Repeated treatment with radioactive iodine in any cases. Features of treatment of the thyroid gland with radioactive iodine: the consequences of a non-surgical technique with local organ irradiation. How dangerous is radioactive iodine to others?

Radioactive iodine is used in endocrinology to treat the thyroid gland. It is capable of destroying thyrocytes and atypical cells of malignant neoplasms of the endocrine organ.

Radioactive iodine therapy is a successful alternative to traditional medical treatments. The advantage of the procedure is the elimination of radiation exposure to the body as a whole.

Indications for treatment

Radioactive iodine I-131 is prescribed for the treatment of the following diseases of the gland:

Hyperthyroidism caused by increased secretion of hormones - while radioactive iodine neutralizes or suppresses the activity of hypertrophied areas of the organ, selectively destroying those areas that have thyrotoxic properties;
A malignant process in the gland is follicular or papillary cancer.

Complications of using radioactive iodine

Sometimes, after treatment, the following unpleasant complications appear:

sore throat;
nausea, vomiting;
discomfort in the neck;
increased fatigue;
sudden flushes of blood;
an inflammatory process in the salivary glands against the background of which the patient complains of severe soreness of the cheeks and
dry mouth;
pathologically high growth or, on the contrary, a drop in hormones in the blood.

Contraindication to radioiodine therapy

is pregnancy.

Women who are expecting a child have an increased risk of developing consequences that can be dangerous to the fetus, provoking developmental defects in him. During lactation, women should refuse to breastfeed their baby.

Radioactive iodine treatment

With the help of this treatment, there are high chances of getting rid of hyperthyroidism, diffuse goiter and oncological pathology without surgery, and there are many advantages to this:

there is no need for anesthesia,
there will be no painful sensations,
there will be no postoperative scar.

It is enough just to take the necessary dosage of radioactive iodine, while the radiation force will not be distributed to the entire patient's body.

The effectiveness of the treatment can be judged 2 months after the start of the procedure, but there is evidence of faster results.

A physiological decrease in the function of the gland will indicate the cure of hyperthyroidism and recovery - the amount of hormones produced by it will significantly decrease, sometimes up to another opposite state - hypothyroidism.

Preparing for radioiodine therapy

One month before the scheduled procedure

a complete rejection of iodine and hormone-containing drugs is necessary.

A week before the procedure, the refusal of medication applies to all drugs used to treat hyperthyroidism.

Approximately 2 hours before taking radioactive iodine, it is important not to eat food or any liquid.

Patients of childbearing age should definitely have a pregnancy test to eliminate unnecessary risk.

Immediately before the procedure, diagnostics are performed to demonstrate how the thyroid gland absorbs iodine.

Based on the data obtained, the doctor selects the required dosage of I-131 for the patient on an individual basis. If a malignant process is detected in the endocrine organ, a total resection of the gland is performed.

What is the treatment procedure?

The tactics are simple: the patient is given several pills with radioactive iodine, which he must take with clean water.

The active substance of the drug physiologically enters the tissue of the gland and begins its action.

As a rule, iodine is localized almost completely in the thyroid tissue of the endocrine organ, including in cancer cells, starting its destructive effect.

This mechanism is based on the radioactive radiation of the drug, the depth of action of which remains within 2 mm - it turns out that isotopes act exclusively in the tissues of the thyroid gland.

If necessary, the drug is offered to the patient in liquid form, while its therapeutic characteristics will remain intact.

Is radioactive iodine dangerous for others?

For the patient, the use of a radioactive method of treatment is undoubtedly a benefit. But for those who come into contact with him, it is more likely harm and an increased risk.

Therefore, for the duration of treatment, the patient is placed in a separate room, or in a room where patients are already receiving similar therapy.

Medical workers will appear in the ward only for manipulations in special protective clothing.

Any patient visits and contacts

with the outside world outside the hospital walls during treatment are prohibited.

Immediately after the internal use of radioactive iodine, it is recommended to adhere to the following rules:

exclude contact with strangers;
do not eat food for at least two hours after the procedure;
do not restrict fluid intake;
wash your hands more often with soap;
after the toilet room, flush twice;
rinse the toothbrush with plenty of running water after each use.

48 hours after the procedure

do not stand near strangers for more than three minutes;
do not sleep in the same room with healthy people;
keep at a distance of three meters from others;
use disposable handkerchiefs;
go to the shower daily;
it is allowed to start taking drugs intended for the treatment of the gland in the same volume.

After a month, you need to visit a doctor.

The fact is that radioactive iodine can cause hypothyroidism - an insufficient function of the gland.

And this pathology can manifest itself at any minute. Therefore, the state of the endocrine organ must be monitored in dynamics until the amount of hormones in the blood becomes stable.

