Treatment with radioactive iodine. Consequences of treatment with radioactive iodine Where is treatment with radioactive iodine

All chemical elements form isotopes with unstable nuclei that, during their half-lives, emit α-particles, β-particles or γ-rays. Iodine has 37 types of nuclei with the same charge, but differing in the number of neutrons, which determine the mass of the nucleus and atom. The charge of all isotopes of iodine (I) is 53. When referring to an isotope with a certain number of neutrons, write this number next to the symbol, separated by a dash. IN medical practice use I-124, I-131, I-123. The normal isotope of iodine (not radioactive) is I-127.

The number of neutrons serves as an indicator for various diagnostic and medical procedures. Radioiodine therapy is based on different half-lives of radioactive isotopes of iodine. For example, an element with 123 neutrons decays in 13 hours, with 124 in 4 days, and I-131 will be radioactive in 8 days. I-131 is most often used, the decay of which produces γ-rays, inert xenon and β-particles.

The effect of radioactive iodine in treatment

Iodine therapy is prescribed after removal thyroid gland fully. Upon partial removal or conservative treatment this method does not make sense to use. Thyroid follicles receive iodides from the tissue fluid that washes them. Into tissue fluid by diffusion or with the help of active transport iodides come from the blood. During iodine starvation, secretory cells begin to actively capture radioactive iodine, and degenerate cancer cells they do it much more intensely.

β-particles released during half-life kill cancer cells.

The damaging ability of β-particles acts at a distance of 600 – 2000 nm, this is quite enough to destroy only the cellular elements of malignant cells, and not neighboring tissues.

The main goal of treatment with radioiodine therapy is the final removal of all remnants of the thyroid gland, because even the most skillful operation leaves behind these remnants. Moreover, in the practice of surgeons it has already become customary to leave several gland cells around parathyroid glands for them normal operation, and also around recurrent nerve, innervating vocal cords. The destruction of the iodine isotope occurs not only in residual thyroid tissue, but also in metastases in cancerous tumors, which makes it easier to monitor the concentration of thyroglobulin.

γ rays do not have therapeutic effect, but they are successfully used in diagnosing diseases. The γ-camera built into the scanner helps determine the localization of radioactive iodine, which serves as a signal for recognizing cancer metastases. The isotope accumulates on the surface of the front of the neck (in place of the former thyroid gland), in salivary glands ah, along the entire length digestive system, V bladder. Not many, but there are still iodine uptake receptors in the mammary glands. Scanning allows you to identify metastases in the separated and nearby organs. Most often they are located in the cervical lymph nodes, bones, lungs and mediastinal tissues.

Prescriptions for treatment with radioactive isotopes

Radioiodine therapy is indicated for use in two cases:

If the condition of a hypertrophied gland is detected in the form of a toxic goiter (nodular or diffuse). State diffuse goiter characterized by the production of thyroid hormones by the entire secretory tissue of the gland. In nodular goiter, only the tissue of the nodes secretes hormones. The objectives of administering radioactive iodine are reduced to suppressing the functionality of hypertrophied areas, since the radiation of β-particles destroys precisely those areas that are prone to thyrotoxicosis. At the end of the procedure it is either restored normal function glands, or hypothyroidism develops, which is easily brought back to normal by using an analogue of the hormone thyroxine - T4 (L-form).
If a malignant neoplasm of the thyroid gland (papillary or follicular cancer) is detected, the surgeon determines the degree of risk. In accordance with this, risk groups are identified according to the level of tumor progression and possible distant localization of metastases, as well as the need for treatment radioactive iodine.
The low-risk group includes patients with a small tumor, not exceeding 2 cm and located within the outline of the thyroid gland. IN neighboring organs and tissue (especially in lymph nodes) metastases were not detected. These patients do not need to be given radioactive iodine.
Patients at average risk have a tumor greater than 2 cm, but not exceeding 3 cm. If folded poor prognosis and the capsule grows in the thyroid gland, a dose of radioactive iodine of 30-100 mCi is prescribed.
Group with high risk has a pronounced aggressive growth pattern cancerous tumor. There is growth into neighboring tissues and organs, lymph nodes, and there may be distant metastases. Such patients require treatment with a radioactive isotope of more than 100 millicuries.

