Radioiodine (I-131) Therapy for Hyperthyroidism

Radioiodine (I-131) Therapy for Hyperthyroidism

Article
Ear, Nose, & Throat (ENT)
Radiology Procedures
+2
Contributed byKrish Tangella MD, MBAFeb 06, 2019

Background Information:

What are the other Names for the Procedure?

  • Radioactive Iodine Ablation
  • Radioactive Iodine Therapy for Hyperthyroidism

What is Radioiodine (I-131) Therapy for Hyperthyroidism radiology procedure? (General Explanation)

  • Radioiodine (I-131) Therapy for Hyperthyroidism is a branch of nuclear medicine that uses radioactive material to treat or diagnose the overactive thyroid that causes a condition called hyperthyroidism
  • The procedure uses isotope of iodine to destroy the thyroid gland and to resolve the symptoms of hyperthyroidism

What part of the Body does the Procedure involve?

The Radioiodine Therapy for Hyperthyroidism procedure involves the thyroid gland, which is located in the neck region.

Why is Radioiodine (I-131) Therapy for Hyperthyroidism radiology procedure Performed?

Radioiodine Therapy for Hyperthyroidism is used to treat hyperthyroidism.

  • Thyroid gland is located in the neck area. It produces thyroid hormones which controls the body metabolism and affects multiple organ systems
  • Hyperthyroidism is a condition in which excessive thyroid hormone is produced that leads to a variety of symptoms involving many organ systems. The common symptoms of hyperthyroidism include excessive sweating, changes in the nails or hair, weight loss, change in sleep, and fatigue
  • Grave’s disease can cause hyperthyroidism by making the thyroid gland overactive
  • Thyroid nodules within the thyroid gland can also produce excessive thyroid hormone leading to hyperthyroidism

What is the Equipment used? (Description of Equipment)

In Radioiodine Therapy for Hyperthyroidism, one is required to swallow radioactive material. The procedure does not require any kind of equipment.

What are the Recent Advances in the Procedure?

There have been no recent advances with respect to the Radioiodine Therapy for Hyperthyroidism procedure.

What is the Cost of performing the Radioiodine (I-131) Therapy for Hyperthyroidism radiology procedure?

The cost of Radioiodine (I-131) Therapy for Hyperthyroidism procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

  • It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding Radioiodine (I-131) Therapy for Hyperthyroidism procedure and what needs to be done
  • If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician
  • Also, if the procedure involves multiple steps or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

http://www.ncbi.nlm.nih.gov/pubmed/25673019 (assessed on 3/4/2015)

http://www.ncbi.nlm.nih.gov/pubmed/25593832 (assessed on 3/4/2015)

http://www.ncbi.nlm.nih.gov/pubmed/25317178 (assessed on 3/4/2015)

Prior to Radioiodine (I-131) Therapy for Hyperthyroidism radiology procedure:

How does the Radioiodine (I-131) Therapy for Hyperthyroidism radiology procedure work?

The Radioiodine Therapy for Hyperthyroidism procedure works in the falling manner:

  • Radio isotope of iodine (I-131) is a swallowed by the patient
  • This isotope goes through the gastrointestinal tract and is absorbed into the bloodstream there
  • The isotope gets concentrated in the thyroid gland from the blood stream and it begins destroying the thyroid gland cells

How is the Radioiodine (I-131) Therapy for Hyperthyroidism radiology procedure Performed?

Radioiodine Therapy for Hyperthyroidism is performed as an outpatient procedure.

  • The patient is given a capsule or liquid form of radioiodine I-131 to swallow. Once it is swallowed, it goes to the gastrointestinal tract and gets absorbed into the bloodstream
  • It concentrates in the thyroid gland and begins to destroying the gland. The radiation from I-131 starts to diminish in a few days
  • The effect of this procedure is seen in 1-3 months and the maximum benefit is observed after six months

Where is the Procedure Performed?

Radioiodine (I-131) Therapy for Hyperthyroidism is performed as an outpatient procedure, at a hospital.

Who Performs the Procedure?

A radiology technologist under the supervision of a radiologist performs the Radioiodine Therapy for Hyperthyroidism procedure.

How long will the Procedure take?

Radioiodine Therapy for Hyperthyroidism involves only swallowing the radioactive material; thus, it takes only a few minutes.

Who interprets the Result?

A radiologist interprets the results of the Radioiodine Therapy for Hyperthyroidism procedure.

What Preparations are needed, prior to the Procedure?

Following preparations are needed for the Radioiodine Therapy for Hyperthyroidism.

  • The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient, including information related to the medications that are currently being taken
  • Do inform the medical professional if you have a history of any medical conditions such as a heart disease, asthma, diabetes, or kidney disease
  • Patients are usually advised not to take anti-thyroid medications, at least a week before the therapy
  • The patient may be asked to avoid eating or drinking several hours before the procedure
  • Do inform the medical professional about any allergies, especially related to barium, iodinated contrast material or radioactive material, which may be used in the procedure
  • It is advisable to wear comfortable and loose clothes. Avoid wearing any metal objects or jewelry, as it may interfere with the X-ray
  • Women should notify the physician if they are pregnant or breastfeeding their child, as many such procedures may not be performed on pregnant women

What is the Consent Process before the Procedure?

A physician will request your consent for the Radioiodine (I-131) Therapy for Hyperthyroidism procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent. 

You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What are the Benefits versus Risks, for this Procedure?

