Bad environment, stress and other adverse conditions often lead to thyroid diseases. Its increase harms the body. Thyrotoxicosis can take many different forms, including diffuse toxic goiter, also called Graves' disease or Graves' disease. Sometimes it even leads to thyroid cancer. To destroy the overgrown tissue of the gland and radioactive iodine is called upon.
Thyroid disease
Thyrotoxicosis, which is hyperthyroidism, can take many forms. These include diffuse and nodular toxic goiter, Plummer's disease, Hashimoto's goiter and some other ailments. Treatment with radioactive iodine successfully copes with these diseases (in Moscow it is carried out, for example, in TsNIIRRI and some other clinics). This method is complemented by the treatment of many types of cancer and other tumors of the thyroid gland, including lymphoma and Hashimoto's thyroiditis.
The opposite of thyrotoxicosis is hypothyroidism, which does not pose a serious threat and is corrected with drugs. In addition to illnessesthyroid gland, sometimes there is insufficiency or hyperfunction of the parathyroid glands, i.e. hypoparathyroidism and hyperparathyroidism. Deficiency is treated with medication, but hyperfunction requires surgery.
Therapy for thyrotoxicosis and cancer
Most of these diseases are effectively eliminated by radioactive iodine treatment. This type of therapy is also carried out in Moscow. Of course, conservative treatment is first prescribed, say, for toxic adenoma or diffuse toxic goiter with the help of medications. But efficiency rarely exceeds 40%, and often almost half as much. If such treatment fails or relapse occurs, then the best solution would be to prescribe therapy with radioactive iodine I 131. Radiation can also be used, but it increases the risk of cancer of the gland, and iodine remains harmless.
Cancer is removed promptly. But even in this case, radioactive iodine treatment in Moscow, as well as throughout the world, is carried out as an additional method of therapy. It is important here to meet the deadlines after thyroidectomy and to treat according to the protocol, then the risk of metastases can be minimized.
Why not surgery?
Sometimes an alternative therapy for thyrotoxicosis is surgery. Of course, the operation is always associated with great risk, not to mention the fact that the scar on the skin is not a very aesthetic thing. The anesthesia itself, the risk of bleeding, the possibility of damage to the recurrent nerve are all factorswho speak against surgery in favor of a more gentle, but effective radioiodine therapy. Of course, in some cases, emergency measures simply cannot be dispensed with, as in the case of cancer.
With the surgical method, part of the tissue was often preserved in order to prevent hypothyroidism. However, this approach is fraught with relapse of the disease. Thyroid-stimulating autoimmune antibodies again attack the remnants of the gland, leading to a new round of the disease. Therefore, now they prefer to get a full therapeutic effect instead of a temporary one. And the cost of radioactive iodine treatment is more acceptable.
World practice
Mild forms of the disease are preferred to be treated with medication. Also, this method is started when problems arise in adolescents and children. In other cases, it is better to treat thyrotoxicosis with radioactive iodine. The drug has the form of a capsule or an aqueous solution.
By the way, in Europe, doctors in general have more confidence in various antithyroid drugs than in radioactive iodine treatment. But in the United States, preference is given to radioiodine therapy as more effective. Of course, after it you need to go through a rehabilitation program, but taking medication also requires further recovery of the body.
The first introduction of radioisotopes of iodine was carried out in 1941 in the United States. And since 1960, the method has been widely used in medicine. Over the past period, we have become convinced of its usefulness, reliability and safety. Yes, for treatmentradioactive iodine price has become more affordable. In some clinics in America and Europe, treatment with small doses of iodine is already being carried out on an outpatient basis. We also allow such a regimen, but only for doses within 10.4 mCi in terms of activity. Abroad, the norms are somewhat different, allowing for a stronger effect, which also has a positive effect on treatment.
Basic method
In medicine, the isotopes I 123 and I 131 are used. The first is for diagnostics, since it has no cytotoxic effect. But the second isotope just allows for treatment. It emits ß- and ɣ-particles. ß-radiation produces an irradiating effect localized in the tissues of the thyroid gland. ɣ-radiation allows you to control the dose and distribution of the drug. The thyroid gland accumulates this radioisotope of iodine I 131, and it, in turn, damages the thyroid tissue, which is the therapy for thyrotoxicosis.
Safety for other tissues is explained by the fact that the thyroid gland binds iodine isotopes and attracts them to itself. In addition, its half-life is only 8 days. The intestinal and urinary systems capture, as a rule, a minimum of the isotope, without exceeding the permissible limits. The cytotoxic effect is localized, destroying only thyrocytes, which leads to a decrease in the thyroid gland in volume and the transition to hypothyroidism without surgical intervention.
Hypothyroidism, in turn, is corrected with medication. L-thyroxine preparations are prescribed, which compensates for the necessary hormones, in the usual caseproduced by the thyroid gland. Although this hormone is synthetic, it is practically not inferior to the endogenous one. Control over the level of hormones is undoubtedly necessary, sometimes the dosage needs to be changed, but otherwise the patients return to their usual way of life.
Treatment prescription
Now even our experts are inclined to believe that it is necessary to conduct a single treatment with radioactive iodine in Moscow or other cities in order to cause the development of hypothyroidism. Treatment with small doses simply reduces the symptoms, removes the problem only for a while, which is not as effective as complete elimination. The dosage of the drug is calculated for each patient individually. This indicator depends on the volume of the gland, the severity of the disease, its stage, the absorption test and the scintigraphy routine.
First, an examination is performed, concomitant pathologies are specified, calculations are made. Sometimes a decision is made to perform two injections of the drug to achieve the desired result. But there are cases when surgery is more appropriate.
Cancer is also being treated with radioactive iodine, but already as a second stage of therapy. The dosages here are higher, aimed at eliminating the risk of developing metastases. The amount of the drug depends on the severity of the case and the prevalence of the process. This procedure is not performed on an outpatient basis, preferring to leave the patient for two or three days in the clinic.
Effects of taking the drug
Be prepared for what's to comeafter treatment with radioactive iodine. For several days after taking the drug, radioactive iodine will leave the body through saliva and urine. These symptoms may last for a variable period of time, depending on age and the prescribed dose. At the same time, the elimination process is accelerated in young people, compared with the situation in the elderly.
This has practically no effect on well-being. Only a few sensitive people who have undergone radioactive iodine treatment report nausea during this period. You may also experience dry mouth or pain in your neck and throat. Increased fatigue and a metallic taste in the mouth are noted. May occasionally cause constipation or diarrhea.
Restrictions after treatment
But there are a number of restrictions that are instructions for action. So, for a certain period of time it will be necessary to avoid close contact with other people so as not to irradiate them. You will have to sleep alone, refuse kisses and hugs, avoid sharing dishes and follow similar measures. In this regard, a number of prescriptions for the behavior of the patient can be distinguished.
Main recommendations
Patients undergoing radioactive iodine treatment, reviews confirm this, should pay more attention to hygiene for a while. So, it is better to flush the toilet twice, wash your hands after visiting it especially carefully in plenty of water and soap. Separate dishes, towels, bed linen will be needed, which no one else will usewill be. Naturally, linen and clothes should also be washed separately from the belongings of relatives. Do not prepare food for the household.
Even garbage is better to collect in a separate basket, and then give it to a medical institution for disposal (if such a service is provided). Otherwise, you can throw it in a regular trash can after 8 days. The dishes should not be washed together with other people's items, it is better to wash them by hand without a dishwasher. Disposable plates and utensils are all placed in the same separate trash bag.
