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How Does Radioactive Iodine Affect The Thyroid Gland

Hyperparathyroidism Two Years After Radioactive Iodine Therapy In An Adolescent Male

Treating Hyperthyroidism With Radioactive Iodine

Dorothy I. Shulman

1University of South Florida Diabetes Center, Department of Pediatrics, University of South Florida Morsani College of Medicine, 12901 Bruce B. Downs Boulevard, MDC 62, Tampa, FL 33612, USA

Academic Editor:

Abstract

Primary hyperparathyroidism is a very rare complication following radioactive iodine therapy. There is typically a latency period of more than a decade following radiation exposure and, therefore, it is observed almost exclusively in adults. Consequently, pediatricians are not aware of the association. We present a case of primary hyperparathyroidism due to a solitary parathyroid adenoma occurring in an adolescent male two years following radioactive iodine treatment for papillary thyroid carcinoma. Periodic screening of serum calcium following ablative doses of radioactive iodine for thyroid cancer may be justified even in adolescents.

1. Introduction

2. Case Presentation

Ultrasound and technetium sestamibi scan of nonpalpable 1cm nodule in right neck prior to removal of parathyroid adenoma.

3. Discussion

Conflict of Interests

The authors declare that there is no conflict of interests regarding the publication of this paper.

References

  • J. Kollars, A. E. Zarroug, J. Van Heerden et al., Primary hyperparathyroidism in pediatric patients, Pediatrics, vol. 115, no. 4, pp. 974980, 2005. View at: Publisher Site |
  • M. Fulop, Hypoparathyroidism after 131I therapy, Annals of Internal Medicine, vol. 75, no. 5, p. 808, 1971. View at:
  • Copyright

    What Is Potassium Iodide

    Potassium iodide is the same form of iodine used to iodize table salt. Taking KI fills the thyroid with iodine, thus preventing radioactive iodine from being absorbed. If taken soon enough, KI protects the thyroid from radioactive iodine from all sources milk, other foods, air, and water. KI is a non-prescription drug that can be purchased over the internet and at some pharmacies. KI is available in pill and liquid forms. KI products approved by the Food and Drug Administration are Iosat Tablets , ThyroSafe Tablets , and ThyroShield Solution . Properly packaged, Potassium iodide tablets shelf life is at least 5 years and possibly as long as 11 years. If you take a very old pill, it may not work fully but it will not hurt you.

    What Precautions Should Be Taken With Radioactive Iodine Therapy

    • Women who are pregnant or nursing should not receive RAI therapy. Pregnancy should be delayed at least six to 12 months after RAI treatment for thyroid cancer. Breast feeding should be stopped at least six weeks before RAI and should not be resumed.
    • In the days immediately following your RAI therapy, be aware of these general precautions to prevent radioactive exposure to others. Your healthcare provider will give you specific instructions on how many days to follow these precautions, which will depend on the strength of your dose of RAI.
    • Avoid prolonged, close physical contact with others, especially children and pregnant women.
    • For the first few days stay a distance of at least 6 feet away from others. Avoid public places.
    • Sleep alone in a separate bed .
    • Do not share kitchen and cooking utensils, bedding, towels and personal items with others.
    • Do dishwashing and laundering of the items you use separately.
    • Wash your hands often and shower daily.

    Last reviewed by a Cleveland Clinic medical professional on 09/08/2020.

    References

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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.

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    Who Should Take Ki

    18 Strategies to Beat Hypothyroidism Naturally

    Since children are at the highest risk to exposure to radioactive iodine, KI should be available to all of them. Because of the risk to the fetus, pregnant women should also take KI in the event of a nuclear accident. Adults are at a lower risk but still may benefit from KI. In addition to KI, priority should be given to evacuation, sheltering and avoiding contaminated food, milk, and water. KI should not take the place of any other protective measure.

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    When Should Ki Be Taken

    KI fills the thyroid cells with iodine and prevents the gland from absorbing radioactive iodine for approximately 24 hours. People should take one dose a day while they are being exposed to radioactive iodine until the risk no longer exists. KI should be used only under instruction from local health authorities. Not every radioactive release includes the radioactive iodine that can cause thyroid cancer.

    Health authorities can determine which radioactive isotopes are released during a nuclear event. If radioactive iodine is released, then health authorities will advise on when and how long to take KI.

    What To Expect After Treatment

    Most people don’t feel different after treatment. But a few people may have nausea.

    Within a few days after treatment, the radioactive iodine will leave your body in your urine and saliva. How long it takes will depend on your age and on the dose you received. Young people get rid of radioactive iodine faster than older adults. Drink plenty of fluids during this time to help your body get rid of the radioactivity.

    Your doctor will give you written instructions. To avoid exposing other people to radioactivity, it is important to follow your doctor’s instructions carefully. He or she will instruct you on how far to stay away from people, how long you need to sleep alone, and other ways to stay safe. You will be directed to avoid close contact, kissing, sex, and sharing cups, dishes, or utensils.