Procedure for administering radioactive iodine

The radioactive isotope of iodine (I-131) is synthesized artificially. Used orally in the form of gelatin capsules (liquid). The capsules or liquid are odorless and tasteless and should only be swallowed with a glass of water. After drinking the liquid, it is recommended to immediately rinse your mouth with water and swallow it without spitting it out.

If you have dentures, it is better to temporarily remove them before consuming liquid iodine.

You can’t eat food within two hours, you can (even need) to take drinking plenty of fluids water or juice. Iodine-131, not absorbed by the thyroid follicles, is excreted in the urine, so urination should occur every hour with monitoring of the isotope content in the urine. Medicines for thyroid gland, take no earlier than 2 days later. It is better if the patient’s contact with other people during this time is strictly limited.

Before the procedure, the doctor must analyze the medications taken medicines and cancel them in different times: some of them - a week, others, at least 4 days before the start of the procedure. If a woman is in childbearing age, then pregnancy planning will have to be postponed for a period determined by the doctor. Previous surgery requires a test to determine the presence or absence of tissue capable of absorbing iodine-131. 14 days before the start of radioactive iodine administration, it is prescribed special diet, at which the normal isotope of iodine-127 must be completely eliminated from the body. Your doctor will advise you on a list of products for effective iodine removal.

Treatment of cancer tumors with radioactive iodine

If the iodine-free diet is correctly followed and the period of intake restrictions is met hormonal drugs, the thyroid cells are completely cleared of iodine residues. When radioactive iodine is administered against the background of iodine starvation, cells tend to capture any isotope of iodine and are affected by β-particles. The more actively cells absorb a radioactive isotope, the more they are affected by it. The dose of irradiation to the thyroid follicles that capture iodine is several tens of times greater than the effect of the radioactive element on surrounding tissues and organs.

French experts estimated that almost 90% of patients with lung metastases survived after treatment with a radioactive isotope. The ten-year survival rate after the procedure was more than 90%. And these are patients with the last (IVc) stage of a terrible disease.

Of course, the described procedure is not a panacea, because complications after its use are not excluded.

First of all, it is sialadenitis (inflammation of the salivary glands), accompanied by swelling and pain. This disease develops in response to the introduction of iodine and the absence of thyroid cells capable of capturing it. Then the salivary gland has to take over this function. It is worth noting that sialadenitis progresses only with high doses irradiation (above 80 mCi).

There are cases of disruption of the reproductive function of the reproductive system, but with repeated irradiation, the total dose of which exceeds 500 mCi.

Treatment procedure after thyroidectomy

Cancer patients are often prescribed iodine therapy after removal of the thyroid gland. The goal of this procedure is the final destruction of cancer cells remaining after the operation not only in the thyroid gland, but also in the blood.

After taking the drug, the patient is placed in a single room, which is equipped in accordance with the specifics.

Medical personnel are limited in contact for a period of up to five days. At this time, visitors should not be allowed into the ward, especially pregnant women and children, in order to protect them from the flow of radiation particles. The patient's urine and saliva are considered radioactive and must be specially disposed of.

Pros and cons of radioactive iodine treatment

The described procedure cannot be called completely “harmless”. Thus, during the action of a radioactive isotope, temporary phenomena are observed in the form of painful sensations in the area of the salivary glands, tongue, and the front of the neck. There is a dry mouth and a sore throat. The patient is vomiting and is observed frequent urge to vomiting, swelling, food becomes unpalatable. In addition, old chronic diseases, the patient becomes lethargic, gets tired quickly, and is prone to depression.

Despite the negative aspects of treatment, the use of radioactive iodine is increasingly used in the treatment of the thyroid gland in clinics.

The positive reasons for this pattern are:

doesn't happen surgical intervention with cosmetic consequences;
general anesthesia is not required;
relative cheapness of European clinics compared to operations for high quality maintenance and scanning equipment.

Radiation hazard from contact

It should be remembered that the benefits provided by the use of radiation are obvious to the patient himself. For the people around him, radiation can play a cruel joke. Not to mention the patient's visitors, let us mention that medical workers care is provided only when necessary and always in protective clothing and gloves.