After treatment

exclude sex life and kissing for at least one week;
use reliable contraceptives throughout the year;
stop breastfeeding, if it was practiced before treatment with radioactive iodine - then the child should be fed artificially;
get rid of personal items that were used in the hospital, if this is not possible, then put them in a plastic bag and do not touch them for 6 weeks;
personal hygiene items should be used separately from other family members.

The period of elimination and half-life of radioactive iodine is 8 days.

That is, there can be no talk of any long-term pollution of the surrounding space. The drug leaves the human body with urine.

If the treatment was chosen correctly and the patient followed all the necessary recommendations, then the probability of recovery is close to 98%.

No deaths have been recorded over the entire existence of radioactive iodine therapy.

Thus, this type of treatment has no alternatives, it is a fast and effective method of therapy for pathologies of the endocrine system, including an oncological one.

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Thyroglobulin in detail

You should be aware that even after a successful operation, an insignificant part of the thyroid gland remains. Radioactive iodine treatment is used to kill any debris or tumor cells.

The thyroid gland is the only organ in our body that absorbs and retains iodine. This property is used when the thyroid gland is treated with radioactive iodine. Read more about the principles of therapy, risks and consequences for the patient - read the material.

Radioactive iodine (synonyms l131, radioiodine, iodine-131) is one of the isotopes of simple iodine (I126).

It has the ability to decay (spontaneous), in which a fast electron, gamma radiation, quantum and xenon are formed:

Beta particle(fast electron) can reach a very high speed. It is capable of penetrating and destroying biological tissues with a radius of 0.6-2 mm in the isotope accumulation zone. This explains the healing properties of I131 in thyroid cancer, diffusely toxic goiter (in these diseases, patients are often prescribed radioiodine therapy for the thyroid gland).
Gamma radiation can easily penetrate the human body. It has no therapeutic effect, however, it has a diagnostic value: with the help of special gamma cameras, it is possible to record areas of increased accumulation of iodine-131. This allows you to assess the functional activity of the thyroid gland or determine the presence of metastases in case of malignant organ damage.

Thyroid scintigraphy

Consider how to check the thyroid gland using iodine, and what the patient needs to know about the features of the study. Scintigraphy, or radioisotope scanning of the thyroid gland, is a method of functional examination of the functioning of an organ based on its ability to absorb radioactive iodine molecules.

Scintigraphy can be used to assess:

anatomical structure and location of the organ;
the size of the thyroid gland;
diffuse or focal changes in an organ associated with a violation of its functional activity;
the presence of "cold" and "hot" nodes in the thyroid gland.

Note! In addition to the I131 isotope, iodine-123 can also be used to diagnose thyroid problems (the advantage is given to it if the organ is then planned to be treated with radioactive iodine) or technetium Tc99.

Indications for the procedure

Most often, a radioisotope study of the thyroid gland is prescribed for:

an increase in the size of the abnormally located thyroid gland;
retrosternal goiter;
thyroid nodules diagnosed by ultrasound (to determine their functional activity);
thyrotoxicosis for differential diagnosis of the type of disease;
highly differentiated thyroid cancer to detect distant metastases.

Also, according to the testimony of a doctor, the procedure is carried out to control the treatment of thyroid diseases, assess the results of the operation, medical examination of patients being observed for thyroid cancer.

Preparation for scintigraphy: what you need to know before the examination

The instruction for the procedure does not imply any special preparation for it.

However, doctors warn about the importance of following two simple rules:

if the patient is taking iodine preparations, they should be abandoned one month before the study;
any diagnostic tests requiring intravenous administration of a radiopaque contrast agent are excluded in 3 weeks.

How is radioisotope scanning done?

The procedure is painless, takes 15-25 minutes and is carried out in several stages:

Oral (by swallowing gelatin capsules) or intravenous administration of a radiopharmaceutical containing microdoses of I123, I131 or Tc99.
Distribution of radioiodine isotopes with blood flow throughout the body and their accumulation mainly in the tissues of the thyroid gland.
Placement of the patient in a gamma camera, in which the radiation force is read by the cells, the accumulation of radioactive iodine.
Transfer of the received information to the computer, its processing and the issuance of the finished result.

It's important to know. The cost of this study largely depends on the clinic in which it is carried out. The average cost of scintigraphy in private research centers is 3000 rubles.

Evaluation of the results obtained

Normally, isotopes of radioactive iodine are uniformly accumulated in the tissues of the thyroid gland, and on the scan the organ looks like two ovals with clear contours. Signs of pathology that can be diagnosed during the study are presented in the table below.

