I-131 is radioactive iodine, or more correctly, an artificially synthesized isotope of iodine. Its half-life is 8 hours, during which time two types of radiation are produced - beta and gamma radiation. The substance is absolutely colorless and tasteless, has no aroma.

When does a substance provide health benefits?

In medicine it is used to treat the following diseases:

• hyperthyroidism - a disease caused by increased work activity thyroid gland, in which small nodular benign formations form in it;
• thyrotoxicosis – a complication of hyperthyroidism;
• diffuse toxic goiter;
• Thyroid cancer – during it, malignant tumors appear in the body of the gland, and an inflammatory process occurs.

The isotope penetrates the active cells of the thyroid gland, destroying them - healthy and diseased cells are exposed. Iodine has no effect on surrounding tissues.

At this time, the function of the organ is inhibited.

The isotope is introduced into the body enclosed in a capsule - or in the form of a liquid - it all depends on the condition of the gland, whether a one-time treatment is necessary or a course.

Pros and cons of radioactive iodine treatment for the thyroid gland

Treatment with an isotope is considered safer than surgery:

1. The patient does not need to be put under anesthesia;
2. There is no rehabilitation period;
3. No aesthetic defects appear on the body - scars and cicatrices; It is especially valuable that the neck is not disfigured - for women it appearance is of great importance.

A dose of iodine is most often introduced into the body once, and even if it causes unpleasant symptom– itching in the throat and swelling, then it is easy to stop medicines local action.

The resulting radiation does not spread to the patient’s body - it is absorbed by the only organ that is exposed.

The amount of radioactive iodine depends on the disease.

For thyroid cancer reoperation poses a threat to the patient's life, and treatment radioactive iodine is in the best possible way to stop a relapse.

Cons and contraindications

The disadvantages of the technique are some consequences of treatment:

• Contraindications to treatment are conditions of pregnancy and lactation;
• The accumulation of the isotope occurs not only in the tissues of the gland itself - which is natural, but also in the ovaries, so it is necessary within 6 months after therapeutic effects protect yourself carefully. In addition, the function of producing hormones that are necessary for correct formation fetus, so doctors warn that it is better to postpone plans to have children for 1.5-2 years;
• One of the main disadvantages of treatment is the absorption of the isotope by the mammary glands, appendages in women and the prostate in men. Even in small doses, iodine accumulates in these organs;
• One of the consequences of treating thyroid cancer and hyperthyroidism with radioactive iodine is hypothyroidism - this artificially caused disease is much more difficult to treat than if it were a consequence of a malfunction of the thyroid gland. In this case, ongoing hormonal therapy may be required;
• The consequences of treatment with radioactive iodine may be a change in the function of the salivary and lacrimal glands - the I-131 isotope causes their narrowing;
• Complications can also affect the organs of vision - there is a risk of developing endocrine ophthalmopathy;
• Weight may increase, causeless fatigue and muscle pain may appear - fibromyalgia;
• Are escalating chronic diseases: pyelonephritis, cystitis, gastritis, vomiting and changes may occur taste sensations. These consequences are short-term in nature, the diseases are quickly stopped by conventional methods.

Opponents of the method of treating the thyroid gland with iodine largely exaggerate negative consequences this method.

If a complication occurs—hypothyroidism—then you will have to take hormonal medications for the rest of your life. With untreated hyperthyroidism, you also have to take drugs with the opposite effect all your life, and at the same time fear that the nodes in the thyroid gland will become malignant.

Weight increases - if you lead an active lifestyle and eat rationally, then your weight will not increase much, but the quality of life will increase and life itself will be longer.

Fatigue, fatigue– these symptoms are common to everyone endocrine disorders, and cannot be directly linked to the use of radioactive iodine.

After using the isotope, the risk of getting cancer increases small intestine and thyroid gland.

Unfortunately, no one is immune from relapse of the disease, and the possibility of an oncological process occurring in individual bodies– if there were already atypical cells in the body – high and without the use of radioactive iodine.

The thyroid gland destroyed by radiation cannot be restored.

After surgical intervention The removed tissue also does not grow back.

It is necessary to note one more feature of the treatment, which is considered negative factor– for 3 days after taking radioactive iodine, patients should be in isolation. They pose a danger to others by emitting beta and gamma radiation.

