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Hypothyroidism before raidiation iodine therapy?

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Old 05-01-2002, 12:05 PM   #1
Join Date: Apr 2002
Location: San Antonio, TX, USA
Posts: 3
Keico HB User
Hypothyroidism before raidiation iodine therapy?

I have read that if you have cancer and have your thyroid removed, you will subsequetly have to have radiation iodine therapy, which involves isolation. I have also read that you have to be off any and all thyroid medication for six weeks before the radiation therapy. My question is, during those six weeks, won't you develop hypothyroidism? If so, how bad do the sypmtoms get? Are you able to function normally? You know, go to work, take care of your kids? During the therapy, how long do you have to be isolated?

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Old 05-01-2002, 04:15 PM   #2
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Join Date: Jan 2001
Location: Brooklyn, NY
Posts: 190
ArtfulD HB UserArtfulD HB User
Re: Hypothyroidism before raidiation iodine therapy?

Hi Keico. You definitely become hypothyroid, and you will also be told to avoid iodine in your diet (salt, fish, seaweed, etc.) for a few days to a week before the RAI. The idea is to make any residual thyroid tissue hungry for iodine so that it absorbs as much of the RAI as possible.

There are different approaches, depending upon your diagnosis. Many doctors will put you on Cytomel or some other form of T3 medication while you heal following your surgery and before the RAI. T3 meds are also known as "fast-acting" thyroid medication because it is quickly integrated by the body and is also quick to be metabolized.

Alternatively, Synthroid and other T4-only meds break down to T3, T2, T1, etc. as the body uses it. It takes 4-6 weeks for the body to balance after a dosage change of T4, but since Cytomel/T3 is already a breakdown product of T4 you don't have this waiting period.

So...they put you on Cytomel for a month or so before the RAI so you're not too hypo. Then they take you off the Cytomel for a week or so prior to the RAI to minimize the length of time you'll be uncomfortable. But, again, it depends on your diagnosis. If you heal quickly and are able to do the RAI soon after surgery, they may just keep you off all meds entirely between procedures. I had some business trips in between the surgery and RAI, but I seem to recall that when I returned I was taken off all meds for about a month before the RAI.

I won't lie to you, it is uncomfortable, but I took it as a gift. It sounds hokey, but it really made me appreciate what it is to feel well. And my symptoms seemed to be a preview of what it will be like if I live to be in my 80s, so it also made me a bit more compassionate. My symptoms were primarily things that I had become used to over the years, and it was so nice to know it would be temporary.

Here's a short list:

Fibromyalgia-type pain including
- Body and Muscle Ache (mostly my back)
- Sore Legs
- Difficulty Walking (it got to where I could only shuffle along at one point)
Carpal Tunnel-type pain in hands and arms
Difficulty concentrating
Feeling cold all the time
Irritable moods
Fatigue and feeling lethargic
Puffy, swollen face
Lack of coordination/vertigo

The good news is that I found Acupuncture to be a tremendous, immediate relief for the body ache/carpal tunnel/fibromyalgia pain. I was still able to work and function normally, but I tried not to push myself too much. Since I live in New York, I didn't have to drive anywhere, but the subway stairs took on a new meaning.

The RAI treatment itself usually lasts 1-2 days, but it depends on how low they want your radiation levels to be before you return home. I don't have children so, for me, it was an overnight hospitalization. Depending on how young your children are, they may have you stay longer.

I brought a laptop computer, a book, a really big hot/cold mug, and a water filter pitcher and electric kettle with instant soups and teas and snacks (nuts, dried fruit, etc.) that I like. (I brought the water filter pitcher because I remembered from surgery that the hospital tap water tasted funny.) I also brought comfy sweats so I didn't have to wear hospital gowns. A watch or travel clock is a good idea, too, so you can keep it by your bedside.

You can bring any food or clothing you want with you, but don't plan to take it home. The nurses will visit you intermittently to bring food and check your levels, but you're generally on your own. Hopefully, your room will have a window (mine did) so it doesn't really feel isolating.

They place lead shields around your bed (sort of like bedrails, except not attached), and you'll have to walk to and from the bathroom along a paper runner like a bride. They were not happy about my bringing the electric kettle but they pretended not to know it was there. It was extremely helpful for me because I was able to drink gallons and gallons of water and soups without having to call for assistance.

When you go home, you'll be told not to get too close to children and not to let pets sleep on you for about a week. (They give you a sheet of instructions.) I slept in a separate room from my husband. Clothes that I wore in the hospital and at home, plus sheets etc. had to be soaked and washed several times before they could be placed with other clothing.

Then you usually stay hypo for a short time longer as they tend to do a follow-up thyroid scan within a few days of your hospital release. (You're already radioactive, so they just have to do the test.)

It passes quickly, I promise.

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