After discharge, you cannot be in contact with a person closer than 1 meter, and during a long conversation you should move away 2 meters. In the same bed, even after discharge, it is not recommended to sleep in the same bed with another person for 3 days. Sexual contacts and being near a pregnant woman are strictly prohibited for a week from the date of discharge, which occurs five days after the procedure.

How to behave after irradiation with an iodine isotope?

For eight days after discharge, you should keep children away from you, especially touching them. After using the bath or toilet, flush with water three times. Hands are washed thoroughly with soap.

It is better for men to sit on the toilet when urinating to prevent splashing of radiation urine. Breastfeeding should be stopped if the patient is a nursing mother. The clothes the patient wore during treatment are placed in a bag and washed separately a month or two after discharge. Personal items are removed from common areas and storage. In case emergency treatment to the hospital must be notified medical staff about recent completion of a course of irradiation with iodine-131.

All chemical elements form isotopes with unstable nuclei that, during their half-lives, emit α particles, β particles or γ rays. Iodine has 37 types of nuclei with the same charge, but differing in the number of neutrons, which determine the mass of the nucleus and atom. The charge of all isotopes of iodine (I) is 53. When referring to an isotope with a certain number of neutrons, write this number next to the symbol, separated by a dash. In medical practice, I-124, I-131, I-123 are used. The normal isotope of iodine (not radioactive) is I-127.

The number of neutrons serves as an indicator for various diagnostic and therapeutic procedures. Radioiodine therapy is based on different half-lives of radioactive isotopes of iodine. For example, an element with 123 neutrons decays in 13 hours, with 124 in 4 days, and I-131 will be radioactive in 8 days. I-131 is most often used, the decay of which produces γ-rays, inert xenon and β-particles.

The effect of radioactive iodine in treatment

Iodine therapy is prescribed after complete removal of the thyroid gland. With partial removal or conservative treatment, this method does not make sense to use. Thyroid follicles receive iodides from the tissue fluid that washes them. Iodide enters the tissue fluid from the blood either diffusely or through active transport. During iodine starvation, secretory cells begin to actively capture radioactive iodine, and degenerated cancer cells do this much more intensely.

β-particles released during half-life kill cancer cells.

The damaging ability of β-particles acts at a distance of 600 – 2000 nm, this is quite enough to destroy only the cellular elements of malignant cells, and not neighboring tissues.

The main goal of treatment with radioiodine therapy is the final removal of all remnants of the thyroid gland, because even the most skillful operation leaves behind these remnants. Moreover, in the practice of surgeons it has already become a custom to leave several gland cells around the parathyroid glands for their normal functioning, as well as around the recurrent nerve that innervates the vocal cords. The destruction of the iodine isotope occurs not only in residual thyroid tissue, but also in metastases in cancerous tumors, which makes it easier to monitor the concentration of thyroglobulin.

γ-rays do not have a therapeutic effect, but they are successfully used in diagnosing diseases. The γ-camera built into the scanner helps determine the localization of radioactive iodine, which serves as a signal for recognizing cancer metastases. The accumulation of the isotope occurs on the surface of the front of the neck (in the place of the former thyroid gland), in the salivary glands, along the entire length of the digestive system, and in the bladder. Not many, but there are still iodine uptake receptors in the mammary glands. Scanning allows you to identify metastases in the separated and nearby organs. Most often they are found in the cervical lymph nodes, bones, lungs and mediastinal tissues.

Prescriptions for treatment with radioactive isotopes

Radioiodine therapy is indicated for use in two cases:

