After radioactive iodine treatment for thyroid cancer

Having radioactive iodine treatment means you will be radioactive for several days afterwards. You will be able to go home from hospital when the radiation level in your body is at a safe level. As you will still have some radioactivity in your body you may still have to take some precautions when you go home. Your healthcare team will explain everything to you.

Thyroid medicine after radioactive iodine treatment

You may have stopped taking your thyroid hormone tablets in preparation for your treatment. Your nurse will tell you when you should start to take them again. Usually, this is 2 to 3 days after your treatment.

You will need to take thyroxine tablets to replace the hormones that your thyroid gland normally makes. Your doctors will want to keep your thyroid hormones at a slightly higher level than you would normally need. This is to stop your body producing another hormone called thyroid stimulating hormone (TSH). TSH can help some types of thyroid cancer cells to grow.

The doctors will work out the correct dose for you and when to start taking it.

Radiation safety precautions

You will need to follow safety precautions for a few days after your radioactive iodine treatment. This is to protect others from the radiation. 

The advice about precautions varies for different people and for different hospitals. Talk to your doctor or specialist nurse. They will explain how long you need to limit yourself.

These precautions include:

Keeping your distance and avoiding close contact with people

Stay away from crowded places and avoid using public transport. If you live or work with other people, you will need to keep a distance from them. Avoid standing or sitting close to them. This stops them from getting radiation from you. 

Your doctor will tell you not to have close, lengthy contact with others for a couple of weeks. This includes babies, young children, pets and pregnant women. Avoid hugging and kissing other people.

Not sharing a bed

You might need to sleep in a separate bed if you normally share a bed. Check if this applies to you and ask how long this should be for.

Avoiding sexual contact

You might need to avoid sexual intercourse for a period of time or to use a condom. Check if this applies to you and ask how long this should be for.

Read more  Preparing for radioactive iodine treatment for thyroid cancer

It is also recommended that:

  • women use reliable contraception for at least 6 months
  • men use reliable contraception for at least 4 months

This is because the eggs and sperm produced after treatment may be damaged by the radiation. Research suggests that if you wait for the advised period of time, you don’t have an increased risk of abnormalities with future pregnancies or children.

Practicing good hygiene

A small amount of radiation will still be in your sweat, urine and saliva. For a few weeks you will need to use your own towel and keep your cutlery and plates away from others until washed. Continue to flush the toilet twice and wash your hands thoroughly after using the toilet.

Travelling after radioactive iodine treatment

Recent treatment with radioactive iodine may set off radiation alarms at airports. Talk to you doctor if you plan to travel abroad. You can have a certificate from the hospital, or a letter from your doctor, explaining the treatment you have had.

Possible short term side effects

The side effects of radioactive iodine treatment vary depending on your age, whether you have other medical conditions and the dose of radioactive iodine you have. Some people may have one or more of the following short term side effects:

Inflammation of the salivary glands

Your salivary glands can become inflamed after treatment. This can cause symptoms such as swelling and pain. You can have painkillers to help with the inflammation.

Dry mouth

You may make less saliva (spit) and feel like your mouth is dry. This usually gets better with time, but in a few people it may be permanent.

To reduce the risk of getting this side effect, it can help to drink plenty of fluids during your hospital stay. Some doctors recommend that you chew gum or suck sweets to keep the salivary glands working. If you have a dry mouth, you could try using artificial saliva to see if this helps. Your doctor or nurse can arrange this for you.

Changes to your taste

You may have short term changes to your taste and smell. This may not start until you get home. It usually gets better within 4 to 8 weeks. It can help to drink plenty of fluids after your treatment.

  • Go to more information about coping with mouth problems

A swollen or tender neck and feeling flushed

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. Rarely, people can feel pain in their neck.

Tell your doctor or nurse if any of these symptoms happen. They can give you a painkiller or a medicine to reduce inflammation, which can help.

Read more  Thyroid Anti-Inflammatory Energy Tea (Golden Milk)

Feeling sick (nausea)

You may feel sick for the first few days after treatment. Your doctor or nurse can give you anti sickness medicine to help with this.

Possible long term side effects

Possible long term side effects include:

Further radioactive iodine treatments

Some people might need more than one radioactive iodine treatment. This is to make sure the treatment destroys all the remaining thyroid tissue and cancer cells.

  • Find out about your follow up appointments
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— Update: 13-03-2023 — found an additional article Preparing for radioactive iodine treatment for thyroid cancer from the website for the keyword best approach for coming off rai and hypothyroidism.

