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Can Your Thyroid Come Back After Radioactive Iodine

How Does Radioactive Iodine Treat Thyroid Cancer

Radioactive Iodine Treatment

The most common types of thyroid cancer can usually be treated with large doses of radioactive iodine. The therapy is usually given after removal of the thyroid gland to destroy any remaining thyroid tissue.

A tracer dose of radioactive iodine can also be used to track remaining thyroid tissue and/or cancer that could have spread to other parts of the body. These tests show if iodine concentrates in areas that contain thyroid cancer, and whether large amounts of RAI are needed to destroy the tumor implants.

How Can You Reduce Radiation Exposure To Others

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. It is important to let your doctor know if you will not be able to follow all of these instructions.

These instructions apply if you are returning to your own home after treatment using private transportation. You should ask your doctor for additional instructions if you are planning to use public transportation or stay in a hotel or other non-private lodging.

Protecting Others From The Radiation

Being in a room on your own protects other people from radiation. Pregnant women and children are not allowed into your room. Other visitors may be able to stay for a short time when it is safe for them to do so.

The amount of time staff are allowed into your room is limited. They stay at a safe distance from you and can only stay in your room with you for as long as is necessary. This is because they will care for many people who have this treatment. So the amount of radiation they are exposed to has to be carefully controlled. It is important that you know that you are not at any risk from the radiation.

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What Does Rai Do

RAI treatment destroys any remaining thyroid cells after surgery, minimizing the risk of the cancer coming back. It is also called ablation therapy.

The initial RAI treatment may be given anytime, but usually 6 weeks to 6 months after surgery. The reason for a delay may be because your doctor wants to see how youre doing after surgery before deciding if RAI is necessary.

Diagnosis Of Thyroid Cancer

Postoperative Radioiodine Ablation in Thyroid Cancer

Usually, diagnosing thyroid cancer begins when a routine test suggests a problem with the thyroid. Your doctor will ask you about any symptoms you have and do a physical exam. Based on this information, your doctor may refer you to a specialist or order tests to check for cancer or other health problems.

The process of diagnosis may seem long and frustrating. Its normal to worry, but try to remember that other health conditions can cause similar symptoms as thyroid cancer. Its important for the healthcare team to rule out other reasons for a health problem before making a diagnosis of thyroid cancer.

The following tests are commonly used to rule out or diagnose thyroid cancer. Many of the same tests used to diagnose cancer are used to find out the stage, which is how far the cancer has progressed. Your doctor may also order other tests to check your general health and to help plan your treatment.

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Loss Taste After Rai Treatment

I just completed my THIRD RAI treatment two weeks ago and we FINALLY got the last of the cancer that was persistent in my neck. Each time I was treated I lost my taste buds and I developed salivary gland stones, which was excruciating! It took about 6 months for my taste to return and probably 2 months until my salivary glands worked properly. Everything taste like paste and I get this metal like after taste. It’s really nasty, but I’m celebrating regardless because the cancer is gone. You are right, this cancer can be so much more worse for us. We are blessed to have developed the type of cancer with a very slow growth rate and high percentage for treatment and cure. Take care and good luck to you, too!

What Monitoring Is Needed After Radioactive Iodine Therapy For Hyperthyroidism

Ablation of the gland occurs over 2-5 months after radioactive iodine therapy. Most patients become hypothyroid. Checking thyroid functions every 4-6 weeks until the patient stabilizes is recommended.

Once the thyroid hormone levels start falling into the low-normal range, it is reasonable to stop antithyroid medications and to consider starting low-dose thyroid hormone replacement before the patient becomes hypothyroid however, some physicians prefer to document persistently elevated TSH values with the patient off antithyroid medication before starting thyroid hormone replacement.

Starting with partial or low-dose thyroid hormone replacement is recommended . Several weeks after 131I therapy, patients can, in rare cases, become thyrotoxic as a result of vigorous thyroid destruction and release of preformed hormone. This process often is accompanied by a painful, radiation-induced thyroiditis that can be treated with nonsteroidal anti-inflammatory drugs or glucocorticoids.

In addition, radioablation can cause the release of thyroid antigens and exacerbate the autoimmune thyroid disease process. In such cases, Graves disease can worsen.

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If I Choose Surgery Will I Need Radiation Therapy Or Vice Versa

Surgery is the primary therapy for thyroid cancer and is often effective. If the tumor is large, has spread to lymph nodes or you are at high risk for the cancer returning after treatment, you will most likely have surgery followed by I-131 treatment. Surgery followed by EBT and chemotherapy or targeted therapy is used for medullary or anaplastic thyroid cancer. For advanced thyroid cancer patients, treatment may consist of all the therapies listed above.

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Keeping Your Distance And Avoiding Close Contact With People

3 Year update after radioactive iodine treatment

Stay away from crowded places and avoid using public transport. If you live or work with other people, you will need to keep a distance from them. Avoid standing or sitting close to them. This stops them from getting radiation from you.

Your doctor will tell you not to have close, lengthy contact with others for a couple of weeks. This includes babies, young children, pets and pregnant women. Avoid hugging and kissing other people.