If the condition of a hypertrophied gland is detected in the form of a toxic goiter (nodular or diffuse). The condition of diffuse goiter is characterized by the production of thyroid hormones by the entire secretory tissue of the gland. In nodular goiter, only the tissue of the nodes secretes hormones. The objectives of administering radioactive iodine are reduced to suppressing the functionality of hypertrophied areas, since the radiation of β-particles destroys precisely those areas that are prone to thyrotoxicosis. At the end of the procedure, either the normal function of the gland is restored, or hypothyroidism develops, which is easily returned to normal by using an analogue of the hormone thyroxine - T4 (L-form).
If a malignant neoplasm of the thyroid gland (papillary or follicular cancer) is detected, the surgeon determines the degree of risk. In accordance with this, risk groups are identified according to the level of tumor progression and possible distant localization of metastases, as well as the need for treatment with radioactive iodine.
The low-risk group includes patients with a small tumor, not exceeding 2 cm and located within the outline of the thyroid gland. No metastases were found in neighboring organs and tissues (especially lymph nodes). These patients do not need to be given radioactive iodine.
Patients with average risk have a tumor more than 2 cm, but not exceeding 3 cm. If the prognosis is unfavorable and the capsule grows in the thyroid gland, a dose of radioactive iodine of 30-100 mCi is prescribed.
The high-risk group has a pronounced aggressive growth pattern of the cancer tumor. There is growth into neighboring tissues and organs, lymph nodes, and there may be distant metastases. Such patients require treatment with a radioactive isotope of more than 100 millicuries.

Procedure for administering radioactive iodine

If you have dentures, it is better to temporarily remove them before consuming liquid iodine.

You cannot eat food for two hours; you can (even need) drink plenty of water or juice. Iodine-131, not absorbed by the thyroid follicles, is excreted in the urine, so urination should occur every hour with monitoring of the isotope content in the urine. Medicines for the thyroid gland are taken no earlier than after 2 days. It is better if the patient’s contact with other people during this time is strictly limited.

Before the procedure, the doctor must analyze the medications you are taking and stop them at different times: some of them a week, others at least 4 days before the procedure. If a woman is of childbearing age, then pregnancy planning will have to be postponed for a period determined by the doctor. Previous surgery requires a test to determine the presence or absence of tissue capable of absorbing iodine-131. 14 days before the start of the administration of radioactive iodine, a special diet is prescribed, in which the normal isotope of iodine-127 must be completely eliminated from the body. Your doctor will advise you on a list of products for effective iodine removal.

Treatment of cancer tumors with radioactive iodine

If an iodine-free diet is properly followed and the period of restrictions on taking hormonal medications is followed, the thyroid cells are completely cleared of iodine residues. When radioactive iodine is administered against the background of iodine starvation, cells tend to capture any isotope of iodine and are affected by β-particles. The more actively cells absorb a radioactive isotope, the more they are affected by it. The dose of irradiation to the thyroid follicles that capture iodine is several tens of times greater than the effect of the radioactive element on surrounding tissues and organs.

Of course, the described procedure is not a panacea, because complications after its use are not excluded.

There are cases of disruption of the reproductive function of the reproductive system, but with repeated irradiation, the total dose of which exceeds 500 mCi.

Treatment procedure after thyroidectomy

After taking the drug, the patient is placed in a single room, which is equipped in accordance with the specifics.

Pros and cons of radioactive iodine treatment

The described procedure cannot be called completely “harmless”. Thus, during the action of a radioactive isotope, temporary phenomena are observed in the form of painful sensations in the area of the salivary glands, tongue, and the front of the neck. There is a dry mouth and a sore throat. The patient feels nauseous, has frequent vomiting, swelling, and food becomes unpalatable. In addition, old chronic diseases worsen, the patient becomes lethargic, gets tired quickly, and is prone to depression.

Despite the negative aspects of treatment, the use of radioactive iodine is increasingly used in the treatment of the thyroid gland in clinics.

The positive reasons for this pattern are:

there is no surgical intervention with cosmetic consequences;
general anesthesia is not required;
the relative cheapness of European clinics compared to operations with high quality of service and scanning equipment.

Radiation hazard from contact

It should be remembered that the benefits provided by the use of radiation are obvious to the patient himself. For the people around him, radiation can play a cruel joke. Not to mention the patient’s visitors, let us mention that medical workers provide care only when necessary and always wear protective clothing and gloves.

How to behave after irradiation with an iodine isotope?

For eight days after discharge, you should keep children away from you, especially touching them. After using the bath or toilet, flush with water three times. Hands are washed thoroughly with soap.

It is better for men to sit on the toilet when urinating to prevent splashing of radiation urine. Breastfeeding should be stopped if the patient is a nursing mother. The clothes the patient wore during treatment are placed in a bag and washed separately a month or two after discharge. Personal items are removed from common areas and storage. In the event of an emergency visit to the hospital, it is necessary to warn medical personnel about the recent completion of a course of irradiation with iodine-131.

