radioactive iodine what to expect?

[rthomas917]

Hello,
I went to my endo yesterday with new blood test's in hand, my free T3 4.4 and my free T4 1.39, but my TSH keeps bouncing around now it is .006.  My T3 and T4 have gone normal in just one month.  My endo because of the TSH says that it is graves and has suggested that I do the RAI, I don't know what to expect and I have a 2 year old at home and I am scared about being around my young child.

What will it be like at home, and are there thing that I can't do i.e. go around people, be on a plane, sleep in the same bed as my husband, or be around my son etc.?  How do you not hug a two year old?

By the way I am mot being treated as of now with any meds.  Was trying to pregnant.
Thank you
Ronda

[Mark Lupo, M.D.]

A low TSH suggest hyperthyroidism but does not necessarily mean Graves -- if you are young and have normal(izing) t4 and t3 then there is no rush for I-131.  Perhaps you've already had an I-123 scan/uptake and antibody levels all c/w graves, but if not, recommend doing so.  With trying to conceive, it is important to normalize thyroid function and sometimes I-131 is the most efficient way to do this -- need to be away from the 2yo for 3-5 days and not conceive for AT LEAST six months.  May be worth discussing PTU and Tapzole (the anti-thyroid drugs) with your endo to see if this would be an alternative to I-131.

[GravesLady]

Your specific nuclear medical doctor will tell you what instructions to follow or give you written instructions.  Certain diet to follow or foods and drugs to avoid, etc.
The specific precautions that is needed will depend upon the dose of RAI you are given and how it relates to your uptake.
What one patient is told may be different from what another patient is told , and both sets of information can be correct. The precautions that are given are designed to protect those around you from any unnecessary exposure to radiation.

Radiation is known to have a cumulative effect through one's lifetime.
That is the reason we take a few precautions with small children, small animals, and with our spouse, after RAI. They do not need any unnecessary radiation exposure added to their lifetime mix. And the smaller the being, the smaller the overall dose of radiation that is tolerable. So we are asked to be careful.
It's only for a few days. The first two or three are the most important, then the short life span of RAI means that precautions are no longer necessary.
Wear throw-a-way plastic surgical gloves which can be purchased a drug stores. This will allow you to touch things, such as books so you can read, computer, TV remote, hobbies, etc. Helps pass the time.

You go into a nuc Lab in a facility.  They either give you a capsule or liquid with a straw.  Then you go home.  If 1 131 is administered in high doses hospitalizing for a few days might be required.  Although normally for Hyper/Graves' they don't give that high of dose.

Short-term side effects may include nausea and vomiting soon after treatment, which usually only lasts for a day or two. In addition, some of the RAI may be picked up by the salivary glands around the jaws and under the tongue, causing painful swelling and enlargement of these glands. This is treated by drinking plenty of fluids, sucking on lemon drops (in order to stimulate the flow of saliva) and occasionally pain medicine like aspirin.

Because it may take a few weeks after the treatment dose of radioactive iodine before there is a decrease in the blood level of thyroid hormone, you are at risk for a worsening of hyperthyroidism during this period. In many people, this increased period of hyperthyroidism may not be a problem for them, however, for patients with heart disease, such as in the elderly patient, this period of overactive thyroid hormone may put them at risk for a heart attack because the excess thyroid hormone may overstimulate the heart. For this reason, many practitioners prescribe antithyroid drugs for their patients who are about to undergo radioactive iodine treatment in order to prevent this "thyroid storm".

RAI effective time is up to 6 months, so in most cases the destruction of thyroid cells is complete by then. Although I have read where some the duration was 2 weeks after RAI, while others 12 months after.  I guess it depends on the dose, you system via your thyroid. Mine was approx. 3 months.

You should have the first blood test approx 4 weeks after RAI. Then on a regularly bases to have routine thyroid function blood tests. By doing blood tests , hypothyroidism may be discovered in it's earliest stages so you can start thyroid meds. before you develop symptoms like fatigue and weight gain, etc.  The earlier hypo levels are caught and you are put on meds., the better off you will be. You will always have Graves', but the hyperthyroidism due to Graves' is now cured and you are dependent on replacement thyroid meds for "post-ablation hypothyroidism."  And you are on your way to healing.


Also, you should wait 6 to 12 months before attempting to get pregnant

Good Luck - not that you will need it for it's really  non eventful.

GL
Hyper/Graves'/RAI