Thyroid health is a cornerstone of overall well-being, influencing everything from metabolism to energy levels. Among the most commonly used treatments for thyroid conditions is radioiodine therapy, a procedure that has helped countless individuals with thyroid issues. However, while it offers many benefits, there are also risks and side effects that should not be overlooked. In this article, we explore radioiodine therapy, its use in managing thyroid conditions, and the potential risks involved. By understanding these factors, you can make informed decisions about your thyroid health and take steps towards preventative care.
What is radioiodine therapy?1
Radioiodine therapy (often referred to as RAI) is a medical treatment used primarily to address thyroid problems, particularly in cases of hyperthyroidism or thyroid cancer. It involves the administration of a radioactive form of iodine, typically iodine-131, which is absorbed by the thyroid gland. The radiation emitted by iodine-131 helps to destroy overactive thyroid tissue or cancerous cells, thus managing the condition.
When is radioiodine therapy used?2
Radioiodine therapy is typically recommended for patients with the following conditions:
- Graves' disease: An autoimmune disorder causing hyperthyroidism.
- Thyroid cancer: Often used after surgery to destroy any remaining cancerous cells.
- Toxic multinodular goitre: An enlarged thyroid gland with hyperactive nodules.
- Thyroid adenoma: A benign tumour of the thyroid that causes excessive hormone production.
In these cases, RAI can provide a long-term solution, either by shrinking an enlarged thyroid or by eliminating malignant cells.
How does radioiodine therapy work?
Once iodine-131 is administered, it is absorbed by the thyroid gland, where it mimics the behaviour of regular iodine. The thyroid naturally takes up iodine from the bloodstream to produce thyroid hormones. However, the radioactive iodine emits radiation that destroys thyroid cells in the process. This approach is targeted, as the thyroid is the only organ in the body that absorbs significant amounts of iodine.
The treatment is typically given in the form of a pill or liquid, and it may require a single dose, although in some cases, additional doses are needed. The amount of radiation involved is carefully calculated to ensure efficacy while minimising exposure to surrounding tissues.
Benefits of radioiodine therapy
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Non-invasive
Unlike surgery, RAI does not require incisions or anaesthesia.
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Effective
It has a high success rate in treating conditions like hyperthyroidism and thyroid cancer.
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Minimally disruptive
Recovery time is often quicker than with surgical interventions.
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Risks and side effects of radioiodine therapy
While radioiodine therapy is generally safe, it is important to be aware of potential risks. As with any treatment, it comes with possible side effects, some of which can affect your thyroid health in the long term.
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Hypothyroidism (underactive thyroid)
One of the most common side effects of radioiodine therapy is the development of hypothyroidism, particularly if too much thyroid tissue is destroyed. This occurs when the thyroid gland becomes underactive and cannot produce enough thyroid hormone. Symptoms of hypothyroidism include fatigue, weight gain, cold intolerance, and depression. Fortunately, hypothyroidism can be managed effectively with hormone replacement therapy.
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Radiation exposure to others
Although the amount of radiation used in radioiodine therapy is relatively low, patients are advised to take precautions for a period after the treatment. This may include avoiding close contact with pregnant women, children, and pets for a few days to minimise radiation exposure to others.
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Dry mouth and changes in taste
Some patients may experience dry mouth or a metallic taste after undergoing radioiodine therapy. This occurs because iodine-131 can affect the salivary glands. In severe cases, it may lead to sialadenitis, an inflammation of the salivary glands. Chewing gum or drinking water frequently can help alleviate these symptoms.
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Eye problems
For patients with Graves' disease, one of the risks associated with radioiodine therapy is the exacerbation of eye problems. Graves' disease is an autoimmune condition that affects the thyroid and is often accompanied by eye issues such as bulging eyes (exophthalmos), dryness, irritation, and vision problems. In some cases, radioiodine therapy can worsen these symptoms, making eye care a critical part of managing the condition.