For thyroid cancer, diffuse toxic goiter, and other severe thyroid pathologies, doctors often use non-surgical techniques with high efficiency. Radioiodine therapy - modern method destruction of atypical cells. The use of iodine isotopes - 131 allows you to quickly destroy tissue malignant neoplasms. Risk of relapse hormonal disorders and complications are lower than with traditional method surgical treatment with removal of the problem organ.

To achieve positive result You need to properly prepare for radioiodine therapy: change your diet, stop taking certain medications. Important nuances associated with the use of radioactive iodine, the advantages of the method, indications, and features of the postoperative period are described in the article.

Radioiodine therapy: what is it?

A unique technique stops the progression, beta radiation has a limited effect on the affected area, and prevents the spread of destruction to new areas. Studies of processes in oncopathology - papillary adenocarcinoma have confirmed the assumptions of doctors about the active uptake of iodine isotopes - 131 by cancer cells. Atypical cells that produce are sensitive to the effects of radiation. The optimal dose of radiation affects the affected areas, which leads to the death of the affected elements. Beta radiation acts directly on the problem area; healthy gland tissues experience virtually no negative effects.

The first stage is stimulation of secretion (TSH). It is important to ensure that the hormone level increases to 25 mgIU/ml. The second stage is taking a small capsule with iodine - 131. With iodine deficiency, cancer cells in the thyroid gland quickly take up iodine. Powerful exposure to radioactive isotopes provokes tissue death papillary carcinoma, tumor development stops. Radionuclides are eliminated from the body after 8 days.

After a certain period (usually six months after the procedure), skeletal scintigraphy should be performed. Scanning parts of the skeleton using a modern SPECT/CT tomograph allows us to identify areas of accumulation of radioactive iodine. Metastases develop in these areas. It is important to detect distant lesions in time for timely radiation or chemotherapy to eliminate complications due to oncological pathology.

Indications for radioiodine therapy:

papillary and follicular forms of thyroid cancer, other types of malignant process in important element endocrine system;

diffuse toxic;

identification of metastases in which iodine accumulates - 131;

relapses after resection of thyroid tissue with surgical treatment diffuse goiter.

Contraindications

Radioiodine therapy is not performed during pregnancy. Development of the fetus in the womb - absolute limit not only for taking capsules with iodine - 131, but also for all types of examinations and procedures using iodine isotopes. After radioiodine therapy, pregnancy can be planned no earlier than 12 or 24 months later.

Another limitation for local irradiation of thyroid tissue using beta particles is the lactation period. There are no other contraindications for radioiodine therapy.

Advantages of modern non-surgical technique

The modern method of treatment has many positive aspects:

high efficiency: relapses are rare;

there is practically no effect on healthy thyroid tissue: radioactive iodine is captured only by altered gland cells, the range of action of iodine isotopes - 131 - from 0.5 to 2 mm;

rapid removal of radionuclide residues from the body: half-life - 8 days;

the ability to avoid thyroid surgery;

minimum list of restrictions;

discomfort in the thyroid gland after the procedure goes away quite quickly after use local funds and carrying out symptomatic treatment;

there are no unsightly scars on the neck, as after surgery;

swelling of the larynx occurs rarely;

not needed for the procedure general anesthesia, the use of which is prohibited for many violations;

other organs are practically not affected by radiation;

specific rehabilitation period with minimal discomfort: the basic rule is radiation safety of others and family members;

complications occur much less frequently than during surgical treatment of thyroid cancer.

Flaws

It is important to know about the nuances of using radioactive iodine:

you will have to give up breastfeeding and wait to plan a pregnancy;

possible complications in the area of the salivary glands, blurred vision, and other side effects;

Hypothyroidism most often develops after radioiodine therapy; long-term use hormonal drugs.

How to prepare for radioiodine therapy

When issuing a referral for radioiodine therapy, the endocrinologist gives the patient a memo with a list of rules that must be followed. Violation of the requirements reduces the effectiveness of treatment and increases the risk of complications.