Table: Signs of thyroid pathology with radioisotope scanning:

Sign	The appearance of "cold" areas	The emergence of "hot" areas
Characteristic	Against the background of uniformly colored thyroid tissue, light areas appear	Highlighted highly colored areas delimited by a light rim (steal syndrome)
What does this mean	"Cold" nodes indicate a decrease in the production of thyroid hormones in this area	"Hot" areas are a sign of an increase in the functional activity of the thyroid gland and an increase in the concentration of thyroid hormones in the blood
Possible diseases of the thyroid gland	Fibrosis Chronic, including autoimmune, thyroiditis Thyroid cancer	DTZ (Basedow's disease)

Note! Radioisotope scanning is not a reliable method for diagnosing a malignant neoplasm of the thyroid gland. The doctor can diagnose "cancer" only after a fine-needle biopsy and subsequent morphological examination of the obtained biomaterial.

Just about complicated

Radioactive iodine is used to treat hyperthyroidism, it gradually reduces the volume of the thyroid gland until it is completely destroyed. The method of treatment is much safer than it seems and, in fact, it is more reliable, has a stable result, in contrast to taking antithyroid drugs.

During the operation, the surgeon carefully removes the glandular tissue. The difficulty lies in the very close location of the nerve of the vocal cords and, it is necessary to act very carefully to prevent damage. The operation is complicated by an even larger number of blood vessels in the endocrine gland tissue.

What is ablation?

Radioactive iodine can destroy either all or part of the endocrine gland. This property is used to reduce the symptoms that accompany hyperthyroidism.

Ablation means destruction or erosive ulceration. Ablation with radioactive iodine is prescribed by a doctor, after the exact setting of the dose of the trace element. Absorption is determined by scanning, the doctor monitors the activity of the endocrine gland and the amount of radioactive iodine that it captures. In addition, a specialist "sees" diseased and healthy tissues during examination.

When determining the optimal dose of iodine, important criteria are:

the size of the thyroid gland;
absorption test result.

Accordingly, the dose of radioactive iodine is increased depending on the size of the thyroid gland, and the more it absorbs it, the more its amount is reduced.

How it works?

The isotope decomposes spontaneously to form several substances. One of them is a beta particle, which penetrates into biological tissue with great speed and provokes the death of its cells. The therapeutic effect is achieved with the help of this type of radiation, which has a point effect on the tissues that accumulate iodine.

The penetration of gamma radiation into the human body and organs is recorded in gamma cameras, which reveal the centers of accumulation of the isotope. The places of the luminescence, recorded in the images, indicate the location of the tumor.

The cells of the thyroid gland are arranged in an orderly manner, forming spherical cavities of A-cells (follicles). An intermediate substance is produced inside the organ, which is not a full-fledged hormone - thyroglobulin. This is a chain of amino acids, which contains tyrosine, which captures 2 atoms of iodine.

Stocks of ready thyroglobulin are stored in the follicle, as soon as the body needs the hormones of the endocrine gland, they immediately go out into the lumen of the vessels.

To start therapy, you need to take a pill and a large amount of water to accelerate the passage of radioactive iodine through the body. You may need to stay in the hospital in a special unit for up to several days.

The doctor will explain to the patient the rules of behavior in detail in order to reduce the effects of radiation on the people around him.

Who is prescribed treatment

Among the applicants are patients:

with a diagnosed diffuse toxic goiter;

The popularity of the method is ensured by its high efficiency. Less than half of patients with thyrotoxicosis receive adequate help when taking pills. Treatment of the thyroid gland with radioactive iodine is an excellent alternative to radical treatment.

The principle of therapy

Before starting the process, the patient has to go through the following stages:

Collection of analyzes and research of the thyroid gland.
The approximate date of radioiodine therapy is calculated and antithyroid drugs are discontinued in 2 weeks.

The effectiveness of treatment during the initial session reaches 93%, with repeated therapy 100%.

The doctor will prepare the patient in advance and explain what awaits him. On the first day, vomiting and nausea are possible. Pain and swelling appear in places where radioactive iodine accumulates.

Very often, the salivary glands react first, a person feels dryness of the mucous membranes of the mouth and a violation of taste. A few drops of lemon on the tongue, lollipop or gum help to correct the situation.

Short term side effects include:

neck tenderness;
swelling;
swelling and soreness of the salivary glands;
headache;
lack of appetite.

Goiter

With a toxic form of goiter (nodular or diffuse), hormones are present in excess, which is conducive to thyrotoxicosis. With diffuse damage to the endocrine gland, hormones are produced by the entire tissue of the organ, with nodular goiter - by the resulting nodes.

The goal is, when using radioactive iodine - treatment of the thyroid gland, by exposing its areas to radiation from the isotope. Gradually it is possible to "curb" the excess production of hormones and form a state.