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Possible long-term risks
Though rare, there are concerns about the long-term effects of radiation exposure, including a slightly increased risk of developing certain cancers, such as leukaemia. However, the benefits of radioiodine therapy typically outweigh these risks, especially when the treatment is necessary for managing thyroid cancer or severe hyperthyroidism.
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Fertility and pregnancy concerns
Radioiodine therapy is generally not recommended for women who are pregnant or breastfeeding due to the potential risks to the baby. It is advised to wait for at least 6-12 months after treatment before trying to conceive, as iodine-131 can be passed on through breast milk.
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Managing thyroid conditions: prevention and treatment
While radioiodine therapy is a highly effective treatment, there are other ways to manage thyroid conditions, and prevention should always be a key consideration in any healthcare plan.
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Regular monitoring
Thyroid conditions can sometimes develop without clear symptoms, so regular check-ups are vital. A thyroid function test, which measures levels of hormones like TSH (thyroid-stimulating hormone), T3, and T4, can help detect early imbalances and allow for prompt intervention.
In addition, thyroid conditions, particularly after radioactive iodine therapy, can impact liver health through metabolic changes, liver enzyme elevations, and the development of hypothyroidism. Therefore, it's important for individuals receiving RAI treatment to have regular monitoring of liver health as part of their ongoing care.
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Diet and lifestyle choices
A healthy diet rich in essential vitamins and minerals, including iodine, selenium, and zinc, plays a significant role in thyroid function. However, it's important to balance iodine intake, as both excessive and insufficient iodine can contribute to thyroid problems.
- Iodine is essential for the production of thyroid hormones and can be found in foods such as iodized salt, seaweed (like nori, wakame, and kelp), and seafood (fish like mackerel, anchovies, and prawns).
- Selenium, which supports the conversion of thyroid hormones, is found in seafood (e.g., tuna and shrimp), eggs, and legumes like soybeans (e.g., tempeh or tofu).
- Zinc is involved in thyroid hormone production and immune function, and can be found in foods such as shrimp, pork, chicken, pumpkin seeds, and rice.
Including these nutrient-rich foods in your diet can help support thyroid health, but it’s important to consult with a healthcare provider to ensure you're meeting your nutritional needs in a balanced way.
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Stress management
Chronic stress has been shown to affect thyroid health, particularly in autoimmune thyroid disorders like Graves’ disease. Regular exercise, mindfulness, and relaxation techniques can help reduce stress and support thyroid function.
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Medication adherence
For those already diagnosed with thyroid conditions, adhering to prescribed medications is crucial. Whether taking levothyroxine for hypothyroidism or anti-thyroid medications for hyperthyroidism, consistent medication use can prevent complications and improve quality of life.
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DID YOU KNOW?
Graves’ disease is an autoimmune condition that often leads to bulging eyes (exophthalmos).
This occurs because the immune system attacks the tissues around the eyes, causing swelling and inflammation. About 30% of individuals with Graves' disease experience eye problems, and radioiodine therapy can sometimes worsen these symptoms. If you have Graves' disease, it's essential to work closely with your healthcare provider to manage both thyroid and eye health.
Conclusion: Be proactive about thyroid health
Radioiodine therapy is an effective treatment option for certain thyroid conditions, but it is important to approach it with awareness of the potential risks and side effects. By understanding the basics of radioiodine therapy, thyroid health, and preventive measures, you can make better-informed decisions about your health. If you are at risk for thyroid disorders, be proactive about monitoring your thyroid function and adopting healthy lifestyle habits. Early detection and proper management can prevent serious complications and help you maintain optimal thyroid health.
References
- Radioiodine therapy. MedlinePlus. Available at: https://medlineplus.gov/ency/article/007702.htm#:~:text=Radioiodine%20therapy%20uses%20radioactive%20iodine,diseases%20of%20the%20thyroid%20gland.
- Radioactive iodine therapy: 9 things to know. MD Anderson Cancer Center. Available at: https://www.mdanderson.org/cancerwise/radioactive-iodine-therapy--9-things-to-know.h00-159466368.html.
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