Main task preparatory stage- reduce the amount of iodine in the body by adjusting medications and diet. The stronger the iodine deficiency, the more active the cancer cells in the thyroid gland capture radioactive isotopes.

2 weeks before the procedure, the patient should limit the following items in the diet:

dairy products;

preparations with seaweed extracts;

greens of all kinds;

seafood;

bread and buns with food additives containing iodine;

egg yolk;

iodized salt;

seaweed;

beans, especially varieties with bright colors of skin and pulp;

pizza, mayonnaise, ketchup, sausages, canned meat and fruit;

spices;

Japanese and Chinese cuisine;

cherries, bananas, dried apricots, apples and puree, feijoa, persimmons, olives;

cereals, cereals, rice;

sea fish, black and red caviar;

vegetables: zucchini, sweet pepper, green peas, cauliflower, potato;

dry milk porridge;

meat, turkey.

Learn about diseases, as well as the structure and functions of important organs in the human body.

A page is written about the norm of glycated hemoglobin in men, as well as the causes and symptoms of deviations.

Go to the address and read about the features of thyroid treatment in women folk remedies at home.

Taking medications:

give up iodine-containing dietary supplements and medications: Potassium iodide, Iodine balance, Antistrumin;

Amiodarone and Cordarone, NSAIDs, progesterone, salicylates should not be taken temporarily;

a month before the start of therapy, stop taking , 10 days - triiodothyronine to actively increase the values of thyroid-stimulating hormone;

for 20-30 days before the procedure, it is forbidden to make an iodine grid, use alcohol solution iodine for treating wounds and scratches.

Important! When living by the sea, 7-10 days before starting radioiodine therapy, you need to leave your usual area so that the iodine content in the body decreases, which is rich in seaside air and water in a natural salty reservoir.

How is the treatment carried out?

The patient is undergoing radioiodine therapy in the hospital. The first stage is taking a capsule that contains the optimal dose of iodine isotopes - 131.

After the procedure, the patient is in a special room, through the walls of which radioactive radiation does not penetrate. There is an isolated system inside the room so that the patient can meet basic needs and physiological functions without negative impact on medical staff and other patients.

Recovery

The rehabilitation period after radioiodine therapy is less difficult than after surgery. Complications and discomfort occur less frequently.

After discharge from the hospital, it is important to follow the radiation safety rules:

When communicating, maintain the optimal distance: to adults - from 1 to 2 m;

Another family member takes care of the babies. Children under 3 years of age should not be approached closer than 2 meters. It is necessary to sharply limit communication so that the baby does not receive a dose of radiation exposure;

Before discharge from the hospital, doctors advise disposing of all clothing, hygiene items and bedding to avoid bringing radiation sources home. The medical facility has special lead containers that trap radioactive particles;

At home, you need to thoroughly rinse the bathroom, sink, toilet, shower stall, tiles on the floor and walls after carrying out daily hygiene procedures;

be sure to wash your hands thoroughly, use a lot of water so that there are no iodine particles left on your palms - 131;

It is imperative to provide the patient with a separate cutlery, indoor shoes, towel, washcloth, comb, other accessories;

if the procedure was completed by an employee child care facility, then contact with wards is allowed only as directed by the doctor after a certain period of time;

it is imperative to prevent pregnancy for 12-24 months after non-surgical treatment of oncopathologies in the tissues of the thyroid gland;

with the development of severe infectious disease, acute condition, which requires hospitalization, it is important to warn doctors about recent local irradiation of the affected organ. Rules must be followed to ensure that other patients and hospital staff do not receive an unnecessary dose of radiation.

Consequences and complications

After the procedure and local irradiation of the thyroid gland, side effects are possible:

discomfort in the throat;

causeless weakness;

weight fluctuations;

visual impairment;

attacks of nausea;

exacerbation of liver and stomach diseases;

narrowing of the salivary glands;

weakness and painful sensations in the muscles.

The use of local remedies and drugs for symptomatic therapy quickly eliminates negative manifestations. Unlike surgery on the thyroid gland for a cancerous tumor, taking a capsule with iodine isotopes has less effect on well-being. Be sure to get high-quality products, monitor the regularity of food intake, and avoid overeating or refusing to eat due to nausea.

