Radioactive Iodine Therapy

What Is Radioactive Iodine Therapy (Atomic Therapy)?

The body's internal balance is maintained by the endocrine system, which is made up of hormone-secreting glands. One of the main glands of the endocrine system is the thyroid gland. The thyroid gland is located at the front of the neck and has a butterfly-like shape. It secretes hormones such as thyroxine, triiodothyronine and calcitonin. Through these hormones it can control many functions in the body. Its main tasks include controlling the metabolic rate, which covers the process of converting food into energy, and regulating the amount of calcium in the blood.

An overactive or underactive thyroid gland brings a series of problems with it. When the gland becomes overactive for various reasons, it produces more thyroid hormones than the body needs. This condition is called hyperthyroidism. Hyperthyroidism can also speed up metabolism. Conversely, when thyroid hormones cannot be secreted in sufficient amounts, hypothyroidism develops. With hypothyroidism, metabolism may slow down. Goitre is a condition in which the thyroid gland grows much larger than normal, and it usually occurs with iodine deficiency. Finally, thyroid cancer can be mentioned among thyroid diseases. Cells that divide uncontrollably in the thyroid tissue give rise to thyroid cancer.

Radioactive iodine therapy, also known as atomic therapy, is a treatment method used for thyroid diseases. Because the thyroid gland needs iodine to function, the patient is given a small amount of radioactive iodine (I-131) during treatment. Until it is eliminated from the body, radioactive iodine emits both gamma and beta rays. Thanks to the gamma rays, its location can easily be detected by measuring devices. The beta rays, on the other hand, help to kill or destroy cells. In other words, gamma rays have a diagnostic effect, while beta rays have a therapeutic effect. The radiation applied here targets only the thyroid gland. As a result, healthy tissues in the rest of the body are not significantly affected by the radiation.

Radioactive iodine therapy (RAI) has more than one area of use. For example, it can be used to destroy cancerous thyroid tissue that cannot be removed by surgery or cancer cells that have metastasised. This treatment can be used to destroy thyroid tissue that cannot be surgically removed, or to treat certain types of thyroid cancer that have spread to the lymph nodes and other parts of the body. Radioactive iodine therapy is used to treat papillary or follicular thyroid cancer that has spread to the neck or other parts of the body, and it is now standard practice in such cases. RAI therapy is not an alternative to surgical treatment. If the cancer has not spread and can be removed by surgery, attempting to treat it with RAI may reduce the effectiveness of treatment. Radioactive iodine therapy cannot be used to treat anaplastic and medullary thyroid carcinomas, because these types of cancer do not take up iodine.

Which Diseases Is Radioactive Iodine Therapy (Atomic Therapy) Used to Treat?

Radioactive iodine therapy, also known as atomic therapy, has more than one area of use. RAI therapy may be preferred in the following situations:

• Hyperthyroidism

• Destroying tissue remaining from a tumour that has largely been removed surgically

• Destroying cancer cells that have spread to other parts of the body

• Goitre

• Destroying thyroid tissue that has not been removed surgically

The thyroid gland needs iodine to produce its secretions. In radioactive iodine therapy (RAI), radioactive iodine is given to the body to damage or destroy thyroid cells. RAI can be taken orally in capsule form and does not require hospitalisation unless the dose is high. You can go home after receiving your treatment dose. After treatment, plenty of water must be drunk to help eliminate the radioactive iodine from the body. In addition, an iodine-free diet may be required for at least seven days. In this case, your doctor and dietitian will inform you about it.

A few doses may be sufficient in the treatment of hyperthyroidism. In the treatment of thyroid cancer, however, a higher dose of radioactive iodine may be needed. In thyroid cancer, RAI alone may not be sufficient. However, it may be preferred to destroy the remaining mass after most of the cancerous tissue has been removed surgically. A "tracer" dose of radioactive iodine may be given to monitor remaining cancerous tissue or cells that have metastasised to other tissues. The purpose of this dose is to determine the need for RAI or to identify in which other areas the cancer is concentrated.

While RAI therapy is the best option in some situations, other treatment options may need to be preferred in others. For example, if you have a tumour that can be removed entirely by surgery, RAI may not be the right choice for you. It is therefore beneficial to talk in detail with your doctor about treatment options and which one is most suitable for you.

What Are the Options for Radioactive Iodine Therapy (Atomic Therapy)?