    Some general recommendations include:footnote 1

    • Keep your distance from other people, especially children and pregnant women.
    • Do not sit next to someone in a motor vehicle for more than 1 hour.
    • Avoid close contact, kissing, or sexual intercourse.
    • Sleep alone in a separate room.
    • Use separate towels, face cloths, and sheets. Wash these and your personal clothing separately for 1 week.
    • Flush the toilet twice after each use. Rinse the bathroom sink and tub thoroughly after you use them.

    After you take your treatment, you may have follow-up exams every 4 to 6 weeks until your thyroid hormone levels return to normal.

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    Language Families Of The World

    Language familyDialectologyHistorical linguisticsList of language familiesDistribution of languages in the world

    The world’s languages can be grouped into language families consisting of languages that can be shown to have common ancestry. Linguists recognize many hundreds of language families, although some of them can possibly be grouped into larger units as more evidence becomes available and in-depth studies are carried out. At present, there are also dozens of language isolates: languages that cannot be shown to be related to any other languages in the world. Among them are Basque, spoken in Europe, Zuni of New Mexico, Pur├ępecha of Mexico, Ainu of Japan, Burushaski of Pakistan, and many others.

    The language family of the world that has the most speakers is the Indo-European languages, spoken by 46% of the world’s population. This family includes major world languages like English, Spanish, French, German, Russian, and Hindustani . The Indo-European family achieved prevalence first during the EurasianMigration Period , and subsequently through the European colonial expansion, which brought the Indo-European languages to a politically and often numerically dominant position in the Americas and much of Africa. The Sino-Tibetan languages are spoken by 20% of the world’s population and include many of the languages of East Asia, including Hakka, Mandarin Chinese, Cantonese, and hundreds of smaller languages.

    Definition Of Pituitary Hypothyroidism

    Thyroid Gland, Hormones and Thyroid Problems, Animation

    Pituitary hypothyroidism is also known as central hypothyroidism or secondary hypothyroidism. It is a disorder of either the hypothalamus or the pituitary gland and is generally accompanied by low levels of TSH, T3 and T4 hormones. However, TSH levels can also be normal or even slightly higher than normal in patients with central hypothyroidism. Therefore relying on TSH levels as an indicator of secondary hypothyroidism is not reliable and shouldnt be used to make either a diagnosis or determine appropriate treatment.

    Interesting Questions about Thyroid:

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    Does Rai For Thyroid Imaging Provide The Best Results

    I-123 is the usual isotope used to take pictures and determine the activity of the intact thyroid gland , since it is harmless to thyroid cells. No special radiation precautions are necessary after a thyroid scan or RAIU using I-123. I-131 can also be used to take pictures of the thyroid gland, although it is rarely used due to the harmful effects it has on thyroid cells.

    Mental Faculty Organ Or Instinct

    One definition sees language primarily as the mental faculty that allows humans to undertake linguistic behaviour: to learn languages and to produce and understand utterances. This definition stresses the universality of language to all humans, and it emphasizes the biological basis for the human capacity for language as a unique development of the human brain. Proponents of the view that the drive to language acquisition is innate in humans argue that this is supported by the fact that all cognitively normal children raised in an environment where language is accessible will acquire language without formal instruction. Languages may even develop spontaneously in environments where people live or grow up together without a common language for example, creole languages and spontaneously developed sign languages such as Nicaraguan Sign Language. This view, which can be traced back to the philosophers Kant and Descartes, understands language to be largely innate, for example, in Chomsky’s theory of Universal Grammar, or American philosopher Jerry Fodor‘s extreme innatist theory. These kinds of definitions are often applied in studies of language within a cognitive science framework and in neurolinguistics.

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    Taste And Smell Changes

    Ageusia or altered taste is thought to be caused by radiation destruction of lingual taste buds from the RAI secreted into saliva.5,36 When low and high doses of 131I were compared , a higher incidence of taste disturbance was associated with the higher dose.37 However, a paucity of literature supports this common clinical observation. The loss of taste may be accompanied by a metallic or chemical taste, which usually resolves in 4 to 8 weeks. No long-term alterations in taste have been reported.

    Is There Reason To Be Concerned About Thyroid Cancer

    Do You Know The Importance Of Iodine And Your Thyroid ...

    In general, 90% of patients survive thyroid cancer. The post-Chernobyl cancers have some aggressive features and have been unusual in affecting children younger than 10 years. Thyroid cancer survivors always remain at risk for recurrence and require lifelong medical care. Likewise, the children who were exposed to radioactive iodine from the Chernobyl accident, but have not developed thyroid cancer, remain at risk for life and must continue to be tested though the question of surveillance is still unsettled.