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How Well It Works

In almost all cases, your thyroid hormone levels will return to normal or below normal after radioactive iodine treatment. This may take 8 to 12 weeks or longer. If your thyroid hormone level does not go down after 6 months, you may need another dose of radioactive iodine.

If you have thyroid cancer and you are treated with radioactive iodine, it may take from several weeks to many months for your body to get rid of any remaining cancer cells.

Your thyroid nodule is unlikely to grow after being treated with radioactive iodine.

Treating Hypothyroidism After Radioactive Iodine Treatment Helps You Find Balance

For those who struggle with hyperthyroidism or thyroid cancer, radioactive iodine treatment can be a life-changing treatment option. But despite the promise of RAI, there is often a downside: you are likely to develop transient or permanent hypothyroidism after completing treatment. If you have had RAI or are about to start, this potential outcome can be a serious concern, and its important to have the right resources in place to address it. By connecting with a skilled health practitioner with expertise in hormone replacement therapy, you will have the support you need to manage hypothyroidism and achieve a healthy balance.

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Treating Hyperthyroidism With Rai

Perhaps one of the most common uses of RAI is as a therapy to treat hyperthyroidism.

As we discussed, RAI results in complete and irreversible damage to the thyroid gland.

Because of this, you should consider all available options and therapies available to you before you undergo this procedure.

In the case of hyperthyroidism , RAI is considered to be a “definitive” therapy.

It’s definitive because after the procedure your thyroid gland will no longer function optimally and your hyperthyroidism will have been treated.

You can compare this to temporary hyperthyroid treatments such as thyroid blocking medication.

Thyroid blocking medication is NOT definitive because once you stop taking the medication your condition will most likely come back.

Is RAI effective at treating hyperthyroidism?

The answer is yes.

Up to 60-80% of patients with hyperthyroidism have Graves’ disease which is an autoimmune disease.

Patients with this condition often experience excessive doses of thyroid hormone as antibodies stimulate the thyroid gland.

Because of this, it is considered a safe alternative to complete thyroid removal for hyperthyroidism.

It’s important to realize that RAI is not the only option available for the treatment of hyperthyroidism.

Before you undergo RAI make sure that you have evaluated all options available to you.

There are 3 primary ways to treat hyperthyroidism:

#1. Thyroid blocking medications

#2. RAI

#3. Thyroidectomy

Can I Lower The Risk Of My Cancer Progressing Or Coming Back

Radioactive Iodine Treatment  Thyroid Cancer Canada

If you have thyroid cancer, you probably want to know if there are things you can do that might lower your risk of the cancer growing or coming back, such as exercising, eating a certain type of diet, or taking nutritional supplements. Unfortunately, its not yet clear if there are things you can do that will help.

Adopting healthy behaviors such as not smoking, eating well, getting regular physical activity, and staying at a healthy weight is important. We know that these types of changes can have positive effects on your health that can extend beyond your risk of cancer.

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What Does Going Hypo Mean

Our bodies require thyroid hormone to function normally. This is why people need to take a synthetic form of the hormone, by pill, once the thyroid has been removed. Synthroid® and Eltroxin® are brands of thyroid pills in Canada.

Without thyroid hormone, the body produces more and more thyroid stimulating hormone . A high level of TSH is needed for RAI treatment to be effective. This is why your doctor may instruct you to stop taking your thyroid pills 4-6 weeks before starting RAI treatment. Temporarily stopping your thyroid pills may cause symptoms of hypothyroidism . Symptoms tend to be more common in the 2 weeks leading up to your RAI treatment.

They include:

  • Puffiness in the face bloating
  • Poor concentration

Your doctor may prescribe a drug called Cytomel® to help ease these symptoms of hypothyroidism.

Can You Ever Restore Thyroid Function

The answer is maybe.

But why would you want to restore thyroid function to your thyroid gland if you had it destroyed because you were already producing too much?

It may sound counterintuitive, but you’ll understand why you might want to after your procedure.

It turns out, which should come as no surprise, that medications are not a 100% complete substitute for the activity that your thyroid gland does on a day to day basis.

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.

But is it actually possible?

The answer is maybe, and it depends on the person, how much damage was done to their thyroid, and other factors that aren’t always in your control.

But, if I was being honest, I think that most people should not rely on the possibility of restoring much thyroid function after their procedure.

This shouldn’t stop you from trying natural therapies but you should have reasonable expectations as you do so.

I’ve certainly seen some patients reduce their total dose of thyroid medication by undergoing some natural therapies to help restore thyroid function after RAI .

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When Do You Have Radioactive Iodine

You might have radioactive iodine treatment:

  • after surgery, to kill any cancer cells that may have been left behind
  • to treat thyroid cancer that has spread
  • to treat thyroid cancer that has come back after it was first treated

You may only need to have this treatment once. But it can be repeated every 3 months if needed, until there is no sign of any thyroid cancer on your scans.

