Indications
The indications for treatment with radioactive iodine are essentially represented by hyperthyroidism and thyroid neoplasms [(the therapy allows the elimination of any metastases and residual thyroid tissues after surgery (ablation)].
Patients must however present suitable characteristics, on which the therapeutic efficacy of the treatment depends. Candidates include those individuals for whom the removal of the thyroid gland (thyroidectomy) is contraindicated and all patients in whom antithyroid treatments (thyrostatic drugs - thionamides) do not produce the desired effect (post-treatment recurrences) or cause too many side effects .
What to do after the exam
After treatment with iodine 131 the patient can safely return to his daily routines; nevertheless, since the care received has required the administration of a radioactive substance, it is necessary to prevent other people from being exposed to radiation risk. Most of the absorbed 131 iodine is gradually eliminated within a week, especially in the 48 hours following the exam; most of the isotope leaves the body with urine, but small amounts can also be excreted through other body secretions, such as saliva, tears, sweat, vaginal secretions, and feces. Therefore, after therapy with iodine 131 very often the doctor advises the respect of the following behavioral rules for 7-8 days:
- during the first day drink a lot, for example a glass of water every hour, and urinate frequently, for example once every two hours; this in order to quickly eliminate the iodine contained in the body but not fixed to the thyroid.
- For the 3 day period the patient should not sit or stay close to other people, staying as far away as possible. In any case it should maintain a distance greater than 1 meter and greater than 2 meters when it stops for a long time with the others (for more than an hour).
- Children under the age of 2 should not be cared for by the patient, who should avoid as much as possible direct contact with them, staying as far away as possible (not less than 2 meters). It is however preferable to entrust children to relatives or friends. Similar attentions should also be reserved for pregnant women, staying as far away as possible (not less than 2 meters)
- If the persons with whom the patient makes contact are older than 60 years, the risk due to exposure to ionizing radiation is much lower.
- It is very important to sleep in separate rooms. If this is not possible it is necessary to maintain a distance between the two beds of at least 2 meters; this foresight must be observed even in the presence of a possible dividing wall.
- For the first 3 days it is recommended to use preferably a personal bathroom. If this is not possible avoid any urine leakage outside the vessel. It is also advisable for men to urinate while sitting. Operate the toilet flush several times after use.
- Avoid going to crowded places where you stay for a long time and in close contact with others, such as cinemas or theaters.
- Limit the use of public transport for more than two hours for a week. Look for an isolated place if possible, and in any case not near children or young women. In case of use of taxis or private vehicles, use the seat at a greater distance from the driver.
- A small part of radioactive iodine is eliminated even with sweat or saliva. For this, cutlery, crockery, towels, sheets, etc. they should not be used by others. After washing these items are absolutely safe and do not need to be washed separately.
- In case of unexpected hospitalization in the days following the treatment, inform the doctor about the radioiodine treatment received.
Subsequent to radiometabolic therapy, possible therapies can be used for other pathologies.
- The resumption of normal working activity depends on the type and working conditions.