Clothes and things that were in the room and on the patient will need to be washed with running water or destroyed in the future.

Preparation for the procedure

You should prepare to take radioactive iodine in advance - already 10-14 days before treatment.

You should start with changing your diet. Products with increased content iodine - cells must experience iodine starvation. But you shouldn’t give up salt completely – just reduce the amount to 8 g per day.

If the thyroid gland is absent - it was removed, and the disease has now recurred, then the accumulation of iodine is taken over by the lungs and lymph nodes– it is their sensitivity that will be tested – how the isotope is absorbed by the body.

You must stop using all medications, including hormonal agents– this must be done no later than 4 days before the start of treatment.

Wounds and cuts should also not be treated with iodine solution; you should not be in salt room, swim in the sea and breathe sea air. If you live in a coastal area, then isolation from external influences is necessary not only after the procedure, but also 4 days before it.

Radioactive iodine (iodine isotope I-131) is a radiopharmaceutical that exhibits high efficiency in the non-surgical treatment of thyroid pathologies.

Despite the relative safety of treatment with radioactive iodine, the consequences can still manifest themselves in very unsightly ways.

To prevent their occurrence from becoming an obstacle to healing, it is necessary to consider all possible options developments of events.

Basic therapeutic effect This method of treatment is due to the destruction (ideally complete) of damaged areas of the thyroid gland.

After starting the course, positive dynamics in the course of the disease begin to appear after two to three months.

During this time the organs endocrine system adapt to new conditions of existence, and gradually normalize the mechanism for performing their functions.

The net result is a decrease in thyroid hormone production to normal indicators, i.e. recovery.

In case of repeated manifestation of the pathology (relapse), it is possible to prescribe an additional course of radioiodine I-131.

The main indications for prescribing radioactive iodine therapy are conditions in which excessive amounts of thyroid hormones are produced or formation occurs. malignant tumors:

• hyperthyroidism - increased hormonal activity of the thyroid gland, accompanied by the formation of local nodular neoplasms;
• thyrotoxicosis is a complication of hyperthyroidism that occurs due to prolonged intoxication with an excess of secreted hormones;
• various types oncological diseases(cancer) of the thyroid gland - degeneration of the affected tissues of the organ, characterized by the appearance malignant tumors against the background of the current inflammatory process.

If during the examination distant metastases were identified, the cells of which accumulate iodine, then radioactive therapy is carried out only after surgical removal of the gland itself. Timely intervention followed by treatment with the I-131 isotope in most cases leads to a complete cure.

Toxic goiter

Radioiodine therapy is highly effective as a replacement surgery for pathologies such as Graves' goiter, the so-called. Graves' disease(diffuse- toxic goiter) and functional autonomy of the thyroid gland (nodular toxic goiter).

The practice of using this healing method is especially popular in patients for whom there is a high probability postoperative complications or the operation involves a risk to life.

Radioiodine therapy is strictly contraindicated in pregnant and lactating women. During these periods, exposure to iodine I-131 can negatively affect the process of fetal formation and its further development.

Treatment with radioactive iodine for the thyroid gland - consequences

Radioiodine therapy often causes suppression of thyroid function, which may result in the development of hypothyroidism. The lack of hormones during this period is compensated by medications.

After restoration of normal hormonal levels, the further life of recovered people is not limited to any special framework or conditions (excluding cases of complete removal of the organ).

Extensive research into the method has shown the likelihood of certain negative consequences:

• deterministic (non-stochastic) effects - accompanied by acute symptoms;
• long-term (stochastic) effects - occur unnoticed by humans and are revealed only after some time.

Feeling good immediately after completing the course does not guarantee absence side effect radioactive iodine.

Thyroid cancer has been treated. in 90% of cases it is completely cured with adequate therapy.

You can familiarize yourself with the basic methods of treating the thyroid gland.

Medullary thyroid cancer has poor prognosis, however, 5- and 10-year survival rates are high. You can read more about this disease.

Deterministic effects

Most people who have undergone this type of therapy do not notice a pronounced negative reaction. Sudden painful symptoms- are rare and, as a rule, pass quickly without the use of medications.