Treatment of diffuse toxic goiter with radioactive iodine will reduce the hydration of the eyeball. This is an obstacle to wearing contact lenses, so you will have to give them up for a few days.

After therapy, the patient needs to consume a large amount of water in order to quickly flush out radioactive iodine from the body.
When visiting the toilet, you should adhere to the rules of hygiene as much as possible so that urine with isotope residues does not get anywhere except to drain the toilet.
Hands are washed with detergent and dried with disposable towels.
Be sure to change your underwear often.
Take a shower at least 2 times a day to wash away sweat well.
The clothes of a person who has received radioactive iodine therapy are washed separately.
The patient is required to observe the safety of other people, in this connection: not to be near for a long time (closer than 1 meter), to avoid public crowded places, to exclude sexual contacts for 3 weeks.

The half-life of radioactive iodine lasts 8 days, during this period of time thyroid cells are destroyed.

Cancer disease

A cancerous tumor is a mutated normal cell. As soon as at least one cell acquires the ability to divide at a high rate, they talk about the formation of oncology. Interestingly, even cancer-affected cells are capable of producing thyroglobulin, but at much lower concentrations.

The thyroid gland in your body absorbs almost all of the iodine in your body. When a person takes radioactive iodine in the form of capsules or liquid form, it is concentrated in its cells. Radiation can destroy the gland itself or its cancer cells, including metastases.

Treating thyroid cancer with radioactive iodine justifies the small effect on the rest of your body. The radiation dose is used much more heavily than scanning.

The procedure is effective when it is necessary to destroy the thyroid tissue that is left after surgery after thyroid cancer treatment, if the lymph nodes and other parts of the body are affected. Radioactive treatment of the thyroid gland improves the survival of patients with papillary and follicular cancer. This is standard practice in such cases.

Although the benefits of radioactive iodine therapy are considered less obvious in patients with mild thyroid cancer. Surgical removal of the entire organ is considered more effective.

To effectively treat thyroid cancer, the patient must have high levels of thyroid-stimulating hormone in the blood. It stimulates the absorption of radioactive iodine by cancer and organ cells.

When removing the endocrine gland, there is a way to raise the TSH level - stop taking pills for several weeks. Low hormone levels will cause the pituitary gland to activate the release of TSH. The condition is temporary, it is artificially induced hypothyroidism.

The patient must be warned about the occurrence of symptoms:

tiredness;
depression;
weight gain;
constipation;
muscle pain;
decreased concentration.

As an option, thyrotropin is used in injections to increase TSH before radioactive iodine therapy. The patient is advised to refrain from eating foods containing iodine for 2 weeks.

Risks and side effects

Patients taking therapy should be warned of the consequences:

Men who receive high cumulative doses of radioactive iodine will have a reduced number of active sperm. Very rarely, cases of the development of subsequent infertility are recorded, which can last up to 2 years.
After therapy, women should abstain from pregnancy for 1 year and be prepared for menstrual irregularities, since radioiodine treatment affects the ovaries. Accordingly, breastfeeding should be excluded.
Anyone who has received isotope therapy has an increased risk of developing leukemia in the future.

After treatment with radioactive iodine, the patient needs regular medical supervision throughout his life. Radioiodine therapy has undeniable advantages over another radical solution - surgery.

The price of the procedure in different clinics varies slightly. An instruction has been developed that takes into account all the requirements for safety and efficiency.

Radioiodine treatment allows you to painlessly and quickly eliminate the cause of thyroid disease. It is a modern way to regain lost wellness with minimal health risks.

In the treatment of pathologies of the thyroid gland, radioactive iodine can be used. This isotope has its own dangerous properties, therefore, the procedure for its introduction into the body should be carried out exclusively under the supervision of a highly qualified doctor.

Radioactive iodine - thyroid gland treatment

The isotope procedure has the following advantages:

there is no rehabilitation period;
no scars and other aesthetic defects remain on the skin;
during it, anesthetics are not used.

However, treatment with radioactive iodine has its drawbacks:

The accumulation of the isotope is observed not only in the thyroid gland, but also in other tissues of the body, including the ovaries and prostate. For this reason, the next six months after the procedure, patients should be carefully protected. In addition, the introduction of the isotope disrupts the production of hormones, which can negatively affect the development of the fetus. Women of childbearing age will have to postpone conceiving a child for 2 years.
Due to the narrowing of the lacrimal canals and changes in the functioning of the salivary glands, disruptions in the work of these body systems can be observed.

Radioactive (usually I-131) iodine is prescribed in the following cases:

neoplasms on the thyroid gland;
thyrotoxicosis;
operations transferred to the thyroid gland;
the risk of developing postoperative complications.

