treating hyperthyroidism

TREATING HYPERTHYROIDISM

CHOICES OF TREATMENT

TREATING HYPERTHYROIDISM

DO NOTHING SURGERY BLOCKING MEDICATIONS RADIO-ACTIVE IODINE

TREATING HYPERTHYROIDISM

DO NOTHING ADVANTAGES

Might get better “by itself”

DISADVANTAGES COULD TAKE MONTHS TO YEARS SYMPTOMS COULD GET WORSE

TREATING HYPERTHYROIDISM

SURGERY ADVANTAGES

QUICK FIX

DISADVANTAGES Surgery risks Require thyroid hormone replacement Risk of hypOcalcemia (low calcium)

TREATING HYPERTHYROIDISM BLOCKING MEDICINES (PTU or TAPAZOLE)

ADVANTAGES No surgery required No radioactive iodine required

DISADVANTAGES Not a cure May be required for years Metallic taste Needs to be taken 3 to 4 times a day Allergy to medication may develop Could cause agranulocytosis (white blood

cells disappear)

TREATING HYPERTHYROIDISM

RADIOACTIVE IODINE ADVANTAGES

Can cure the problem Surgery (without surgery)

DISADVANTAGES Usually results in hypOthyroidism Activities restricted for a few days after the

treatment Sometimes a repeat treatment is required

TREATING HYPERTHYROIDISM

RADIO-ACTIVE IODINE WHY IS IT USED? HOW LONG HAS IT BEEN USED? IS IT SAFE? WHAT CAN YOU EXPECT WHEN YOU

GO TO THE NUCLEAR MEDICINE DEPARTMENT

TREATING HYPERTHYROIDISM with RADIOACTIVE IODINE--- Why is it used?

The thyroid normally uses iodine from the blood to make thyroid hormone

The thyroid “traps” iodine so it can also “trap” radio-active iodine

Radioactive iodine stays in the thyroid and destroys the thyroid and ONLY the thyroid

HOW LONG HAS IT BEEN USED? This method of treatment has been used

for the past 50 years

IS IT SAFE? It is a proven method and it is safe (unless

the patient is pregnant)

TREATING HYPERTHYROIDISM with RADIOACTIVE IODINE

TREATING HYPERTHYROIDISM with RADIOACTIVE IODINE -- WHAT CAN YOU EXPECT WHEN YOU GO TO THE NUCLEAR MEDICINE DEPARTMENT

1) We will make an appointment for you to go to the nuclear medicine department of your local hospital

2) Once there, you will have the radioactivity of your thyroid measured (we all have a basic amount of radioactivity in our body)

3) Then you will be given a “tracer” amount of radioactive iodine (a pill) by mouth (test dose)

4) Then 2- or 4- hours later the radioactivity in your thyroid will be measured again . It will be measured one more time the NEXT DAY about 24 hours after the “test dose” is given.

TREATING HYPERTHYROIDISM with RADIOACTIVE IODINE -- WHAT CAN YOU EXPECT WHEN YOU GO TO THE NUCLEAR MEDICINE DEPARTMENT

You will also have a physician at the nuclear medicine department examine your thyroid and help to determine (along with your physician here), what dose of radio-active iodine to give you to treat your thyroid. This dose is determined with the help of the numbers from your iodine uptake study

TREATING HYPERTHYROIDISM with RADIOACTIVE IODINE -- WHAT CAN YOU EXPECT WHEN YOU GO TO THE NUCLEAR MEDICINE DEPARTMENT

Once the calculations are completed and the dose of radioactive iodine is decided upon, it will be ordered for delivery…this delivery is usually the next day, now day #3.

Once the capsule has arrived, you will be given the radio active capsule.

You will not feel any differently, nor will you need to be protected from the radioactivity (the people who handle this material everyday will be protected because of their repeated exposure)

TREATING HYPERTHYROIDISM with RADIOACTIVE IODINE -- WHAT CAN YOU EXPECT WHEN YOU GO TO THE NUCLEAR MEDICINE DEPARTMENT

The physician at the hospital will give you some guidelines which are designed to conform with NY state regulations.

These guidelines are REQUIRED by the state to be given to you.

Some patients become frightened when they hear the guidelines.

You need to remember that this treatment is very safe and that no harm has come to individuals related to treated persons.

If there were any reasons to have a concern about this form of treatment, we would not be recommending it.

TREATING HYPERTHYROIDISM with RADIOACTIVE IODINE -- WHAT CAN YOU EXPECT WHEN YOU GO TO THE NUCLEAR MEDICINE DEPARTMENT

You will also have a thyroid scan (picture) taken after receiving an intravenous injection (this will take place on the first or second day of the study). This scan will tell us which part of your thyroid is functioning (or over-functioning) and which might not be functioning

TREATING HYPERTHYROIDISM

Five days after your treatment dose with radioactive iodine, you will likely be asked to re-start the anti-thyroid medications that you were taking before the dose (some patients will not need to do this)—make sure you know if you are (or are not) to start your anti-thyroid medication

TREATING HYPERTHYROIDISM

You should call us after your treatment if you have any questions about how to proceed

You should have an appointment with us approximately one month after your treatment dose.

SUMMARY

Treatment options are as follows: 1) watching and doing nothing actively, but following

clinically 2) having surgery 3) the likely use of beta blockers (and their role in

preventing symptoms) , regardless of the therapy chosen 4) using PTU (or TAPAZOL) to control the gland initially 5) using Radioactive Iodine to ablate the gland (the

patient understanding that lifetime replacement with thyroid hormone would then be required). The patient also understands that #5 could follow #4; or that #4 could follow #5. Finally, the sequence #4-5-4 is also possible.

SUMMARY

Suggestions are welcomed

THE END