In some cases, after the procedure, the following reactions may occur:

• tightness and discomfort in the neck area;
• pain when swallowing;
• allergic manifestations - rash, itching, elevated temperature etc.;
• inflammation of the salivary and lacrimal glands (resorption of lollipops helps restore the patency of the canals);
• nausea, vomiting, aversion to food;
• exacerbation of gastritis, ulcers (the condition can be treated with special medications);
• amenorrhea (lack of menstrual flow) and dysmenorrhea (periodic pain during the cycle) in women;
• oligospermia (decreased volume of seminal fluid) in men (potency will not be affected);
• post-radiation cystitis (corrected by increased stimulation of urination with diuretics);
• Pancytopenia, aplasia and hypoplasia - a violation of the formation and development of tissues, a deterioration in the component composition of the blood (they go away on their own).

When working with patients with thyrotoxicosis, there is high probability exacerbation of the disease within one to two weeks after the iodine radiotherapy procedure. During this period, antithyroid drugs are additionally prescribed to prevent further intoxication.

Long-term effects

The experience of using radioactive iodine I-131 for medicinal purposes goes back more than fifty years.

During this time, no carcinogenic effect on humans was detected: in place of destroyed thyroid cells, connective tissue, which reduces to an absolute minimum the risk of developing malignant neoplasms.

Currently, instead of the original liquid solution a capsule form of radioactive iodine is used, the irradiation radius of which is from 0.5 to 2 mm. This allows you to almost completely isolate the body as a whole from harmful radiation.

Mutagenic and teratogenic effects have also not been confirmed. Radioactive iodine has a fairly short half-life and does not accumulate in the body. After treatment, the genetic material and reproductive ability are preserved, so you can plan a pregnancy within a year. As a rule, this time is enough to restore all damaged systems, which will allow the production of germ cells suitable for fertilization to resume.

If you neglect these warnings, then there is a high probability of conceiving offspring with genetic abnormalities. With a properly planned pregnancy, radioiodine therapy will not affect the health or life of the child.

The possibility of conception should be discussed with a specialist, because... its safety depends on many factors, and the permitted period is set individually in each individual case.

Four weeks after surgery, you may be given radioactive iodine treatment to eliminate any remaining thyroid tissue (the small amount left after the thyroid gland is surgically removed) as well as any other areas affected by thyroid cancer.

Elimination of residual thyroid tissue will facilitate subsequent monitoring and detection of any possible recurrence of cancer. Radioiodine ablation also improves survival in cases where the cancer has spread to the neck or other parts of the body.

The decision whether or not to undergo radioactive iodine treatment depends on certain factors related to the stage of the cancer. Your doctor will discuss the benefits and risks of treatment with you. Patients who are at low risk of relapse are generally not prescribed radioactive iodine treatment.

If you are recommended for radioactive iodine treatment, you will most likely receive it 3 to 6 weeks after surgery. You will receive a therapeutic dose of radioiodine in the form of one or more capsules or liquid that you swallow.

The principle of radioiodine treatment is based on the fact that the thyroid tissue is able to absorb and retain iodine. After you swallow a dose of radioactive iodine (I-131 isotope), it travels through the bloodstream to the thyroid gland. Radiation will destroy both normal residual gland tissue and cancerous areas with minimal negative effects on healthy tissues and organs.

The dose of I-131 used for ablation is measured in millicuries. A dose of 30 to 100 millicuries is used to remove residual thyroid tissue.

For patients with advanced disease, a higher dose (100 to 200 millicuries) is used. Very in rare cases the dose may be even higher.

It's also worth noting that radioiodine is generally safe for patients with allergies to seafood or radiocontrast dyes. Since she allergic reaction usually occurs due to proteins or compounds containing iodine rather than the iodine itself, and also because the amount of iodine in radioiodine is very small compared to iodine from other sources.

Preparing for radioactive iodine treatment

Raising your TSH levels

A prerequisite for effective implementation Radioiodine therapy is to increase TSH levels. Your TSH level should be well above the normal range before treatment. This is necessary because TSH stimulates both normal and cancerous thyroid tissue to absorb iodine.

Another reason for increased TSH levels is that thyroid cancer cells, unlike normal cells, do not absorb iodine as actively. Thus, by increasing TSH levels before treatment, we help cancer cells better absorb iodine.

There are two methods to increase TSH levels. Both of them are equally effective. Your doctor will recommend the method that is most suitable for your situation.

