Iodine Treatment

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RAI ablation treatment for differentiated thyroid cancer: 
Radioactive I131 is mainly used to terminate remaining thyroid tissues in the neck, ones that have metastasized, in addition to monitoring disease progression, recurrence or metastases. In thyroid cancer treatment programs radioactive iodine is used as a form of continuation to the treatment after the surgery.

Preparing for treatment:
This treatment should be implemented 4-6 weeks post op, and after it has been discussed with your physician to explore eligibility in addition to treatment benefits and risks. You should follow a regime to raise TSH levels in order to stimulate thyroid tissues for an optimum iodine absorption.

Methods of raising TSH:
  • Thyroid hormone withdrawal
    Can raise TSH levels to over 30, through stopping thyroid hormone replacement for at least 3 weeks, leaving you in a hypothyroid state and the symptoms might even be felt.
  • Thyrogen injections
    As an alternative to thyroid hormone withdrawal, during this treatment you will not be experiencing any hypothyroid symptoms. Over the course of two days, you will be receiving recombinant human TSH (rhTSH) injections; however on the third day I131 treatment will be used.
  • Low Iodine diet
    Increasing the thyroid tissue capacity to absorbing radioactive iodine is crucial. Which can be achieved through lowering dietary iodine intake. Prior to the treatment you will be provided with a list of foods that should be avoided at least 2 weeks prior to the treatment.

In order to be able to properly measure the required dose as to provide the most advantageous treatment the following should be provided:
  • A surgery report
  • A histopathology report
  • Reports of any previous (CT, MR, X-ray … etc.) scans
  • CBC, KFT, LFT tests
  • A 2-3 weeks post op neck ultrasound
  • A pregnancy test taken within 24 hours prior to the treatment

Before treatment procedures:
Upon consulting your physician, the treatment could be either administered after admitting you to the hospital or you could receive it in our facility where you will be able to return home after the treatment. One hour earlier to the treatment an anti-emetic injection will be administered. It is crucial to be fasting at least four hours before the treatment, and for another two hours after. In case of breastfeeding, you should stop it for several days as to insure that the milk being produced is not radioactive.

The radioactive I131 will be administered orally.

After treatment procedures:
Following the treatment, it is of utmost necessity to be isolated for a minimum of three days while abiding by the following instructions:
  • You should avoid sharing the same toilet with other people, in addition to flushing twice after each use
  • Daily bathing and frequent hand washing are important
  • In the first two days fluid intake should be increased
  • The cutlery you use should be washed separately, or you may use disposable ones
  • Brief close contact such as handshakes and hugging are permitted however, lengthy intimate contact should be avoided for three up to four days, in addition to sleeping alone
  • Your linens, clothes and towels should be washed daily and separately. The washing machine does not require any cleaning between loads
  • As meal preparation requires direct contact with food, it is important to avoid it
  • Breastfeeding after the treatment is not allowed
  • Pregnancy should be avoided for the duration of six months up to a full year later on to the treatment
  • As previously instructed you should resume your thyroid hormone replacement on the third day of receiving the RAI treatment or after you are discharged from the hospital

Post therapy scan:
7-10 days after receiving the treatment you will visit one of our facilities to do a whole body scan. The length of the scan is 30 minutes; there is no need for any special preparations.

Hyperthyroidism treatment through RAI ablation:
One of the treatment methods for benign thyroid conditions is radioactive iodine. In order to terminate enough tissue so as to get overactive thyroid to normally function again, where radioactive iodine can be used in small doses. For RAI ablation, there is no need for hospitalization or isolation, however a set of instructions will be provided by one of our physicians to be followed such as:
  • All supplements or drugs that are being taken which contain iodine such as (multivitamins, Lugol’s solution, SSKI) must be withheld for a minimum of 1 week prior to the treatment
  • For the duration of at least 5 days prior to the treatment Antithyroid drugs should be stopped
  • On the course of 2 months later to the treatment no iodinated contrast should be administered
  • For 2 hours before the treatment and 1 hour after no solid food is allowed
  • I131 treatment is administered orally
  • Increase clear fluid intake, as frequent bladder emptying is advised
  • In order to resume taking Antithyroid drugs your physician should be consulted

Treatment instructions for females:
  • Pregnant women should not receive I131 treatment therefore; we should be informed in case you are currently pregnant or if you are planning to do so over the course of the 6 months following the treatment
  • Any plans for getting pregnant within the 6 months following the treatment should be put on hold
  • Breastfeeding after the treatment is not allowed