The radioactive iodine given in atomic therapy comes in more than one form. These are pills, liquids or forms that can be injected into a vein. In addition, you may be given anti-nausea medication before the procedure to prevent the possibility of nausea. You can decide together with your doctor which form is more suitable and comfortable for you.

Risks and Side Effects of Radioactive Iodine Therapy (Atomic Therapy)

Thanks to today's advancing technology, there is more than one treatment option for most diseases. One of these options may be better than another. Which treatment option is better can vary from person to person. It is normal for every method to carry certain risks and side effects. Before choosing any treatment method, it is beneficial to obtain detailed information about all the options and to ask in detail about their risks and side effects. Some side effects of RAI therapy are:

• Tenderness or swelling in the neck

• Nausea

• Swelling or tenderness of the salivary glands

• Dry mouth

• Changes in taste

• Dry eyes due to reduced tear production

• Reduced sperm count in men

• Irregular menstrual cycles in women

The effect of radioactive iodine therapy before or after pregnancy is also a frequently asked question. Pregnancy is generally not recommended for at least 6 months, and usually for 1 year, after RAI therapy. No side effects have been observed in the children of patients who were treated in the past. Also, because radioactive iodine can pass into breast milk, it is not preferred for breastfeeding women. Although rare, the long-term complications of RAI therapy include an increased risk of developing leukaemia, stomach cancer or salivary gland cancer. For any other questions you may have, it is beneficial to make an appointment with the relevant department of a hospital you trust and talk to your doctor.

Radioactive Iodine Therapy (Atomic Therapy) Rooms at Our Hospital (2 Isolated Rooms)

For RAI therapy to be fully effective, there must be a high level of thyroid-stimulating hormone (TSH) in the blood. A high level of TSH enables the radioactive iodine to be taken up by thyroid tissue. For this reason, in people whose thyroid has been removed, the first goal is to increase the amount of TSH. One way of doing this is a thyrotropin injection. Another way is to stop, or reduce the dose of, the pills you started taking after your thyroid was removed. Both methods will increase the amount of TSH in the body. In addition, depending on your doctor's instructions, you may need to follow an iodine-free diet for a few days (3).

RAI therapy is usually administered in an outpatient clinic or in a special unit of the hospital called nuclear medicine. After you receive radioactive iodine, your body continues to emit radiation for some time. To prevent the people around you from being exposed to radiation, you may need to stay in special isolated rooms in the hospital for a few days, depending on the dose you received. If you are allowed to go home after the procedure, you will be informed about how to protect those around you from radiation exposure. After treatment, avoiding close contact with people, especially pregnant women and young children, will be better for the health of your loved ones. Iodine that is not absorbed is eliminated from the body within a few days, mainly through the urine, as well as through saliva, sweat, tears or stool.

Hisar Hospital Intercontinental has 2 isolated radioactive iodine therapy rooms within its nuclear medicine unit. For more detailed information about the treatment process, which is carried out by specialist doctors and their team, you can contact the hospital.

How Is the Medication Prepared in Radioactive Iodine Therapy (Atomic Therapy)?

It is widely known that, for treatment to be effective, the right medication must be taken at the right dose. However, the correct preparation of medications can often be overlooked. Yet the preparation process of a medication has just as much influence on its effectiveness. The concept of robotic medication preparation, which has emerged with advancing technology, helps prevent human error. Today, with medications prepared fully automatically inside a device, maximum hygiene can be achieved. With robotic medication preparation, the process can be tracked from the moment the doctor prescribes the medication until it reaches the patient. This also makes it possible to trace medications retrospectively. With the robotic medication preparation method, patient safety is at the highest level.

Once you have an idea of what radioactive iodine therapy is and how it is administered, another topic that may come to mind is the cost of radioactive iodine therapy. RAI therapy costs may vary depending on the healthcare facility you choose and what you expect. For more detailed information on whether the treatment is covered by the Turkish Social Security Institution (SGK) and about the process, it is beneficial to contact your healthcare facility.

Frequently Asked Questions About Radioactive Iodine Therapy

Radioactive iodine therapy is one of the effective treatment methods used to treat thyroid gland diseases. Some of the most frequently asked questions about radioactive iodine therapy are addressed below.

Does Radioactive Iodine Therapy Have Side Effects?