1. Cancellation of substitution hormone therapy: You will need to stop taking it hormonal drugs thyroid gland in the period from 3 to 6 weeks before treatment with radioiodine. This will cause your TSH level to rise to 30 or higher, which is well above the upper limit of the normal range. You will experience significant hypothyroidism and will most likely feel symptoms of it.

2. Thyrogen injections: Thyrogen is thyrotropin-alpha (a recombinant of human TSH). Injecting this drug a few days before the ablation quickly increases your TSH levels. This way you don't experience symptoms of hypothyroidism for several weeks.

Symptoms of hypothyroidism during withdrawal of hormone replacement therapy.

Although the hypothyroidism that results from stopping hormone replacement therapy (Option 1) is temporary and lasts only a few weeks, it can lead to symptoms. Symptoms of hypothyroidism may include: fatigue, weight gain, drowsiness, constipation, muscle pain, decreased concentration, emotional changes resembling depression, etc. Some people experience mild symptoms, while others experience severe hypothyroidism.

To reduce symptoms of hypothyroidism, your doctor may prescribe thyroid hormones short acting, which are called Triiodothyronine, Cytomel (T3). You will take Cytomel for several weeks. About two weeks before receiving radioiodine, you will need to stop taking Cytomel in order for your TSH levels to rise enough for radioiodine treatment.

As noted above, both methods of increasing TSH have shown comparable success rates for ablation of residual thyroid tissue. As a result, Thyrogen is increasingly being used to increase TSH as it helps patients avoid symptoms of hypothyroidism.

Dental care before radioactive iodine therapy.

Diagnostic scan

Some centers take one more step in preparation for radioiodine therapy - a whole-body radioiodine scan.

The purpose of the scan is to determine the size of residual thyroid tissue or cancerous tissue that needs to be destroyed.

The results of the diagnostic scan can help the doctor determine the required dose of radioactive iodine ablation

For the diagnostic scan, you will need to swallow a small dose of radioiodine I-131 or another form of it, I-123.

Low iodine diet

Another step in preparing to treat patients with papillary or follicular thyroid carcinoma with radioactive iodine is to follow a low-iodine diet for a short period before treatment. This diet, recommended by the American Thyroid Association, can increase the effectiveness of treatment.

The diet must be followed for 1 to 2 weeks before treatment with radioactive iodine, and also for 1 to 2 days after treatment.

The diet reduces the intake of regular iodine. As a result, when you receive a therapeutic dose of radioactive iodine, all remaining thyroid cells, including thyroid cancer cells, will become iodine deficient and will therefore be much more efficient at absorbing radioactive iodine. Eventually, the radioactive iodine will destroy these cells.

A low-iodine diet reduces iodine intake to less than 50 mcg of iodine per day (but does not completely eliminate iodine). Iodine is not related to sodium, so this diet is different from a low sodium diet. The recommended daily dose of iodine is 150 mcg per day. Most people in the US consume much more than 150 micrograms of iodine per day.

The foods and drinks you eat while on the diet will contain small amounts of iodine, amounting to less than 50 micrograms per day.

The following foods and ingredients contain large amounts of iodine and should be avoided:

Iodized salt and sea ​​salt and any products containing iodized salt or sea salt.

Seafood, seaweed, products containing marine additives: agar-agar, algin, alginate, and nori.

Dairy products.

Egg yolks or whole eggs and products containing eggs.

Baked goods made from dough containing iodine/iodate. Baked goods with low iodine content are allowed.

Red dye #3, erythrosine (or E127 in Europe)

Most chocolate (as it contains milk). Cocoa powder and some types of dark chocolate are acceptable.

Soybeans and most soy products. You can consume soybean oil and soy lecithin.

The following foods can be consumed in any quantity:

Fresh fruits and vegetables, unsalted nuts and unsalted nut butters, fresh meat up to 140g per day (you need to check the labels on products, as many manufacturers may introduce broths into meat). Cereals/grain products that do not contain ingredients with high content iodine (some diets limit grain intake to 4 servings per day), pasta that does not contain high iodine ingredients.

Sugar, jelly, honey, maple syrup, black pepper, fresh or dried herbs, everything vegetable oils(including soy).