Treatment of thyrotoxicosis with radioactive iodine

This therapy gives good results. For the treatment of hyperthyroidism with radioactive iodine to be effective, the dose of I-131 absorbed by the tissues of the gland must be 30-40 g. This amount of the isotope can enter the body simultaneously or fractionally (in 2-3 doses). Hypothyroidism may occur after therapy. In this case, patients are prescribed Levothyroxine.

According to statistics, in those who are diagnosed, after treatment with an isotope, after 3-6 months, the disease recurs. Such patients are prescribed repeated therapy with radioactive iodine. The use of I-131 for more than 3 courses in the treatment of thyrotoxicosis has not been recorded. In rare cases, in patients, therapy with radioactive iodine does not work. This is observed with resistance of thyrotoxicosis to the isotope.

Treatment of thyroid cancer with radioactive iodine

The isotope is prescribed only to those patients who have been diagnosed with cancer based on the results of surgical intervention. More often, such therapy is carried out at a high risk of recurrence of follicular or papillary cancer. Treatment of the thyroid gland with radioactive iodine is performed in the presence of residual tissue that absorbs and accumulates I-131. Before this, a scintigraphy is performed.

The isotope is prescribed to patients in the following dosage:

during therapy - 3.7 GBq;
in the case when metastases have affected the lymph nodes - 5.55 GBq;
with damage to bone tissue or lungs - 7.4 GBq.

Radioactive iodine after removal of the thyroid gland

In order to detect metastases, I-131 is used. Scintigraphy using radioactive iodine is performed 1-1.5 months after surgery. This diagnostic method is considered more effective. Radiography is a less reliable way to detect metastases. If the result is positive, radioactive iodine therapy is prescribed. Such treatment is aimed at destroying lesions.

Preparing for radioiodine therapy

The patient's condition after treatment largely depends on compliance with the doctor's prescriptions. Not the least role here is assigned to how correctly the preparation for the procedure was performed. It includes compliance with the following rules:

Make sure there is no pregnancy.
If there is a nursing baby, transfer him to artificial feeding.
Tell the doctor about all medications you are taking. Their consumption should be stopped 2-3 days before radioiodine therapy.
Follow a special diet.
Do not treat wounds and cuts with iodine.
Swimming in salt water and inhaling sea air is prohibited. A week before the procedure, you should stop walking on the coast.

In addition, a couple of days before the radioiodine therapy, the doctor will conduct a test to determine the intensity of the absorption of I-131 by the patient's body. Immediately before thyroid radioactive iodine therapy is performed, a TSH test should be taken in the morning. Also, 6 hours before the procedure, you should refuse to eat, and from drinking water - 2 hours.

Diet over radioactive iodine

Such a nutritional system is prescribed 2 weeks before the procedure. It ends 24 hours after therapy. An iodine-free diet before treatment with radioactive iodine includes a ban on such foods:

eggs and food containing them;
seafood;
red, variegated and lima beans;
chocolate and products where it is present;
cheese, cream, ice cream and other milk;
food in the preparation of which iodized salt was added;
soy products.

Radioactive iodine - how the procedure is performed

I-131 is taken orally: the patient swallows gelatin-coated capsules containing the isotope. Such pills are odorless and tasteless. They must be swallowed with two glasses of water (juice, soda, and other drinks are not allowed). Do not chew these capsules! In some cases, treatment of toxic goiter with radioactive iodine is carried out using a chemical agent in liquid form. After taking such iodine, the patient needs to rinse his mouth well. In the next hour after the procedure, food and drink are prohibited.

For the patient, radioactive iodine is of great benefit - it helps to cope with the disease. For visitors to the patient and other people in contact with him, the isotope is extremely dangerous. The half-life of this chemical element is 8 days. However, even after being discharged from the hospital, in order to protect others, the patient is recommended:

Forget about kissing and intimate relationships for another week.
Destroy personal items used in the hospital (or put them in a tight plastic bag for 6-8 weeks).
Reliably protect yourself.
Place personal hygiene items separately from other family members.

Treatment with radioactive iodine of the thyroid gland - consequences

Due to the individual characteristics of the body, complications may arise after treatment. Radioactive iodine has the following consequences for the body:

difficulty swallowing;
swelling in the neck;
nausea;
lump in the throat;
intense thirst;
distortion of taste perception;
vomit.