When identifying thyroid cancer pathologies, thyrotoxicosis, nodular goiter, others severe lesions endocrine organ A good alternative to surgery is radioiodine therapy. Application modern techniques using iodine isotopes - 131 - an effective and safe method of treating thyroid cancer and other intractable diseases without pain and serious consequences for the body. Compliance with all radiation safety rules during the recovery period allows you to avoid exposure to radiation on doctors and family members.

The following video briefly highlights the meaning of using radioiodine in the treatment of thyroid cancer:

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 of the endocrine system adapt to new living conditions 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 radioactive iodine therapy are conditions in which excessive amounts of thyroid hormones are produced or malignant tumors form:

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 surgical operation 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 and conditions (except in cases complete removal 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 a poor prognosis, but 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 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

Experience of using radioactive iodine I-131 in medicinal purposes dates back more than fifty years.

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

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 quite short term 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.

06.06.2014

Radioactive iodine used to treat the thyroid gland is recognized safe method, which is no less effective than traditional ways. The iodine isotope I-131 has the unique ability to destroy thyroid cells, while there is no general radiation effect on the body. Treatment consists of taking a drug, the dose of which is calculated individually. The essence of the method is radiation, the radius of which does not exceed 2 mm, so the isotope affects only thyroid tissue that can accumulate iodine.

Indications for use

Hyperthyroidism – increased hormonal activity of the thyroid gland in benign formations
Thyrotoxicosis - intoxication as a result of excessive secretion of gland hormones
Malignant neoplasms

The therapeutic effect after treatment with radioactive iodine occurs no earlier than 2-3 months if the course is favorable. Therefore, the success of the therapy is judged, as a rule, six months after RIT. But it is impossible to predict the time of onset of the effect in advance - in some patients it may occur after taking the first dose, for others it is necessary rerun procedures.

In most cases, the outcome is hypothyroidism - a decrease in gland function; subsequently, therapy is prescribed to compensate for a possible lack of hormones. Life after radioactive iodine in such patients subsequently proceeds without discomfort and inconvenience.

As a result of many years of research, they distinguish:

acute, deterministic (non-stochastic) effects
long-term, probabilistic (stochastic) consequences of treatment with radioactive iodine

Deterministic effects

As a rule, most patients do not experience a pronounced reaction after the procedure. Acute symptoms are short-lived and often go away on their own.

Some patients may experience discomfort, swelling in the neck, and pain when swallowing. 1% of patients experience allergic reactions for iodine in the form skin manifestations, a slight increase in temperature.
In 10% of patients, the effects of radioactive iodine are manifested by inflammation of the lacrimal and salivary glands. Sucking on lollipops can help relieve the condition.
A third of patients are concerned about lack of appetite, nausea, vomiting, and gastritis, which are completely regulated by diet and taking special medications.
25% of women experience amenorrhea and dysmenorrhea in the first couple of months. As studies have shown, the procedure does not affect the ability to bear children or the health of the unborn child. The only limitation is that pregnancy after treatment with radioactive iodine should be excluded in the first six months, in some cases – a year. In men, oligospermia may occur, but potency does not suffer.
Post-radiation cystitis is a rather rare phenomenon, easily corrected by increasing diuresis
Aplasia, hypoplasia, pancytopenia - these phenomena resolve on their own

Particular attention should be paid to patients with exacerbation of thyrotoxicosis, which may occur during the first two weeks. But the danger similar phenomenon can be prevented with proper combination of RIT with antithyroid drugs.

Long-term effects

Long-term effects (mutagenic, carcinogenic, genetic) after exposure ionizing radiation don't occur very often. They usually occur in children conceived during the period of treatment by the patient. However, the role of radiation and the likelihood of long-term consequences should not be exaggerated or minimized - an unfavorable radiation environment is a risk factor, and the cumulative effect remains to be studied. Although a number of studies have cast doubt on the carcinogenic effect of radioactive iodine, the result of treatment is the replacement of thyroid cells connective tissue. In this case, the conditions for development malignant tumor No.

This treatment method is modern, effective and used all over the world and has many advantages. I feel much better after radioiodine therapy. Of course, it is sometimes difficult for an ordinary patient who does not have special knowledge to understand the mass of information. Therefore, you should consult your doctor with any questions.