Treatment with radioactive iodine in Moscow. Treatment of thyrotoxicosis with radioactive iodine

Bad ecology, stress and other unfavorable conditions often lead to diseases of the thyroid gland. Its increase harms the body. Thyrotoxicosis can take a variety of forms, including diffuse toxic goiter, also called Graves 'disease or Graves' disease. Sometimes it comes down to thyroid cancer. Destroy the overgrown tissue of the gland and called for radioactive iodine.

Diseases of the thyroid gland

Thyrotoxicosis, which is a hyperthyroidism, can take various forms. These include a diffuse and nodular toxic goiter, Plummer's disease, Hashimoto's goiter and some other ailments. With these diseases successfully treated with radioactive iodine (in Moscow it is conducted, for example, in the Central Research Institute of Health and some other clinics). Supplement this method treatment of many varieties of cancer and other tumors of the thyroid gland, including lymphoma and Hashimoto's thyroiditis.

The opposite of thyrotoxicosis is hypothyroidism, which is not a serious threat and is corrected by drugs. In addition to diseases of the thyroid gland itself, sometimes there is a deficiency or hyperfunction of the parathyroid glands, i.e. Hypoparathyroidism and hyperparathyroidism. Insufficiency is treated medically, but hyperfunction requires surgery.

Therapy of thyrotoxicosis and cancer

Most of these diseases effectively eliminate the treatment with radioactive iodine. In Moscow, this type of therapy is also conducted. Of course, at first conservative treatment, say, of toxic adenoma or diffuse toxic goiter with medicines is prescribed. But efficiency rarely exceeds 40%, and often almost half as much. If treatment of the results does not bring or relapse, then the optimal solution is administration of therapy with radioactive iodine I131. You can also use irradiation, but it increases the risk of cancer of the gland, and iodine remains harmless.

Cancer is removed promptly. But in this case, treatment with radioactive iodine in Moscow, as well as all over the world, is conducted as an additional method of therapy. It is important to sustain the established time after thyroidectomy and perform treatment according to the protocol, then the risk of metastases can be minimized.

Why not surgery?

Sometimes an alternative to thyrotoxicosis therapy is surgery. Of course, the operation is always associated with a greater risk, not to mention the fact that the scar on the skin is not a very aesthetic thing. The narcosis itself, the risk of bleeding, the possibility of damage to the recurrent nerve are all factors that speak against the operation in favor of a more gentle, but effective radioiodine therapy. Of course, in some cases, without emergency measures simply can not do, as in the case of cancer.

With the surgical method, part of the tissue was often retained to prevent hypothyroidism. However, this approach is fraught with recurrence of the disease. Thyroid-stimulating autoimmune antibodies again attack the remnants of the gland, leading to a new twist of the disease. Therefore, now they prefer to get a full therapeutic effect instead of a temporary one. Yes, and the treatment with radioactive iodine value is more acceptable.

World practice

Light forms of the disease prefer to be treated medically. Also with this method begin when there are problems in adolescents and children. In other cases it is better to treat thyrotoxicosis with radioactive iodine. The preparation has the form of a capsule or an aqueous solution.

By the way, in Europe doctors generally trust more precisely different antithyroid drugs than treatment with radioactive iodine. But in the US preference is given to radioiodine therapy as more effective. Of course, after it you need to undergo a rehabilitation program, but after all, taking medications also requires a further recovery of the body.

The first introduction of radioisotopes of iodine was carried out in 1941 in the USA. And since 1960 the method began to be used in medicine already widely. During the past period, we were convinced of its usefulness, reliability and safety. Yes, and for treatment with radioactive iodine, the price has become more affordable. In some clinics in America and Europe, treatment with small doses of iodine is already conducted on an outpatient basis. We also allow such a regime, but only for doses within 10.4 mCi by activity. Abroad, the norms are somewhat different, allowing a stronger impact, which also affects the treatment positively.

The basis of the method

In medicine, isotopes I 123 and I 131 are used. The first is for diagnosis, since it does not have a cytotoxic effect. But the second isotope just allows you to carry out treatment. It emits ß- and ɣ-particles. The ß-radiation gives an irradiating effect, localized in the tissues of the thyroid gland. Ɣ-radiation allows you to monitor 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 of thyrotoxicosis.

Safety for other tissues is explained by the fact that the thyroid gland binds the isotopes of iodine and attracts them to itself. In addition, the half-life period is only 8 days. Intestinal and urinary systems capture, as a rule, the minimum of the isotope, not exceeding the permissible limits. The cytotoxic effect turns out to be localized, destroying only the thyroid cells, which leads to a decrease in the thyroid gland in the volume and the transition to hypothyroidism without surgical intervention.

Hypothyroidism, in turn, is adjusted medically. Assign drugs L-thyroxine, which also reimburses the necessary hormones, usually produced by the thyroid gland. This hormone, although synthetic, but endogenous almost not inferior. Controlling the level of hormones is undoubtedly necessary, at times the dosage should be changed, but otherwise the patients return to their habitual way of life.

Purpose of treatment

Now even our specialists are inclined to the opinion that it is necessary to undergo a single treatment with radioactive iodine in Moscow or other cities to cause the development of hypothyroidism. Treatment with small doses simply reduces 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 routine of scintigraphy.

First, a survey is performed, concomitant pathologies are specified, calculations are performed. Sometimes it is decided to perform two injections of the drug to achieve the desired result. But there are cases when surgical intervention is more suitable.

Also, the treatment of cancer with radioactive iodine, but already as a second phase of therapy. 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. Outpatiently this procedure is not performed, preferring to leave the patient for two or three days in the clinic.

Consequences of taking the drug

You should be prepared for what will be after treatment with radioactive iodine. A few subsequent days after taking the drug, the radioactive iodine will leave the body through saliva and urine. These symptoms can last for different periods of time, depending on the age and the prescribed dose. At the same time, the process of excretion among young people is accelerated, in comparison with the situation in the elderly.

On the state of health it practically does not affect. Only some sensitive people, who have been treated with radioactive iodine, give feedback about nausea during this period. There may also be dry mouth or pain in the neck and throat. They note increased fatigue and metallic taste in the mouth. Sometimes it can affect the onset of constipation or diarrhea.

Restrictions after treatment

But there are a number of limitations, which 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. Sleep will have to be one, from kisses and hugs to refuse, to avoid the exchange of dishes and to comply with such measures. In connection with this, a number of prescriptions on the behavior of the patient can be singled out.

Key recommendations

Patients undergoing treatment with radioactive iodine, the testimonials confirm this, should pay more attention to hygiene some time. So, it is better to lower water in the toilet twice, hand wash after visiting it should be especially carefully in a lot of water and with soap. Requires separate dishes, towels, bed linen, which no one else will not use. Naturally, clothes and clothes should also be washed away from the things of relatives. Do not prepare food for the household.

Even garbage is better collected in a separate basket, and then given for disposal to a medical institution (if such a service is provided). Otherwise, it can be discarded in an ordinary trash can after 8 days. The dishes should not be washed together with other people's items, it is better to wash it by hand without a dishwasher. Disposable plates and appliances are all placed in the same separate garbage bag.