Side Effects of Radioactive Iodine Treatment

Although this method of therapy is considered safe for the patient, it also has the other side of the coin. Exposure to radioactive iodine brings with it the following problems:

vision deteriorates;
existing chronic ailments are exacerbated;
radioactive iodine contributes to weight gain;
muscle pain and fatigue are observed;
the quality of blood deteriorates (the content of platelets and leukocytes decreases);
against the background of a decrease in the production of hormones, depression and other mental disorders develop;
in men, the number of active spermatozoa decreases (cases of infertility have been recorded);
the risk of development increases.

Which is better - radioactive iodine or surgery?

There is no definite answer, because each specific case is individual. Only a doctor can determine what will be most effective for a given patient - radioactive iodine or surgery. Before choosing a method to combat thyroid pathology, he will take into account various factors: the patient's age, the presence of chronic diseases, the degree of damage to the disease, and so on. The doctor will definitely tell the patient about the features of the chosen method and describe the consequences after radioactive iodine.

Radioiodine therapy for the thyroid gland has been practiced for half a century. The method is based on the properties of the thyroid gland to absorb iodine entering the body. After entering the thyroid gland, the radioactive isotope of iodine destroys its cells. Thus, the excessive production of hormones is blocked, which led to the disease. Such therapy requires preparation and hygiene requirements during rehabilitation. However, radioactive iodine treatment has advantages over surgery.

What is radioactive iodine

Radioactive iodine began to be used to treat the thyroid gland more than 60 years ago. Iodine-131 (I-131) is an artificially created radioactive isotope of iodine. Its half-life is 8 days. As a result of the decay, beta and gamma radiation is released, propagating from the source at a distance of half to two millimeters.

The method is based on the ability of the thyroid gland to absorb all the iodine in the body. Moreover, its variety does not matter. Once in the thyroid gland, I-131 destroys thyroid cells and even (atypical) cells outside the thyroid gland.

The radioactive type of iodine dissolves in water and can be airborne, so treatment with this substance requires strict precautions.

Who is radioiodine therapy indicated for?

Treatment of thyrotoxicosis with radioactive iodine is carried out due to the need to suppress the excessive production of a hormone that poisons the body.

Radioiodine therapy is indicated:

with thyrotoxicosis due to;
with oncological diseases of the thyroid gland;
afterwards, to get rid of the remnants and metastases of cancer tumors of the thyroid gland (ablation);
with autonomous adenomas;
with unsatisfactory results of previous treatment with hormones.

Radioiodine therapy is the most effective method when compared with surgery and hormonal treatment.

Cons of surgical excision of the thyroid gland:

the inevitability of anesthesia;
long period of suture healing;
the risk of damaging the vocal cords;
no guarantee of complete removal of pathogenic cells.

Hormone therapy also has many unpredictable side effects.

How is the thyroid gland treated with radioactive iodine?

When all the tests have been passed and the thyroid gland studies have been completed, the doctor together with the patient determines the date of the therapeutic procedure. Its effectiveness is about 90% the first time. When repeated, the figure reaches 100%.

The entire therapeutic period is divided into three stages: preparatory, the procedure itself and the time of rehabilitation. It is important to know in advance what they are, so that no requirement or question of the doctor is caught by surprise. Understanding and cooperation on the part of the patient increases the chances of a successful procedure.

Preparation

An iodine-free diet before radioiodine therapy is considered the most important exercise. The beginning of the period is discussed with the doctor, but occurs no later than two weeks before the procedure. The task of the thyroid gland at this time is to “starve” for iodine so that when I-131 enters the body, the thyroid gland gets the maximum dose. After all, if there is enough iodine in it, the medicinal dose simply will not be absorbed. Then all efforts will be wasted.

Before receiving radioiodine therapy, women should have a pregnancy test.

Exclude from the diet:

seafood, especially seaweed;
soybeans and other legumes;
foods colored red;
iodized salt;
any medicinal.

The concentration of thyroid-stimulating hormone must be increased so that the thyroid cells absorb as much iodine as possible. Its amount should exceed the norm.

Procedure

Treatment of the thyroid gland with radioactive iodine takes place in a hospital. You don't need to take a lot of things with you, because you still won't be able to use them. Before the procedure, the medical staff will provide disposable clothing. The patient deposits his belongings until discharge.

The doctor suggests taking a capsule with iodine 131, drink plenty of water. Some clinics use an iodine solution. Since the introduction of a radioactive isotope is unsafe for healthy people, medical personnel are not present in the room, and the patient now needs isolation.

After a few hours, the following symptoms may manifest themselves:

dizzy;
vomiting even to vomiting;
places of accumulation of radioactive iodine hurt and swell;
dryness in the mouth;
dries eyes;
the perception of taste changes.

Sour candies, drinks (you can take them) help to avoid dry mouth.

