Graves' Disease After Radioiodine Treatment
Radioactive iodine treatment has a “calming” influence on the hyper active thyroid gland. This is achieved by destroying the thyroid cells. RAI is generally administered orally. The radioactive iodine gets collected in the thyroid gland and emits certain radiations, resulting in inflammation, followed by necrosis of the thyroid gland cells.
Effects of RAI
The sole objective of RAI is to achieve euthyroidism by destroying some targeted part of the thyroid gland. The complete effects of RAI treatment will begin to take form only after a few months or so after the radioactive iodine is administered.
The doctors need to be extremely careful of the amount of dose that they administer to the patients. Excess of RAI can result in hypothyroidism. In order to avoid this complication, the first dose is generally kept low. But this may lead to persistent sub-clinical hyperthyroidism or total failure treatment. Fixed amoun of RAI is still a hot topic for debate. The doses depend on each individual based on the degree of the disorder.
RAI results in the necrosis of thyroid cells which sometimes can lead to the release of the thyroid hormones in precarious amounts. In order to prevent this occurrence, doses of beta blockers and anti thyroid drugs are given before and after the administration of RAI. Patients suffering from mild levels of hyperthyroidism do not require to consume the anti thyroid drugs. In such cases, Beta blockers are enough to alleviate the symptoms.
Patients with cardiac problems or the elderly patients need to be monitored extra-closely for increased secretion of thyroid hormones can augment the cardiac symptoms. The cells of the thyroid gland that are left behind after the necrosis of target gland cells, may continue to be overactive and overproduce the hormones. But since there are a lesser number of thyroid gland cells now, this is compensated for. Sometimes, the patients undergo euthyroidism for a couple of years and then develop hypothyroidism. In such cases, the patients will have to supplement the body with synthetic thyroid hormones for, perhaps, the rest of their lives.
Around 10% of the patients subjected to RAI treatment need a second dose for complete recovery. RAI treatment is sometimes supplemented with surgery.
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