Can you get Graves disease again after radioactive iodine treatment?
Abstract. The use of radioactive iodine (131I) in the treatment of Graves' disease results frequently in hypothyroidism requiring thyroid hormone supplementation. Relapse of Graves' disease months after inadequate treatment with 131I is well-recognized.
Commonly, people develop hypothyroidism after RAI, though the rate at which this occurs within the first year after treatment depends on the radioiodine dose. The higher the dose, the higher the likelihood of hypothyroidism. Hypothyroidism can be a long-term side effect and develop years after treatment.
The radioiodine-induced hypothyroidism is mostly irreversible. Though, early recurrences can be due to treatment failure, inadequate radioiodine dose or rarely due to Marine-Lenhart syndrome.
Graves' disease is usually treated with antithyroid drugs, radioactive iodine therapy, or surgery.
Recurrence of hyperthyroidism after RAI therapy may be due to inadequate dosing or early Marine Lenhart syndrome. Herein we report a rare case of recurrent Graves' hyperthyroidism occurring after 2 years of successful radioiodine treatment.
Emotional or physical stress. Stressful life events or illness may act as a trigger for the onset of Graves' disease among people who have genes that increase their risk. Pregnancy. Pregnancy or recent childbirth may increase the risk of the disorder, particularly among women who have genes that increase their risk.
It is thought unlikely that patients with recurrent Graves' hyperthyroidism would go into remission after a second course of ATD, and guidelines therefore recommend definitive treatment by RAI or Tx in case of recurrences.
Some people may have a feeling of tightness or swelling in their neck for a few days after treatment. This is more common if you still had a large part of your thyroid gland when you have radioactive iodine treatment. Some people also feel flushed.
Most radiation from the RAI is gone in about one week. Ask your doctor about ways to protect your salivary glands, which also absorb the RAI. Ways include sucking on sugar-free lemon candy or eating certain foods. Your doctor will have instructions on what to do, and when to do it.
Reported long-term side effects were benign thyroid nodules, multinodular benign goiter, hyperparathyroidism, and papillary thyroid carcinoma. These side effects affecting thyroid tissue were only reported in cases in which the RAI treatment aim was euthyroidism.
How many times can you have radioactive iodine treatment?
You may only need to have this treatment once. But it can be repeated every 3 months if needed, until there is no sign of any thyroid cancer on your scans.
Conclusion: Radioactive iodine treatment is an effective modality for definitive treatment of hyperthyroidism with long-term cure approaching 80%.
These prescription medications include propylthiouracil and methimazole (Tapazole). Because the risk of liver disease is more common with propylthiouracil, methimazole is considered the first choice when doctors prescribe medication.
Despite this, there have been cases of Graves' disease after total thyroidectomy. Rates of recurrence are variable from 0% to 33%. Graves' disease after total thyroidectomy (removal of all visible thyroid tissue in the neck) can recur in the thyroid bed if tissue is missed during surgery or in ectopic thyroid tissue.
An association between radioactive iodine (RAI) therapy for GD and the development or worsening of Graves' orbitopathy (GO) is widely quoted. RAI-associated leakage of thyroid antigen(s) leads to an increased production of TSH-R antibodies that may initiate the eye injury.
Even if the disease goes into remission after anti-thyroid treatment, it can come back. Follow-up appointments to check thyroid activity usually are scheduled once every six months for the first two years after the disease goes into remission.
How long does radioiodine stay in your body? The radioiodine from your treatment will remain in your body temporarily. Most of the radioiodine not collected by your residual thyroid tissue will be eliminated during the first two days after your treatment.
For most people, one dose of radioactive iodine treatment will cure hyperthyroidism. Usually, thyroid hormone levels return to normal in 8 to 12 weeks. In rare cases, the person needs a second or third dose of radioactive iodine.
Thyroid conditions such as Grave's disease (hyperthyroid) and Hashimoto's thyroiditis (hypothyroid) are worsened by chronic stress so learning ways to lessen stress is your key to better health.