Cola, Diet Coke and sparkling water (no colorings). Insoluble coffee and tea, beer, wine, and others alcoholic drinks, lemonade, fruit juices.

Please check the ingredient list on all packaged items. food products. Consult your doctor about all medicines that you accept.

Please note that sodium is not an issue. Iodine, which is added to iodized salt, should be avoided. Iodized salt is widely used in prepared foods. Therefore, if salt is one of the listed ingredients, you have no way of knowing whether that salt is iodized or not. This rule does not apply to products that contain sodium without salt as an ingredient.

There are many foods that you can eat while on a diet with reduced content Yoda. It is best to cook your own food using fresh ingredients, including fruits, vegetables, and meats that have not been pre-processed. Some patients experience nausea the first day after radioactive iodine therapy, so doctors usually prescribe anti-nausea medications immediately before receiving the therapeutic dose. If your doctor hasn't offered you a remedy for nausea, you can ask him about it.

After treatment with radioactive iodine - in a hospital or at home

After receiving therapeutic dose of radioiodine, you may be kept in the hospital for one or more days or sent home immediately, depending on the dose you receive and other factors.

At some centers, patients stay there for a few hours after receiving radioiodine and then go home the same day.

Your center will provide written instructions on what to do after discharge. Your personal circumstances, such as having a newborn or small child in the home may affect the decision whether to discharge you or keep you in the hospital for one or more days after receiving the treatment dose.

Radioactive iodine that is not absorbed by the remaining part of the thyroid gland is removed from the body in sweat, saliva, feces and urine. Most of the radiation leaves the body within a week.

First day

Ask your doctor how to protect salivary glands, which, like the thyroid gland, absorb radioactive iodine. You can protect your salivary glands by eating sugar-free lemon drops or certain foods. Your doctor will give you recommendations on what to do and when to do it. Also ask how much fluid you can drink.

The following days after radioiodine therapy

Tips and precautions

Below are tips and precautions to take during and after treatment with radioactive iodine to protect yourself, your family, co-workers and others from radiation exposure.

The warnings listed below are for the few days following radioiodine therapy. Please be aware that your doctor's instructions may differ from the ideas above. Discuss any questions or uncertainties you may have with your doctor.

During isolation in hospital or at home

You will be in a special hospital room with closed door until the radiation safety officer gives you permission to leave.

If you are taking any medications, tell your doctor. Somewhere, a day or two after radioiodine therapy, you will be prescribed thyroid hormones in the form of tablets.

You will most likely be kept on a low iodine diet. Before going to the hospital, stock up on some foods, such as fruits and unsalted nuts, in case the hospital does not have special food low in iodine. You will likely be able to order kosher, vegetarian or diabetic food. Served dishes and utensils must remain in special plastic bags in your room.

You will be able to bring newspapers and magazines into the room, which you will have to leave there. Most likely, there will be a TV in your room.

Bring your glasses with you, contact lenses and other personal medical supplies. Don't take things like this with you personal computer, since they may be contaminated by radiation, and you will only be able to pick them up after some time.

Being in isolation after radioiodine therapy can feel lonely and may be emotionally difficult, but it does not have to be physically painful.

It is useful to prepare yourself psychologically for isolation. We advise you to use your telephone to communicate with family and friends.

Your nurse will frequently check on your well-being by telephone or intercom.

To avoid radiation contamination of your own clothing when sweating, please wear hospital gowns and slippers.

You will be given instructions on how much fluid you should drink.

You may be advised to take a laxative to reduce the effect of radiation on your intestines.

How to behave on the way home and while at home (precautionary measures)

Be guided the following measures precautions:

In the first five days after returning home, do not approach people within a distance of 1 meter. Most of the time, try to stay at least 2 meters away. This distance must be maintained in relation to children and pregnant women for 8 days. The same recommendations apply to pets. Don't kiss anyone.

Your doctor should give you more specific instructions about how long you should avoid close contact. The number of days you should take precautions depends on whether there are small children, pregnant women in your home, where you work, and other factors.

Do not sit next to another passenger in a car or public transport more than one hour. If possible, sit in the back seat on the side opposite the driver.

Sleep in a separate room or at least 2 meters away from your partner. Use separate towels and wash them, as well as your underwear, separately throughout the week.

