Radioactive Iodine Therapy (RAI)
Radioactive Iodine Therapy (RAI) is a targeted treatment that uses radioactive iodine to selectively destroy overactive or cancerous thyroid cells while minimizing effects on the rest of the body. It is a highly effective option for treating conditions like hyperthyroidism and thyroid cancer, though it often requires long-term management of hypothyroidism as a result.
My RAI Therapy Journey
Once I was diagnosed with hyperthyroidism, I scheduled an RAI therapy appointment - but then canceled it. I decided to try homeopathy and an anti-inflammatory diet instead. While these did help with the symptoms, they didn’t improve my thyroid condition (those numbers actually got worse). So after the few months I had set aside - I made the decision to proceed with RAI (Radioactive Iodine) therapy.
Scheduling the appointment was a big step. I'm nervous. I knew I was about to lose a part of my body, and it wasn’t a decision I made lightly. On the day of the appointment, as the tech is discussing the precautions, it hit me when I saw the lead container holding the pill. It’s designed to contain the radiation, that’s when I thought: I’m about to become radioactive. What if I forget something? What if I make my husband or dog sick? I can’t even remember things as it is.
I took the pill, it was smallish, grey and easy to swallow. We went home and I had to figure out how to keep my dog away from me - he's my shadow - I think this was the hardest part.
I felt okay overall, with only mild nausea and a slight headache. By day 4 after RAI therapy, I began experiencing a loss of taste (even water) and most foods had an strange flavor. The loss of taste didn't last long.
My memory is still somewhat iffy, but on a good note, my heart wasn't racing, finally giving up its dream of qualifying for the Indy 500.
What Happens After Taking the Radioactive Iodine Pill?
Ingesting RAI
After ingesting the radioactive iodine (I-131), the thyroid gland absorbs it, as it does with regular iodine. The radioactive iodine emits radiation, destroying overactive or cancerous thyroid cells while sparing most of the rest of your body.
Immediate Precautions
- Radiation Safety: You’ll emit small amounts of radiation for a few days to a week. Doctors will provide specific precautions, such as maintaining distance from others, especially children and pregnant women, and avoiding sharing items like utensils or towels.
- Hygiene: Frequent hand washing, flushing the toilet twice, and showering regularly are usually recommended.
Symptoms After Treatment
You may experience side effects such as:
- Sore throat
- Neck tenderness
- Swelling
In some cases, hyperthyroid symptoms like anxiety or a rapid heart rate can temporarily worsen as the destruction of thyroid cells releases stored hormones. Mild nausea or dry mouth may also occur but generally resolve quickly.
Loss of Taste
Another potential side effect of RAI therapy is a temporary loss or alteration of taste. This happens because the radioactive iodine may affect the salivary glands near the thyroid, leading to less saliva production, also known as "dry mouth." You might notice food tastes different, metallic, or bitter, or that you can’t taste as well as before. This can be frustrating but it usually gets better over time. Drinking plenty of water, sucking on sour candies, and talking to your doctor can help manage this issue.
Will a Person Develop Hypothyroidism?
Yes, hypothyroidism is a common and often expected outcome of RAI therapy. This is especially true for patients with hyperthyroidism caused by conditions like Graves disease or for those treated for thyroid cancer. The purpose of RAI therapy is to destroy enough thyroid tissue to halt excessive hormone production, but this frequently results in the thyroid gland being unable to produce adequate hormones, leading to hypothyroidism.
Hypothyroidism may develop within weeks to months after treatment. Regular blood tests to monitor thyroid hormone levels (TSH, T3, and T4) are essential during this time to detect and manage the condition early.
Why Hypothyroidism Happens
Radioactive iodine therapy often intentionally destroys most, if not all, of the thyroid gland to stop overactive or cancerous processes. Without enough functional thyroid tissue, the gland cannot maintain normal hormone production, necessitating external hormone replacement.
Managing Hypothyroidism
Managing hypothyroidism involves restoring and maintaining normal thyroid hormone levels through consistent treatment and ongoing monitoring, ensuring optimal health and well-being.
Thyroid Hormone Replacement Therapy
When hypothyroidism develops, doctors typically prescribe levothyroxine, a synthetic thyroid hormone, to restore normal hormone levels. This medication is carefully dosed based on blood tests and symptoms, and adjustments may be needed periodically.
Ongoing Monitoring
Regular follow-ups to assess thyroid hormone levels ensure proper treatment and long-term well-being. Most individuals achieve a stable dose of hormone replacement therapy, enabling them to maintain a healthy and active lifestyle.
Lifestyle After Radioactive Iodine (RAI) Therapy
- With appropriate hormone replacement and monitoring, most individuals live a normal, healthy life post therapy.
- Early detection and management of hypothyroidism are key to avoiding complications like weight gain, fatigue, or cardiovascular issues.
Radioactive Iodine Therapy is a highly effective treatment for many thyroid conditions, but it requires long-term commitment to monitoring and potentially managing hypothyroidism. Discussing your concerns and expectations with your healthcare provider is essential to ensure the best outcomes.
