Poor ecology, stress and other adverse conditions often lead to diseases thyroid gland. Its increasing harms the body. Thyrotoxicosis can take the most different forms, including diffuse toxic goiter, also called the Based disease or graves disease. Sometimes it comes to destroy the crude gland fabric and the radioactive iodine is called up.

Diseases of the thyroid gland

Thyareotoxicosis, which is hyperthyroidism, can take various forms. These include the diffuse and the disease of the planmer, Goz Hashimoto and some other ailments. With success, the treatment with radioactive iodine is successful (in Moscow it is carried out, for example, in Tsniyircher and some other clinics). This method is complemented by the treatment of many types of cancer and other thyroid tumors, including lymphoma and thyroidita Hashimoto.

The opposite of thyrotoxicosis is hypothyroidism, which does not represent a serious threat and is corrected by drugs. In addition to the diseases of the thyroid gland itself, sometimes there is insufficiency or hyperfunction of the porous glands, i.e. Hypoparatyosis and hyperparathyroidism. Insufficiency is treated with medication, but hyperfunction requires operation.

Therapy of thyrotoxicosis and cancer

Most of these diseases effectively eliminates the treatment with radioactive iodine. Moscow also has such a type of therapy. Of course, first assigned conservative treatment, say, toxic adenoma or diffuse toxic goiter with medicines. But effectiveness rarely exceeds 40%, and often almost twice as much. If such treatment does not bring the results or is observed relapse, the optimal solution will be the assignment of therapy with the help of radioactive iodine I 131. You can also use irradiation, but it increases the risk of cancer of the gland, and iodine remains harmless.

Cancer is removed operational. But in this case, treatment with radioactive iodine in Moscow, as well as around the world, is carried out as additional method Therapy. It is important to withstand the deadlines after the thyroidectomy and the treatment according to the protocol, then the risk of metastases can be minimized.

Why not surgery?

Sometimes an alternative to thyrotoxicosis therapy is surgery. Of course, the operation is always associated with a big risk, not to mention the fact that the scar on the skin is not a very aesthetic thing. The anesthesia itself, the risk of bleeding, the possibility of damage to the return nerve is all the factors that speak against the operation in favor of more gentle, but at the same time efficient radioiodterepia. Of course, in some cases, without emergency, it's just not to do, as in the case of cancer.

With a surgical method, part of the tissue was often preserved to prevent hypothyroidism. However, this approach is fraught with recurrences of the disease. The thyroidity of autoimmune antibodies again attack the remains of the gland, leading to a new turn of the disease. Therefore, now prefer to get a complete therapeutic effect instead of temporary. Yes, and the treatment with radioactive iodine cost is more acceptable.

World practice

Light forms of the disease prefer to treat drugs. Also from this method begin with problems in adolescents and children. In other cases, it is better to carry out treatment of thyrotoxicosis with radioactive iodine. The drug has the form of a capsule or an aqueous solution.

By the way, in Europe, the doctors are generally more trusted by various anti-random means than treatment with radioactive iodine. But in the US, preference is given by radio poiodterals as more efficient. Of course, after it, you need to go through the rehabilitation program, but after all, the reception of medicines also requires further restoration of the body.

For the first time, the introduction of iodine radioisotopes was carried out in 1941 in the United States. And since 1960, the method began to use in medicine already wide. Over the past period, they were convinced of its benefits, reliability and safety. Yes, and the treatment with radioactive iodine the price has become more affordable. In some clinics of America and Europe, the treatment with minor doses of iodine is already under an outpatient mode. We also allow such a mode, but only for doses within 10.4 MCI in activity. Abroad standards are somewhat different, allowing a stronger impact, which and for treatment is affected positively.

The basis of the method

Medicine uses isotopes I 123 and I 131. The first for diagnosis, since it does not have cytotoxic effect. But the second isotope just allows treatment. It emits ß- and ɣ particles. ß-radiation gives irradiating effect localized in the tissues of the thyroid gland. ɣ-radiation allows you to monitor doses and distribution of the drug. The thyroid gland accumulates this radioisotope iodine I 131, and it, in turn, damages thyroid tissue, which is therapy of thyrotoxicosis.