Use separate dishes, or better yet, disposable dishes. Wash used dishes separately from common dishes for a week. Don't cook food for other people.

Wash and rinse sinks and tubs thoroughly after use. Take a shower every day.

After using the toilet, wash your hands with soap and a large number water. Flush the toilet and clean the toilet sink after each use. Males should urinate while sitting for a week to avoid urine splashing.

Discuss with your doctor how long you should abstain from pregnancy (usually at least 2 months after treatment for men and 6 to 12 months for women)

If you are breastfeeding, you should stop breastfeeding before treatment. Feeding should not be resumed after treatment. However, if you later have children, you will be able to breastfeed them.

If you need to travel by plane or other means of transportation after radioiodine therapy, take a letter from your doctor with you about the treatment you received. This is because radiation detectors at airports, bus terminals and train stations can pick up radiation from your body. Keep the above card with you for three months after treatment.

Dental care after radioiodine therapy

Caring for your teeth after radioiodine therapy is very important to neutralize the changed acidity of your saliva.

If you notice any changes in taste or salivation, stop using regular toothpaste and mouthwash. Use ultra-soft toothpaste and rinses that do not contain alcohol, phenol or bleaching agents.

A good alternative to commercial products is baking soda, used for brushing teeth and a solution baking soda, for rinsing your mouth 4-5 times a day. To rinse, dissolve one full teaspoon of baking soda in 100 - 200 g of water. It is also important to floss daily.

Scan after radioiodine therapy

2 to 10 days after treatment, you should undergo a full body scan known as an I-131 scan. This test will be performed in the radiology department.

This test usually lasts from 30 minutes to an hour.

You will be fully clothed and lying on a narrow bed that moves slowly through the scanner or the scanner itself moves along your body while the bed itself remains motionless.

In some hospital radioisotope departments, you will visit the doctor immediately after the scan, or you will learn the results of the scan from your endocrinologist over the phone or at a follow-up visit.

Almost everyone (98% of those scanned) has a small amount of residual thyroid tissue, since it is almost impossible to remove all the smallest particles of the gland during surgery. The presence of a small amount of residual tissue is assessed as normal. The scan also shows the presence of an inevitable but unwanted accumulation of radioactive iodine in salivary glands and gastrointestinal tract.

The scan also shows the location of malignant cells.

Months after radioiodine therapy

After three weeks, only traces of radioactive iodine will remain in your body. However, the full effect of destroying both normal and malignant thyroid cells will only be achieved after several months. This happens because radiation affects cells gradually.

Possible side effects treatment with radioactive iodine

Side effects of treatment may include the following:

Pain in the neck, burning sensation.

Nausea, upset stomach (less commonly, vomiting).

Swelling and painful sensitivity in the area of ​​the salivary glands as a result of their inflammation in response to exposure to radioiodine.

Change in taste (usually temporary).

Dry mouth.

Reduced tear production.

Pain or tenderness, if present, usually does not last long. However, sometimes other side effects last longer or appear several months after treatment.

Radioiodine therapy often causes lung metallic taste in your mouth even when you don't eat or change in taste certain products. These taste disturbances gradually disappear. However, some people experience this for several months. The taste changes may go away, but then appear again after a few months.

Tips for coping with some side effects of radioiodine therapy

Talk to your doctor and get their recommendations.

Painful sensitivity in the neck area can be reduced by using painkillers that are available over the counter.

Sometimes dry mouth appears. If this symptom does not go away, ask your doctor to prescribe medications that may help. These are gels and sprays. For some people, especially those who have received high doses of radioiodine therapy, the effects on the salivary glands, and the resulting dry mouth, may become permanent. This increases the risk of tooth decay. Therefore, it is very important to visit your dentist regularly.

If you experience dry eyes due to insufficient tear production, discuss this with your doctor. If you wear contact lenses, ask your doctor how long it is advisable to stop using them.

Rarely, the ducts of the salivary and tear glands become completely blocked due to their swelling. If this happens, you should contact your doctor immediately to find out what to do.