Graves disease is an autoimmune disorder that involves overactivity of the thyroid (hyperthyroidism). Hallmarks of the condition are bulging eyes (exophthalmos), heat intolerance, increased energy, difficulty sleeping, diarrhea and anxiety.
What are the long term effects of Graves disease?
Graves' disease is rarely life-threatening. However, without treatment, it can lead to heart problems and weak and brittle bones. Graves' disease is known as an autoimmune disorder. That's because with the disease, your immune system attacks your thyroid — a small, butterfly-shaped gland at the base of your neck.
Graves' disease (GD) is the most common cause of hyperthyroidism, affecting approximately 0.5% of men and 3% of women. In Europe, the first choice treatment is most often the administration of antithyroid drugs (1, 2). However, approximately half of patients relapse within two years of drug withdrawal.
Unfortunately, this only occurs in ~25% of patients, so Graves' disease often recurs after stopping the ATD. Frequently, patients will then elect a more permanent option such as thyroid surgery or RAI.
Occasionally, the thyroid stimulating antibodies do go away in patients treated with antithyroid drugs, resulting in remission of the Graves' disease and allowing for discontinuation of the medications. However, the thyroid stimulating antibodies may return causing the Graves disease to relapse.
Taking a closer look at the solid cancer risks, the researchers found that treatment with RAI (versus no treatment with RAI) was associated with increased risk of salivary gland cancer (by 200%), uterine cancer (by 55%), lung cancer (by 42%), and female breast cancer (by 18%).
The most common adverse reaction to medical therapy was a rash in 8 patients, followed by neutropaenia (neutrophils < 1.0 × 109/L) in 6 patients. LFT derangement was reported in 3 patients taking PTU and 1 patient taking carbimazole.
- Do not share cups, glasses, plates or eating utensils. Wash items promptly after using. ...
- Do not share towels or washcloths.
- Flush the toilet twice and rinse the sink and tub after use.
- Wash your towels, bed linens, underwear, and any clothing stained with urine or sweat.
Radioactive iodine is taken up by the thyroid, and destroys the cells in the thyroid gland. This has the effect of reducing the amount of thyroxine made by the thyroid gland and may also reduce the size of the gland.
No. It's only used for patients with certain types of differentiated thyroid carcinomas — specifically, papillary and follicular thyroid cancer. But not even all differentiated carcinomas have the ability to take up iodine. Undifferentiated or medullary thyroid carcinomas will not benefit from iodine therapy.
- Neck tenderness and swelling.
- Nausea and vomiting.
- Swelling and tenderness of the salivary glands.
- Dry mouth.
- Taste changes.
Does radioactive iodine completely destroy the thyroid?
The nuclear medicine team may do scans during your treatment to check where the iodine has been absorbed. The radiation will kill the thyroid gland and, if the treatment is for thyroid cancer, any thyroid cancer cells that might have traveled and settled in other organs.
You may only need to have this treatment once. But it can be repeated every 3 months if needed, until there is no sign of any thyroid cancer on your scans.
The average remission rate after a course of ATD is about 50% [21]. Most recurrences occur within 4 years after discontinuation of ATD [3]. Although prognosis is excellent after 4 years without relapse [30], late recurrences do occur and only one in three patients experiences permanent remission [21].
For some patients who are treated with radioactive iodine to reduce the size of a goitre, there is also a small risk that they may develop Graves' disease. There is no risk that patients treated with radioactive iodine for an overactive or enlarged thyroid will lose their hair as a result of the treatment.
Reported long-term side effects were benign thyroid nodules, multinodular benign goiter, hyperparathyroidism, and papillary thyroid carcinoma. These side effects affecting thyroid tissue were only reported in cases in which the RAI treatment aim was euthyroidism.
How Long Does the Radioiodine Stay in the Body? The radioiodine from your treatment will remain in your body only temporarily. Most of the radioiodine not collected by your thyroid gland will be eliminated during the first two days after your treatment.
Small amounts of radiation from your body may trigger radiation monitors at airports, border crossings, government buildings, hospitals, and waste disposal sites for up to 3 months after treatment. Ask your doctor for advice if you will be in these areas.