Rehabilitation

The first days after the procedure, the rules of behavior and personal hygiene are prescribed. They must be observed so that iodine leaves the body as soon as possible, and also so as not to harm others.

to drink a lot of water;
take a shower 1-2 times a day;
regularly change underwear and clothing in contact with the body;
men are instructed to urinate only in a sitting position;
after visiting the toilet, flush the water 2 times;
do not come into close contact with relatives and other people, especially the prohibition applies to pregnant women and children.

A few days later, the doctor determines the scheme of further drug treatment. By scanning gamma radiation, the location of the metastases is revealed.

The main goal of treatment - destruction of the abnormal thyroid tissue - is achieved only a few months after the procedure.

What drugs can and cannot be taken on the eve and during radioiodine therapy

Levothyroxine, a synthetic thyroid hormone, is canceled a month before the procedure. Withdrawal of this drug may be accompanied by such side effects as depression, constipation, weight gain, dry skin. This is considered the norm.

Multivitamins, cough medicines, and food supplements containing iodine should be put aside.

You need to stop taking:

thyreostatics (Tyrozol, Mercazolil);
any medication containing iodine (Amiodarone);
ordinary iodine for external use.

To whom therapy is contraindicated

Radioiodine therapy is prohibited for pregnant women due to the possibility of abnormalities during fetal growth.

When planning a pregnancy, the doctor will advise you to postpone conception for six months or a year. Moreover, the ban applies to representatives of both sexes. If the pregnancy has already occurred, the specialist will suggest alternative therapies.

I-131 treatment is incompatible with:

lactation;
ulcers of the stomach and duodenum;
renal and hepatic impairment.

The procedure also cannot be performed on children under 18 years of age.

Is a person receiving radioactive iodine dangerous for others?

The half-life of I-131 is 8 days. This is the period during which the thyroid gland is irradiated. The substance leaving the body does not change its qualities. For a patient, such irradiation of the thyroid gland is a targeted therapeutic effect. But the transfer of an isotope emitting radiation to others can contribute to negative consequences.

Therefore, during the rehabilitation period, it is not allowed to have close contact with other people: hug, kiss, even sleep on the same bed. Sick leave is given for a month. For employees of children's institutions, sick leave can be extended to two.

Consequences of treatment with radioactive iodine in the thyroid gland

The use of iodine-131 has certain negative consequences. Their development is possible, but not necessary:

swelling of the small intestine;
autoimmune ophthalmopathy;
requiring lifelong hormonal therapy;
in men, sperm activity decreases, temporary infertility is possible (up to two years);
in women, menstrual irregularities are possible. It is necessary to avoid pregnancy for one year, give up breastfeeding.

Patients treated with radioactive iodine should undergo regular examinations for the rest of their lives.

Where in Moscow can you get treatment and how much does it cost?

The number of clinics offering this service is small. This is explained by the high requirements for radiological safety.

The clinic of the FGBOU DPO RMANPO of the Ministry of Health of the Russian Federation, within the framework of the High-Tech Medical Care and Voluntary Medical Insurance programs, offers free therapy with radioactive isotope of iodine.
FGBU "Endocrinological Research Center" conducts radioiodine therapy at a price of 30 to 73 thousand rubles.
In the Russian Scientific Center for X-ray Radiology, therapy is carried out in the range of 24-75 thousand rubles, depending on the situation.

The use of radioactive iodine helps to regulate hormonal disorders and destroys thyroid tumors. Such a hike is highly effective, although it is not completely safe.

Thyroid problems are manifested in violations of basic functions or changes in the structure of the organ. Treatment with radioactive iodine is one of the options for getting rid of the disease. The method has been used in the process of diagnosing and treating the disease since 1941.

Method action

To understand the essence of the technique, you need to understand what radioactive iodine is. It is a medically obtained drug that is an isotope of iodine I-131. The unique effect is determined by the destruction of harmful thyroid cells of the thyroid gland, as well as the destruction of malignant tumors at the cellular level. In this case, the patient is not exposed to radiation as a whole.

But it is important to understand that destruction also affects healthy cells, along with tissues that have painful damage.

An important quality is considered to be a low penetrating effect of beta rays, which does not pose any threat to the tissues surrounding the gland.

The result is the suppression of the functional abilities of the organ to hypothyroidism, and the reversibility of the process is impossible. The onset of the disease is considered as a consequence of the result of treatment, but not as a complication. Further, the patient must undergo a course of substitution therapy, which effectively eliminates all the consequences of radiation. Also, therapy is necessary in case of thyrotoxicosis.

Thyrotoxicosis is a disease in which the thyroid gland produces excess hormones, which negatively affects the activity of the whole organism.

Important! Treatment with radioactive iodine requires careful attention and lasts for at least several months. Only after a certain period of time has passed, the doctor will be able to accurately determine the positive result of therapy.

