Clinic: I have had hyperthyroidism for just over one year, and
medication does not seem to keep it in check. I do not want to
have my thyroid removed. But I’m nervous about radioactive
iodine treatment, which is what was recommended. Is it safe?
What are the risks?
iodine is a safe, proven and effective treatment for
hyperthyroidism. It is not the best choice for everyone,
however. Talk to your doctor about the pros and cons of all
the available treatment options.
Your thyroid is
a butterfly-shaped gland at the base of your neck. This gland
produces hormones that affect every cell in your body.
Hyperthyroidism is a condition in which your thyroid makes too
much of the hormone thyroxine. This disorder can cause weight
loss, rapid or irregular heartbeat, sweating, nervousness and
conditions can lead to hyperthyroidism. The most common is
Graves’ disease. From your description, it sounds like your
condition may fit this disorder. In addition to affecting the
thyroid gland, Graves’ disease may have an impact on the
tissues behind your eyes, a condition known as Graves’
The options you
mention — medication, radioactive iodine and surgery — are
the three treatments currently available for hyperthyroidism.
Each has risks and benefits.
medications generally bring thyroid hormone levels down to
normal and reduce hyperthyroidism symptoms. However, due to
significant side effects — including liver damage and a risk
of low white blood cell counts — medications are not a
long-term solution. Typically, they are used for no longer
than about 18 months.
In about 30
percent of people who take anti-thyroid medication,
hyperthyroidism does not return when the medication is
stopped. For most, however, the disorder comes back within a
few months. These individuals are then usually treated with
either radioactive iodine or surgery.
idea of putting something radioactive into your body may sound
intimidating, iodine treatment has been shown to be safe and
effective. It usually involves taking one dose by mouth.
Because the thyroid is the only part of your body that takes
up iodine, the radioactive iodine is absorbed only by that
gland. The type of iodine used destroys the thyroid’s
ability to make thyroid hormone over the course of two to
three months. Afterward, hyperthyroidism is eliminated. You
then need to take thyroid replacement hormone for the rest of
studies have examined whether people who take radioactive
iodine have a higher risk of cancer. No increase in cancer
risk was found, even when people were followed over many
iodine may not be appropriate if you have Graves’
ophthalmopathy. Research has shown that radioactive treatment
may make this condition worse, especially if you are a smoker.
If you have
radioactive iodine treatment, you do need to take some
precautions. The iodine not absorbed by your thyroid is
eliminated through urine, sweat and saliva, so you need to be
careful around other people. For about 48 hours after
treatment, you should sleep in a bed separate from others. You
should not share any eating utensils or drinking glasses. In
addition, you have to stay at least six feet away from other
precautions are not due to any proven risk to others. They are
simply to keep the radiation away from people who do not need
to be exposed to it.
also can be eliminated by surgically removing the thyroid
gland. Because several important nerves and other glands are
near the thyroid, it is best to have the surgery done by a
surgeon who is experienced and familiar with the procedure. It
is definitely an operation that requires a specialist.
As you consider
your options, discuss them with your doctor. Thoroughly talk
through all your concerns and questions. After that, you
should be able to make an informed choice that best fits your