced level of blood cells produced
• Risk of developing leukemia in the future
You will be advised to wait at least six months after having radioactive iodine before getting pregnant.
WHAT ARE THE POST PROCEDURE CONCERNS AND CARE?
When you undergo treatment with radioiodine, your body will give off a certain amount of radiation for a while. Because of this, you may expose those around you to the effects of radiation. This radiation can pose a health risk to others, especially small children. Your healthcare provider will give you specific instructions about limiting the amount of time you spend around other people. It is very important that you follow these instructions carefully.
Here are some ways to minimize radiation risks to other people around you after radioactive treatment.In the first 24 hours after therapy, avoid intimate contact. In the first five days or so after the therapy, limit exposure to young children and pregnant women, and, in particular, avoid carrying children in a way that they will be exposed to your thyroid area. Stay at least six feet away from other people for three to 10 days. This means avoiding public transportation, hotels, carpools, and in some cases, your workplace.
To further avoid exposing others to radiation:
• Do not share any towels, razors, toothbrushes, cups, spoons, forks, or dishes.
• Do not cook for anyone else.
• Use disposable dishes and place them in a specially marked plastic bag for disposal.
• Wash your clothes separately.
• If you will be traveling via airplane or crossing an international border in the period following treatment, you must get a written document from your healthcare provider stating medical treatment involving radiation, as security monitoring devices can detect it.