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    Who Should Not Take Ki

    Millions of people have taken KI but few serious sideeffects have been reported. The only people who should not take KI are those who have had a major allergic reaction to iodine it is safe to take KI even if you have a shellfish or contrast dye allergy. During a nuclear emergency, KIs benefit far outweighs any potential risk. Adults over 40 years old do not need KI at all unless they are exposed to extremely high levels of radioactive iodine.

    Patients with thyroid disease can safely take the pills in the FDA recommended doses. KI should be used for 10-14 days or as directed by public officials . If KI is taken for a prolonged amount of time, it can lead to temporary hypothyroidism or hyperthyroidism in some people.

    Prolonged treatment can cause thyroid dysfunction for very young children. Such children should be seen afterward by a health professional. Patients with Graves hyperthyroidism or with autonomous functioning thyroid nodules should also be seen by their health care provider.

    What If I Eat Something High In Iodine By Mistake

    Eating a high iodine food by mistake should not affect your treatment. You should keep following the low-iodine dietary advice provided here.

    Radioactive iodine needs a high level of thyroid-stimulating hormone to be effective. There are 2 ways to increase the TSH level in your blood. The most common way is to be given a drug called Recombinant human thyroid-stimulating hormone.

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    If Treatment Does Not Work

    Recovery from thyroid cancer is not always possible. If the cancer cannot be cured or controlled, the disease may be called advanced or terminal.

    This diagnosis is stressful, and for some people, advanced cancer is difficult to discuss. However, it is important to have open and honest conversations with your health care team to express your feelings, preferences, and concerns. The health care team has special skills, experience, and knowledge to support patients and their families and is there to help. Making sure a person is physically comfortable, free from pain, and emotionally supported is extremely important.

    People who have advanced cancer and who are expected to live less than 6 months may want to consider hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life.

    You and your family are encouraged to talk with the health care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special Nursing care and special equipment can make staying at home a workable option for many families. Learn more about advanced cancer care planning.

    After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss.

    How Much Water Should I Drink After Radioactive Iodine

    How Does Radioactive Iodine Work in a Cat with Hyperthyroidism?

    Clearing the radioactive iodine from your body Follow these guidelines to help the radioactive iodine leave your body quickly. Drink lots of liquids. Starting right after your treatment, try to drink at least 1 cup of low-iodine liquid every hour while youre awake. Keep doing this for 2 to 3 days after your treatment.

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    What Can Be Expected With Radioactive Iodine Treatment For Hyperthyroidism

    If you have thyroid disease, your doctor can discuss which treatment is right for you. The two basic goals for treating thyroid disease are to return thyroid hormone levels to normal and to remove potentially cancerous lumps. Treatments include radioactive iodine, antithyroid drugs, beta-blocking drugs, thyroid hormone pills, and surgery. There are several types of treatment:

    • Radioactive iodine is used to shrink a thyroid gland that has become enlarged or is producing too much hormone. It may be used on patients with hyperthyroidism, a goiter, or some cases of cancer.
    • Surgery is normally used to remove a cancer and may also be used to remove a large goiter.
    • Thyroid hormone pills are a common treatment for hypothyroidism, for patients with a goiter, and for patients who have had thyroid surgery. The pills provide the body with the right amount of thyroid hormone.
    • Anithyroid drugs and beta-blocking drugs are used to treat hyperthyroid patients.

    What Does The Radioactive Iodine Uptake Show

    Iodine is an important building-block for thyroid hormones. Your doctor may give you a small amount of radioactive iodine and then measure the amount absorbed by the thyroid gland. If the thyroid absorbs a lot of this iodine, you may be hyperthyroid. Low iodine uptake may signal hypothyroidism or thyroiditis.

    Why is the structure of my thyroid important?

    Examining the structure of your thyroid gland and the surrounding area tells your doctor about a lump which may be cancerous or enlargement of the thyroid .

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    How Does Radioactive Iodine Treat Thyroid Cancer

    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.

    Preparation Of A Papillary Thyroid Cancer Patient For Radioactive Iodine Treatment

    Radiation Hazards

    Papillary thyroid cancer patients must be taken off of levothyroxine thyroid hormone for a minimum of four weeks, taken off of liothyrionine thyroid hormone for a minimum of two weeks, or receive a medication which is TSH . Additionally, papillary thyroid cancer patients must be on a low iodine diet for a minimum of four weeks to starve their body of iodine. Those patients which have undergone CAT scans with intravenous contrast must wait until their blood iodine levels have been adequately decreased . Note, a desire to treat with radioactive iodine should never prevent the use of necessary CAT scans for the evaluation of a papillary thyroid cancer patient.

    The potential risks of RAI treatment include:

    • Dry mouth and or eyes
    • Narrowing of the drainage duct of the eyes tears leading to excessive tearing down the cheek
    • Swelling in your cheeks from inflammation or damage to the saliva producing glands
    • Short term changes to taste and smell
    • Lowered testosterone levels in males
    • Change in periods in women
    • Second tumors

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