Other potential side effects of radioiodine therapy

Temporary or permanent decrease in blood cells in the blood. It usually does not cause any symptoms. The composition of the blood usually recovers over time, at least to permissible level. Blood test done a few weeks after radioiodine therapy:

Will make sure that the blood composition is within normal limits;

Human, undergone therapy radioactive iodine, may have a slight risk of developing certain types cancer in the future:

But doctors agreed that the risk increases after receiving several total doses of radioiodine therapy of 500 - 600 millicuries;

It is especially important for men who have received a large total dose of radioiodine therapy, sperm production may decrease, or infertility may occur, which happens extremely rarely. Discuss with your doctor the possibility of donating your sperm to a sperm bank if your treatment requires more than one dose of radioiodine therapy;

It is especially important for women that in some of them, after radioiodine therapy, menstrual cycle within a period of up to a year. Most doctors recommend avoiding pregnancy for at least 6 months to one year after treatment.

If you are diagnosed during pregnancy, your doctor will give you special instructions regarding your pregnancy. A pregnant or breastfeeding woman should not receive any form of radioactive iodine treatment (I-123 or I-131). Some women may delay having surgery after giving birth. If surgery is necessary earlier, it is usually performed in the second trimester (22 weeks) of pregnancy. Also, a pregnant woman should not be treated with external radiation and chemotherapy until the baby is born.

You should always discuss your individual circumstances and risk factors with your doctor.

Every year, more than a thousand patients are treated at the St. Petersburg Center for Surgery and Oncology of the Endocrine System.

The clinic has about 30,000 successful operations. We operate according to the rules aesthetic surgery and scars do not disfigure the necks of our patients.

We do not abandon our patients after operations. Our specialists help restore all functions of the patient’s body, improve their figure and adjust their weight.

We have developed, patented and put into practice new methods of examination, surgery and pain relief.

The right choice of a medical institution is the key to your successful treatment!

Who can you trust with your health? What criteria should you follow when choosing a medical institution for yourself and your loved ones, so that the result is as effective as possible, without going broke financially? Where is this optimal price/quality boundary? Over more than 15 years of experience in our work and in close contact with medical institutions, licensed in the area radioactive iodine treatment, we have selected to choose from optimal options for our clients.

Today there is a lot of contradictory and vague information on the Internet. It can be difficult for patients to navigate a highly specialized topic that is at the intersection of several areas of medicine - endocrinology, oncology, surgery and radiology.

In our work we are guided by protocols approved by prestigious Associations for thyroid diseases and nuclear medicine, as well as our personal experience, and the experience of our colleagues - endocrinologists, endocrine surgeons and nuclear medicine specialists.

For successful radioiodine therapy Particular attention should be paid to compliance with a number of the most important criteria and standards:

• Compliance optimal timing conducting a course of radioiodine I-131;
• Proper preparation for the radioiodine therapy procedure ( thyrotoxicosis , thyroid cancer);
• Compliance with the quality of the I-131 capsule and its dosage, according to the protocols of the international European nuclear community;
• Adequate rehabilitation of patients after radioiodine therapy .

An important factor in treatment is compliance with the dosage and quality of the radioiodine capsule I-131

North Estonian Regional Hospital receives radioiodine capsules to order from Finland, when strictest observance conditions of transportation and storage.

Clinic "CHIGOTA" receives radioiodine capsules from France, Budapest or the Vinča Radiological Institute, Belgrade, also for each patient individually, on order and under the strictest quality control.

Moscow X-Ray Center also uses a capsule form of radioiodine of high purity and quality.

Radioiodine therapy protocols in all European clinics are brought into compliance with the recommendations of the European Nuclear Society and the European Thyroid Association, which allows best result in each specific case.

Russian approach to methodology radioiodine therapy has a long, long history and the “backbone” of the methodological system of radioisotope therapy was laid back in Soviet years. As you know, Russia has always been a world leader in the field of nuclear research and scientific base, including the use of radioactive isotopes in medicine and the study of the influence of radioisotopes on human body, is one of the most complete and extensive in the world.

Russian radioiodine therapy protocols in the basic format are also consistent with European and American ones and have slight differences only in the nuances. This is due primarily to the fact that it is very for many years Research in this area in our country was classified and there was no possibility of exchanging information and experience with foreign colleagues. Now it's going very active process"alignment" of Russian and foreign approaches and radioiodine therapy techniques, and we are proud that our company’s specialists play a significant and active role in this difficult work.