Indications for use

The accumulation of the drug occurs only in the gland, contributing to the precise effect on the tissues that tend to accumulate RIT. Therefore, other organs and systems of the body do not suffer in any way in the process of curing the disease. The use of iodine is indicated in the following cases:

disease of diffuse toxic goiter;
hypothyroidism caused by the presence of benign nodal connections;
thyrotoxicosis, manifested as a result of hypothyroidism;
cancers of the thyroid gland;
the consequences of surgical complications after cancer, the risks of which are incredibly high.

Action RIGHT

As a rule, the appointment of treatment occurs after the complete removal of the thyroid gland. Partial excision or conservative treatment is not conducive to this type of procedure. Iodides enter the tissue fluid from the blood, and during iodine starvation, secretion cells actively consume RIT. Moreover, studies show that cancer cells interact especially well with the drug.

Treatment with radioactive iodine has one main goal - the complete removal of thyroid residues left in the patient's body. Even the most skillful operation cannot guarantee the final disposal of organ cells, and iodine "cleans up" everything that can cause harm and again develop into cancerous tumors.

The destructive feature of the iodine isotope affects not only residual tissues, but also metastases, tumors, which allows the doctor to carefully and easily monitor the concentration of thyroglobulin. In particular, it is known that the accumulation of a large percentage of the isotope occurs at the place where the thyroid gland was located, in the salivary glands, in the digestive system and the genitourinary system. There have been isolated cases of isotope capture receptors in the mammary glands. So a general scan will reveal the development of metastases not only in organs and tissues located next to the thyroid gland, but also more distant.

The artificially created drug has radiation, while iodine has no taste or smell. The application is shown as a single use in the form of a liquid substance or a sealed capsule. After the drug enters the patient's body, a certain diet and some procedures are required:

Give up solid food for 120 minutes;
It is recommended not to deny yourself a large amount of juice, water, since the drug that does not get on the tissue of the gland is excreted in the urine;
The first half of the day (12 hours) after the procedure, urination should be every hour - this should be monitored;
Taking medications for the thyroid gland is indicated no earlier than 2 days after the RIT;
Restriction of contacts and communication with other people is shown within 1-2 days.

Preparatory measures before the procedure

In the hospital, preparation for radiation is carried out under the guidance of an experienced nurse. But still it is worth knowing what needs to be done:

Be sure to warn the doctor about the medications taken for thyrotoxicosis, other drugs. Some of them will have to be canceled 3-4 days before the procedure;
Have confirmation of the absence of pregnancy for the period of iodine therapy;
A test for the intensity of absorption of the drug by the thyroid gland is possible, especially after removal of the organ in case of cancer. It is necessary for the drug to indicate the presence or absence (complete) of thyroid tissue that can still function;
An iodine-free diet is required. It is necessary that the body began to starve from a lack of normal iodine. This helps better absorption of the drug, and also (if the thyroid gland has been removed completely in the case of cancer) to see the possible spread of foci of the disease in the body.

Avoiding iodine does not mean giving up salt altogether, as many patients fear. There is a special register of products that fully meet the requirements of an iodine-free diet, which the attending physician will tell you about.

Side effects

It is important to understand that even the most harmless method of treatment has an effect on the body. And even more so the use of a radioactive isotope. Therefore, the following short-term manifestations are possible:

pain in the tongue, salivary glands;
sore throat, dry mouth;
vomiting, nausea;
changes in taste;
exacerbation of gastroduodenal manifestations, as well as all chronic diseases;
a decrease in the content of leukocytes and platelets in the blood;
fatigue, depression, nervous breakdown.

It is important to understand that treatment with radioactive iodine during pregnancy can lead to the fact that the consequences for the fetus are incompatible with life.

Even if the patient has recovered from cancer, thyrotoxicosis, but is breastfeeding, the appointment of the procedure is impossible. If you need to take the medication, you will have to abandon natural feeding for at least 7-10 days after the treatment.

Conclusion

Regardless of the side effects, radioactive iodine treatment has more advantages than disadvantages. Considering the possibilities of getting rid of cancer and thyrotoxicosis of the thyroid gland, patients prefer to choose this particular method, which, unlike surgery, does not leave scars and, most importantly, completely heals without causing any harm to healthy tissues.

It is important that after the procedure there is no need for an expensive recovery course, and there is no need for anesthesia. But, so that there is never a threat of cancer disease again, even with the complete elimination of the thyroid gland, the patient needs systematic observation by a doctor until the hormonal background is completely stabilized. Observations show that the patient's condition is completely normalized after 12-15 days. But the consequences of cancer are not fully understood, so a second session may be required.