Radioactive iodine treatment is a type of internal radiotherapy. It uses a radioactive form of iodine called iodine 131 (I-131). It is a useful treatment in thyroid cancer because the thyroid gland absorbs and stores most of the iodine in your body. The thyroid gland gets iodine from certain foods and uses this to make essential thyroid hormones.

Radioactive iodine is a targeted treatment. The radioactive iodine circulates throughout your body in your bloodstream. But it is mainly taken up by thyroid cells, having little effect on other cells. Thyroid cancer cells in your body pick up the iodine. The radiation in the iodine then kills the cancer cells.

It is only suitable for some types of thyroid cancer. It is a treatment for:

  • follicular thyroid cancer
  • papillary thyroid cancer

It can treat the cancer even if it has spread. But even if you have one of these types of thyroid cancer, this treatment may not be necessary or suitable for you. Not all of the cancer cells take up the iodine so you may have a test dose to see if they do.

When do you have radioactive iodine?

You might have radioactive iodine treatment:

  • after surgery, to kill any cancer cells that may have been left behind
  • to treat thyroid cancer that has spread
  • to treat thyroid cancer that has come back after it was first treated

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.

Before your radioactive iodine treatment

For your treatment to work, one of the hormone levels in your body needs to be high. This hormone is called thyroid stimulating hormone or TSH. A high level of TSH helps any thyroid cancer cells in the body to take up radioactive iodine.

To increase the levels of TSH, your doctor will ask you to do one of the following:

Read more  Correlation Between Hypothyroidism During Pregnancy and Glucose and Lipid Metabolism in Pregnant Women and Its Influence on Pregnancy Outcome and Fetal Growth and Development

  • have an injection of a man-made TSH called recombinant human TSH (rhTSH) once a day for 2 days
  • stop taking your thyroid hormone tablets a few weeks before treatment (thyroid withdrawal)

Your healthcare team will explain what you need to do and what is going to happen. They will also let you know when to re-start your hormone tablets if they have asked you to stop taking them.

Low iodine diet

You might need to have a low iodine diet for a few weeks before you have your treatment. This prepares the thyroid cells so that they can absorb the radioactive iodine. All food and drink contains some iodine.  A low iodine diet means that you should avoid foods that have a high level of iodine in them.

Foods you are allowed 

You can eat the following foods because they contain very low levels of iodine:

  • fruits and vegetables including potatoes
  • cooked green vegetables
  • meat
  • ordinary table salt and sea salt
  • fresh bread
  • rice and dries pasta
  • non dairy spreads such as Vitalite, Pure and non dairy Flora
  • olive oil, vegetable oils and nut oils
  • water, soft drinks, fizzy drinks, fruit juices and alcoholic drinks
  • tea and coffee without milk
  • milk substitutes such as coconut, rice, almond and soya milk avoid ones that contain an ingredient called carrageenan (as this comes from seaweed)
  • dark and plain chocolate that is 70% cocoa or more
  • crisps

Restricted food 

You can eat a small amount of these food items as they have a moderate amount of iodine:

  • milk about 5 – 7 teaspoons a day (25 ml)
  • butter a teaspoon (5 g) each day
  • cheese 25 g (1 ounce) per week
  • dairy products such as yoghurt and dairy ice cream 1 serve per week
  • 1 egg each week
  • products that contain eggs such as mayonnaise, custard, fresh egg pasta, egg fried rice, Yorkshire pudding, pancakes

Food to avoid

You shouldn’t eat these foods as they have high levels of iodine:

  • fish, seafood, seaweed, kelp and laverbread
  • raw green vegetables such as spinach and broccoli
  • cakes and biscuits made with eggs or butter
  • milk chocolate and white chocolate
  • take away foods, fast foods and restaurant food as their ingredients aren't known and might contain iodine
  • iodised salt and Pink Himalaya salt that has come from outside the UK
  • vitamins and mineral supplements, nutritional supplements and cough mixtures (unless prescribed by your medical team, for example vitamin D)

You can return to your normal diet after you have had your treatment.

Pregnancy and breastfeeding

Tell your doctor if you think you may be pregnant. You should not have this treatment during pregnancy.

Talk to your doctor if you are breastfeeding. You will need to stop breastfeeding before you have treatment with radioactive iodine.

  • Go to information about having radioactive iodine treatment
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