Some side effects may occur after radioactive iodine therapy. The side effects of the treatment can range from mild to severe, depending on the dose administered and the patient's general health. The side effects of radioactive iodine therapy may appear shortly after the session or may develop in the long term. Depending on the condition of the disease, early side effects of the treatment include nausea, vomiting, itching, hives, a temporary excess of thyroid hormone, changes in taste in the mouth, problems with the sense of smell, head and neck pain, and brain oedema. All of these effects are temporary and return to normal in a short time. Late complications can be divided into two groups: possible and rare effects. Possible side effects include loss of function in the salivary glands and tear glands. Rare side effects generally depend on how advanced the disease is and on whether radioactive iodine therapy has been given repeatedly and at very high doses. Rare side effects may include health problems such as reproductive side effects, pulmonary fibrosis, bone marrow suppression and secondary cancers. These side effects are very rare but serious complications. For this reason, the dose of radioactive iodine used in atomic therapy must be adjusted by a specialist Nuclear Medicine physician according to the type of health problem and the patient's general health.

Is Any Preparation Needed Before Radioactive Iodine Therapy?

For radioactive iodine therapy to be successful, there must be a high level of thyroid-stimulating hormone (TSH, or thyrotropin). The main reason for this is that radioactive iodine is used by the thyroid tissue. If there is not enough hormone production, the treatment may fail.

One of the methods used before atomic therapy is to stop taking thyroid hormone pills for a few weeks. This method leads to very low thyroid hormone levels (hypothyroidism), which can trigger the pituitary gland to secrete more TSH. This state of hypothyroidism, created under specialist supervision, is temporary. However, patients may experience symptoms such as fatigue, depression, weight gain, constipation, muscle pain, forgetfulness and lack of concentration. In addition, specialists may recommend following a low-iodine diet for 1 or 2 weeks before treatment. At this point, patients may need to avoid iodised salt and seafood, as well as foods containing dairy products, eggs and soy products.

In which department is radioactive iodine therapy performed?

Radioactive iodine therapy is performed only by nuclear medicine specialists in a department licensed by the Turkish Nuclear Regulatory Authority.

What should be eaten during radioactive iodine therapy?

During radioactive iodine therapy, it may be necessary to follow a low-iodine diet. At this point, it may be helpful to avoid foods such as iodised salt, seafood, milk and dairy products.

Where is radioactive iodine therapy administered?

Radioactive iodine therapy is administered by specialist physicians only in a nuclear medicine department licensed by the Turkish Nuclear Regulatory Authority. Patients may be placed in specially designed glass-walled rooms. In this way, they do not experience a fear of being closed in and they do not feel cut off from social contact.

How is radioactive iodine given to the patient?

Radioactive iodine can be given to the patient orally as a capsule or liquid, or intravenously.

Does a radioactive iodine patient emit radiation after treatment?

Depending on the dose of iodine used in atomic therapy, patients emit very intense radiation for a few days after treatment. For this reason, during the first few days patients are advised to keep a distance of at least 2 metres from other people and not to share their belongings with others.

Radioactive iodine therapy is widely used for thyroid gland diseases such as an overactive thyroid or thyroid cancer. At Hisar Hospital Intercontinental, radioactive iodine therapy is performed by Nuclear Medicine physicians who specialise in this field, in special glass-walled rooms designed so that patients feel comfortable and safe and stay socially connected. In addition, patients can complete their entire cancer treatment process in a single building at the Integrated Oncology Centre before being discharged. Don't forget to make an appointment with a specialist Nuclear Medicine physician to get detailed information about iodine therapy.

Is Any Preparation Needed Before Radioactive Iodine Therapy?

For radioactive iodine therapy to be successful, there must be a high level of thyroid-stimulating hormone (TSH, or thyrotropin). The main reason for this is that radioactive iodine is used by the thyroid tissue. If there is not enough hormone production, the treatment may fail.

One of the methods used before atomic therapy is to stop taking thyroid hormone pills for a few weeks. This method leads to very low thyroid hormone levels (hypothyroidism), which can trigger the pituitary gland to secrete more TSH. This state of hypothyroidism, created under specialist supervision, is temporary. However, patients may experience symptoms such as fatigue, depression, weight gain, constipation, muscle pain, forgetfulness and lack of concentration. In addition, specialists may recommend following a low-iodine diet for 1 or 2 weeks before treatment. At this point, patients may need to avoid iodised salt and seafood, as well as foods containing dairy products, eggs and soy products.

Ask Our Specialists