Preparation for radioiodine therapy and follow-up after the course

All our patients are accepted by any of the Clinics we present on an individual basis, after specialized training Endocrinology Department of MedService Plus LLC. Therefore, regardless of which Clinic you choose, it will be enough for you to undergo training with our endocrinologist and you will not even need to remotely consult with specialists of the selected Clinic - we will do all this for you, because We are constantly in touch with our colleagues. You can be sure that You will be provided individual approach , control of all information and materials necessary for treatment, proper preparation and, at your request, monitoring of the condition after radioiodine therapy.

Subsequent rehabilitation of patients after undergoing radioiodine therapy is very important. Our department has developed follow-up programs health status, in close contact with colleagues from partner Clinics, allowing as soon as possible return to your normal lifestyle and avoid many unnecessary complications.

Problems of the thyroid gland manifest themselves in violations of the 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. This is the received medically a drug that is an isotope of iodine I-131. The unique effect is determined by the destruction of harmful thyrocyte cells of the thyroid gland, as well as the destruction of malignant tumors on cellular level. In this case, the patient is not irradiated 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 the low penetrating effect of beta rays, which does not pose any threat to the tissues surrounding the gland.

The result is inhibition of the functional abilities of the organ to the point of hypothyroidism, and reversibility of the process is impossible. The occurrence of a disease is considered as a consequence of the result of treatment, but not as a complication. Next, the patient must take courses replacement therapy, which effectively eliminates all the effects of radiation. Therapy is also necessary in case of thyrotoxicosis.

Thyrotoxicosis is a disease in which the thyroid gland produces excess hormones, which negatively affects the functioning of the entire body.

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

Indications for use

The accumulation of the drug occurs only in the gland, promoting precise action specifically on tissues that tend to accumulate PRT. Therefore, other organs and systems of the body do not suffer in any way during 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 nodular connections;
• thyrotoxicosis, manifested as a result of hypothyroidism;
• thyroid cancer;
• consequences of surgical complications after cancer, the risks of which are incredibly high.

Action of RIT

As a rule, treatment is prescribed after complete removal of the thyroid gland. Partial removal or conservative treatment do not contribute to the use of this type of procedure. Iodide enters tissue fluid from the blood, and during iodine starvation, secretion cells in an active way consume RIT. Moreover, studies show that cancer cells interact especially well with the drug.

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

The destructive property of the iodine isotope affects not only residual tissues, but also metastases and 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 site where the thyroid gland was located, in the salivary glands, in digestive system And genitourinary system. There have been isolated cases of isotope uptake receptors being found in the mammary glands. Thus, a general scan will reveal the development of metastases not only in organs and tissues located near the thyroid gland, but also in more distant ones.

The artificially created drug has radiation, while iodine has no taste or smell. Application is indicated for one-time use in the form of a liquid substance or sealed capsule. After the drug enters the patient’s body, a certain diet and certain procedures are necessary:

1. Avoid eating solid food for 120 minutes;
2. It is recommended not to deny yourself large quantities juice, water, since the drug that does not reach the gland tissue is excreted in the urine;
3. For the first half of the day (12 hours) after the procedure, urination should be every hour - you need to monitor this;
4. Taking medications for the thyroid gland is indicated no earlier than 2 days after RIT;
5. Limiting contact and communication with other people is indicated for 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 it is still worth knowing what needs to be done:

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

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

Side effects

It is important to understand that even the most harmless method of treatment has an impact 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 sensations;
• exacerbation of gastroduodenal manifestations, as well as all chronic diseases;
• decreased levels of leukocytes and platelets in the blood;
• fatigue, depression, nervous disorder.

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

Even if the patient has been cured of cancer or thyrotoxicosis, but is breastfeeding, it is impossible to prescribe the procedure. If you need to take medication, you will have to stop breastfeeding for at least 7-10 days after treatment.

Conclusion

Despite the side effects, radioactive iodine treatment has more pros than cons. When considering the possibilities of getting rid of thyroid cancer and thyrotoxicosis, patients prefer to choose this particular method, which, unlike surgical intervention, 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 will never be a threat again cancer, even with complete elimination of the thyroid gland, the patient needs systematic observation by a doctor until complete stabilization hormonal levels. Observations show that the patient’s condition completely normalizes after 12-15 days. But the effects of cancer are not fully understood, so a repeat session may be required.