In the human organism, the hormones T3 and T4 produced by the thyroid gland regulate metabolic processes in the body and, therefore, have a decisive influence on physical and mental activity. They increase heart activity and body temperature, mobilize energy reserves, and are involved in protein synthesis. Therefore, both hypofunction and hyperfunction can lead to severe disorders of various bodily functions.

Drug therapy can temporarily alleviate the symptoms of this disease but cannot permanently eliminate its cause. This can only be achieved with radioiodine therapy or surgical removal of the affected parts of the thyroid gland.

Radioiodine therapy is a procedure with relatively few side effects that can be used to treat various thyroid diseases effectively. In Germany, this treatment is only carried out under inpatient conditions for radiation protection.

When is radioiodine therapy indicated?

• in functional autonomy
• for immunogenic hyperthyroidism ( Graves' disease )
• for volume reduction in goiter

When can radioiodine therapy not be carried out??

• during pregnancy
• suspected malignancy
• Problems with radiation hygiene (urinary incontinence, need for care)

What do you need to look out for?

You should follow a diet low in iodine (no seafood). Do not use any medication containing iodine (X-ray contrast media, ointments, etc.).

Preliminary examinations

To determine the exact nature of your thyroid disease, you need to measure the thyroid hormone levels in your blood, an ultrasound scan and a scintigraphy of your thyroid gland. A radioiodine test is carried out on an outpatient basis a few days before treatment.

Radioiodine test

Please bring a referral from your doctor. In preparation, you must not eat anything for at least 4 hours before the test. After administering a small amount of test activity, the storage behavior of your thyroid gland is assessed. After approx. 4 hours, the first measurements of the percentage uptake of radioactive iodine can be taken. Measurements are necessary after 24 hours, 72 hours, and on the 6th day. After 24 hours, an iodine thyroid scintigram is made with the given activity. The optimum radioiodine activity required to treat your thyroid disease can now be determined from these measurement results and the ultrasound examination. The calculation of the therapy activity is determined using the Marinelli formula.

Aim of the therapy

In the case of autonomy, hyperthyroidism should be eliminated while sparing normal thyroid tissue. In the case of Graves' disease, treatment aims to essentially eliminate the function of the thyroid gland, as this is the only way to eliminate the risk of recurrence.

The Therapy

On the day of admission, you must not eat anything from 7 a.m. onwards. However, you should take your usual medication and have a good breakfast beforehand. Please pay attention to the recommended intake or omission of specific thyroid-specific medication.

For treatment, you will be administered a therapy capsule in the application room on the therapy ward according to the optimum therapy activity calculated for you in the radioiodine test. You may eat again one and a half hours after taking the therapy capsule.

After taking the therapy capsule, you should keep as much distance as possible to ensure that staff are not exposed to unnecessary radiation.

Activity measurements are carried out in your room. For this purpose, a detector is installed in the ceiling above your bed, which measures the activity of radioiodine in your thyroid gland. We measure your total body activity in the morning.

You are not allowed to leave the therapy ward or receive visitors during your stay.

There is an absolute smoking ban on the therapy ward. We recommend that you bring nicotine patches with you if necessary.

You can use your private clothing without hesitation. Before you are discharged, you will also receive recommendations on what to do in the first few days after discharge.

Possible side effects of radioiodine therapy

When treating large strands with high activity levels, an inflammatory reaction of the thyroid gland may occur temporarily in the first few days of treatment, but this improves with the help of an ice pad and anti-inflammatory medication.

Patients with Graves' disease and endocrine orbitopathy receive corticosteroids during therapy to prevent worsening of the eye symptoms.

As the salivary glands absorb part of the radioactive iodine, a brisk flow of saliva must be ensured to protect them. Lemon drops are administered for this purpose.

Patients after radioiodine therapy have no relevant increased risk of developing cancer, nor is there an increased risk of genetic abnormalities in their offspring.

Response to therapy

In more than 90% of cases, the hyperfunction is eliminated, with only around 5% requiring follow-up treatment or a new course of radioiodine therapy. Hypofunction can develop in 10%, but this can be easily compensated for with hormones.

The volume of a goiter or nodule can be reduced by 30-70%.

In the case of Graves' disease, hyperthyroidism is eliminated in over 90% of cases. Lifelong treatment with thyroid hormones is then necessary.Entlassung

As soon as the radioactivity in your body has fallen below a certain limit specified by law and you have spent at least 2 days on the therapy ward, you can be discharged. After a final consultation with the ward doctor, you will receive information on further check-ups.

You should keep your distance from small children and pregnant women for a certain period or limit contact. Pregnancy should be avoided for up to approx 6 months after radioiodine therapy. There are no restrictions on living with pets.

Follow-up care

Your GP should check your thyroid levels regularly to detect hyperthyroidism or hypothyroidism at an early stage. Radioiodine therapy's success is only achieved after about six months. As part of the therapy follow-up, a detailed examination, ultrasound examination, and scintigraphy will be carried out to determine the thyroid laboratory values.

Even if the thyroid gland functions normally after therapy, you should have your thyroid gland examined at intervals of 1-2 years.