How Long Does It Take For Radioactive Iodine To Work

Radioactive Iodine After Thyroid Cancer

One additional patient received radioactive iodine treatment despite of having a negative radioiodine scan. Of note, all 3 patients with RAS mutations showed uptake on the scan and received radioactive iodine treatment. The average I-131 dose was 204 mCi. The cancer drug was discontinued 2 days after the radioactive iodine treatment.

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Having Your Radioactive Iodine Treatment

You are usually admitted to the ward on the day of your RAI treatment. You usually have radioactive iodine as a capsule. Before and after the treatment, you can eat normally. Your nurse will encourage you to drink plenty of fluids.

Because the iodine is radioactive, you will be radioactive for a while after the treatment. The radioactivity will slowly leave your body in your:

  • urine

Side Effects Of Rai & What To Expect After Therapy


When you take RAI you are intentionally placing radioactive substance inside your body.

Yes, it is true that this radioactivity is mostly confined to your thyroid gland, but there is still a small risk that you can pass some of this radiation onto others.

Because of this, certain precautions must be taken to avoid this transfer to others.

But beyond the side effects, what should you expect after treatment?

Remember that the goal of RAI is to completely destroy your thyroid gland.

This destruction of thyroid gland tissue will permanently alter thyroid hormone status in your body.

After the procedure, you will be reliant upon thyroid medication for the rest of your life.

You are effectively turning yourself into a hypothyroid patient, which can be confusing for many patients, especially those who are undergoing RAI for treatment of hyperthyroidism.

Many of the side effects associated with RAI have to do with the hypothyroid state which occurs AFTER the procedure and not side effects directly associated with the procedure itself.

Weight Gain After RAI

It is well known that RAI poses a potentially serious threat to your current weight .

It has been reported that the risk of becoming overweight and obese increases dramatically after radioactive iodine ablation therapy.

This risk increases anywhere from two-fold to three-fold compared to normal healthy euthyroid controls .

Your thyroid is responsible for about 50-60% of your baseline metabolism .

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About Radioactive Iodine Treatment

Treatment with radioactive iodine lowers your risk of your thyroid cancer coming back. Its also used to treat thyroid cancer that spreads to other parts of your body.

Radioactive iodine is usually given in pill form, but it can also be given in liquid form if needed. Some people have trouble swallowing pills. If you do, tell your doctor in Molecular Imaging and Therapy Service before your treatment. This is sometimes called the Nuclear Medicine service.

Radioactive iodine enters your bloodstream and is taken up by any thyroid- like cells. The radioactivity destroys the cancer cells. The radioactive iodine gives off radiation nearby and destroys the cancer cells over time.

Maximizing The Effectiveness Of Radioactive Iodine Therapy

low iodine

Radioactive iodine therapy for thyroid cancer is most effective in people who have high levels of thyroid-stimulating hormone, or TSH. This hormone is produced by the pituitary gland, which is located at the base of the brain and produces many hormones. TSH tells the thyroid to absorb iodine, which is then converted to thyroxine. The thyroids ability to absorb iodine is important for the success of radioactive iodine therapy.

If youve had surgery to remove part or all of the thyroid, your doctor may wait a few weeks before prescribing a replacement thyroid hormone. During that time, you experience whats known as thyroid hormone withdrawal, which makes the pituitary excrete more TSH. Excess thyroid-stimulating hormone is necessary for the success of radioactive iodine therapy.

Another way your doctor may try to increase the effectiveness of radioactive iodine therapy is to give you an injection of a medication called recombinant human thyroid hormonethyroid-stimulating hormone made in a laboratory. This injection is given for two days before radioactive iodine therapy begins. The medication elevates thyroid-stimulating hormone levels enough to make the radioactive iodine therapy as effective as thyroid hormone withdrawal.

When radioactive iodine therapy is being considered for thyroid cancer, the body must be depleted of inorganic iodine, so the levels of thyroid-stimulating hormone increase, helping with the effectiveness of radioactive iodine therapy.

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What Are The Special Concerns For Men

Men who receive RAI treatment for thyroid cancer may have decreased sperm counts and temporary infertility for periods of roughly two years. Sperm banking is an option in a patient who is expected to need several doses of RAI for thyroid cancer.

Instructions to reduce exposure to others after I-131 RAI treatment


Do You Lose Your Hair With Radioactive Iodine Treatment

Radioactive iodine does not produce hair loss. Nevertheless, hair loss can be associated with changing levels of thyroid hormone, and may be experienced by some patients with hypo or hyperthyroidism. When hair loss occurs as a result of changing levels of thyroid hormone, it almost always grows back.

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Thyroid Medicine After Radioactive Iodine Treatment

You may have stopped taking your thyroid hormone tablets in preparation for your treatment. Your nurse will tell you when you should start to take them again. Usually, this is 2 to 3 days after your treatment.

You will need to take thyroxine tablets to replace the hormones that your thyroid gland normally makes. Your doctors will want to keep your thyroid hormones at a slightly higher level than you would normally need. This is to stop your body producing another hormone called thyroid stimulating hormone . TSH can help some types of thyroid cancer cells to grow.

The doctors will work out the correct dose for you and when to start taking it.


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