Following are the benefits of the Radioiodine Therapy for Hyperthyroidism:

  • It is a noninvasive procedure and has much less complications than a surgery
  • This procedure is very successful in treating the symptoms caused by hyperthyroidism
  • It is also used in cases of thyroid cancer

Following are the risks of the Radioiodine Therapy for Hyperthyroidism:

  • Radio isotope of iodine used during the procedure may cause allergic reaction in certain patients
  • Close contact with the patient following the procedure must be avoided, as it may cause radiation exposure to other individuals
  • Since the thyroid gland is destroyed during the procedure, thyroid hormone must be taken for rest of the one’s life
  • If the patient is pregnant during the procedure, the fetus could be exposed to radiation inadvertently

What are the Limitations of the Radioiodine (I-131) Therapy for Hyperthyroidism radiology procedure?

Radioiodine Therapy for Hyperthyroidism may not be able to treat thyroid cancer completely; there may be a need for additional procedures such as surgeries.

What are some Questions for your Physician?

Some of the basic questions that you might ask your healthcare provider or physician are as follows:

  • What is a Radioiodine (I-131) Therapy for Hyperthyroidism procedure?
  • Why is this procedure necessary? How will it help?
  • How soon should I get it done? Is it an emergency?
  • Who are the medical personnel involved in this procedure?
  • Where is the procedure performed?
  • What are the risks while performing the procedure?
  • What are the complications that might take place during recovery?
  • What are the possible side effects from the procedure? How can I minimize these side effects?
  • How long will it take to recover? When can I resume normal work?
  • How many such procedures have you (the physician) performed?
  • Are there any lifestyle restrictions or modifications required after the procedure is performed?
  • Are there any follow-up tests, periodic visits to the healthcare facility required after the procedure?
  • Is there any medication that needs to be taken for life after the procedure?
  • What are the costs involved?

During the Radioiodine (I-131) Therapy for Hyperthyroidism radiology procedure:

What is to be expected during the Radioiodine (I-131) Therapy for Hyperthyroidism radiology procedure?

  • Patient may experience sore throat and some pain during the Radioiodine Therapy for Hyperthyroidism
  • Over-the-counter pain medications could be taken to relieve this pain

What kind of Anesthesia is given, during the Procedure?

No anesthesia is used during the Radioiodine (I-131) Therapy for Hyperthyroidism procedure.

How much Blood will you lose, during the Procedure?

Since Radioiodine Therapy for Hyperthyroidism is a noninvasive procedure, there is no blood loss involved.

What are the possible Risks and Complications during the Radioiodine (I-131) Therapy for Hyperthyroidism radiology procedure?

There are no risks during the Radioiodine Therapy for Hyperthyroidism procedure.

What Post-Operative Care is needed at the Healthcare Facility after the Radioiodine (I-131) Therapy for Hyperthyroidism radiology procedure?

Close contact with others (especially pregnant women and children) should be avoided for several days (2-5 days) after Radioiodine Therapy for Hyperthyroidism in order to not expose them to radiation.

  • The radioactive material that is not absorbed by the thyroid gland is excreted through urine, feces, saliva, sweat, and tears
  • Patient should use private toilets and ensure that the flush twice to dispose the radioactive material completely
  • Patients should sleep by themselves and avoid any intimate contact for a minimum period of 3-4 days (as advised)
  • Separate utensils must be used, which must also be washed separately
  • All clothes used by the patient should be washed separately for a few days
  • Breastfeeding mothers should stop breastfeeding for several days after the procedure
  • The treated individuals are advised not to get pregnant for 6 months after the procedure, as this might expose the fetus to radiation.

After the Radioiodine (I-131) Therapy for Hyperthyroidism radiology procedure:

What is to be expected after the Radioiodine (I-131) Therapy for Hyperthyroidism radiology procedure?

Some patients experience pain and sore throat after the procedure, which may be relieved through medications.

When do you need to call your Physician?

Patient may call their physician, if the pain or sore throat after the Radioiodine Therapy for Hyperthyroidism procedure does not resolve within a few days, or even after taking pain medications.

What Post-Operative Care is needed at Home after the Radioiodine (I-131) Therapy for Hyperthyroidism radiology procedure?

  • The radioiodine therapy destroys the thyroid gland and completely stops the production of thyroid hormone
  • Thyroid gland is very important for various body metabolisms and thus patients are required to take thyroid hormone pills for the rest of their lives. These pills are taken once a day

How long does it normally take to fully recover, from the Procedure?

  • Patient may resume their normal activities immediately after the Radioiodine Therapy for Hyperthyroidism procedure. However, they need to follow the healthcare provider’s instructions regarding radiation exposure to others
  • The side effects of the procedure may resolve in a few days
  • The outcome of the procedure is seen after six months

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

Radioiodine Therapy for Hyperthyroidism procedure does not involve the removal of any body tissue.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

Since no tissue is removed during the procedure, a pathologist does not get involved in the care of the patient.

Who will you receive a Bill from, after the Radioiodine (I-131) Therapy for Hyperthyroidism radiology procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

  • The hospital, where the procedure is performed
  • Healthcare providers, physicians, and radiologists, who are involved in the process

The patient is advised to inquire and confirm the type of billing, before the Radioiodine (I-131) Therapy for Hyperthyroidism procedure is performed.

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Krish Tangella MD, MBA

Pathology, Medical Editorial Board, DoveMed Team

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