Safety for other tissues is explained by the fact that the iodine isotopes and attracts them to itself. In addition, his half-life is only 8 days. Intestinal and urinary systems capture, as a rule, at least the isotope, not exceeding the permissible limits. The cytotoxic effect is obtained localized, only thyroidocytes are ruined, which leads to a decrease in the thyroid gland in the amount and transition to hypothyroidism without surgical intervention.

Hypothyroidism, in turn, is adjusted by drugs. The drugs of L-thyroxine are prescribed, which compensates the necessary hormones, in the usual case generated by the thyroid gland. This hormone is although synthetic, but the endogenic is practically not inferior. Control over the level of hormones, no doubt, is necessary, sometimes the dosage must be changed, but in the rest of the patients return to the usual way of life.

Appointment of treatment

Now, even our specialists tend to believe that it is necessary to hold one-time treatment with radioactive iodine in Moscow or other cities to cause the development of hypothyroidism. Treatment with small doses simply reduces symptoms, removes the problem only for a while, which is not as efficient as complete elimination. The dosage of the drug is calculated for each patient individually. This indicator depends on the volume of the gland, the severity of the disease, its stage, the absorption test and the routine of scintigraphy.

First, the survey is performed, the accompanying pathologies are specified, calculations are made. Sometimes the decision is made to perform all the two administrations of the drug to achieve the desired result. But there are cases when surgery turns out to be more appropriate.

Cancer treatment is also carried out by radioactive iodine, but already as the second stage of therapy. Dosages are higher here to eliminate the risk of development of metastases. The amount of drug from the severity of the case and prevalence of the process depends. Ambulatory This procedure is not performed, preferring to leave the patient for two or three days in the clinic.

The consequences of the reception of the drug

It should be prepared for what will happen after treatment with radioactive iodine. The radioactive iodine will come out of the body several follow-up for the reception of the drug through saliva and urine. These symptoms can last a different period of time, which depends on age and prescribed dose. At the same time, the youth process is accelerated, compared with the situation among the elderly.

On well-being, it practically does not affect. Only some sensitive people who have undergone treatment with radioactive iodine, their reviews are about nausea during this period. There may also be dry mouth or neck pain and throat. Mark increased fatigue and metal taste in the mouth. Sometimes it can affect the occurrence of constipation or diarrhea.

Restrictions after treatment

But there is a number of restrictions that are instructions for action. So, a certain period of time will need to avoid close contact with other people in order not to irradiate them. Sleep someone, from kisses and hugs to refuse, avoid the exchange of dishes and observe the likes. In this regard, a number of prescriptions on the patient's behavior can be distinguished.

Patients undergoing treatment with radioactive iodine, feedback confirm, follows some time to pay attention to hygiene. So, to lower the water in the toilet is better twice, the hands of washing after its visit should be particularly thorough in a large amount of water and with soap. There will be separate dishes, towels, bed linen, which no other to use. Naturally, underwear and clothing should also be emitted separately from the belongings of relatives. Do not prepare food for households.

Even the garbage is better to collect in a separate basket, and then to dispose into the medical institution (if such a service is provided). Otherwise, in a conventional trash can you can throw it over 8 days later. The dishes should not wash together with the subjects of other people, it is better to wash it manually without a dishwasher. Disposable plates and devices are placed all in the same separate trash bag.

Radioactive iodine is an alternative method that is applied subject to the complete removal of this organ. This therapy is effective with differentiated forms of cancer and other diseases of this organ. In some cases this method It is the only chance for a patient for a favorable outcome. The feasibility of the procedure determines the qualified specialist based on the established diagnosis.

Radioactive iodine 131- What is it?

Iodine is an important element in a person's body, which has the ability to accumulate and resist thyroid cells. This allows the use of the component to produce thiethine hormones necessary for the normal functioning of vital organs and organism systems.

Radioactive iodine 131 is a syntheticly synthesized iodine isotope. The substance does not have taste, colors and smell. In medicine, this component is used to treat various thyroid diseases. The therapeutic effect is based on the fact that when inserting a radioactive iodine in the body for 8 days, self-sustaining and forms xenon, as well as beta and gamma radiation. This feature of the substance is the main purpose of treatment, as it contributes to the destruction of tumor cells.

90 % therapeutic effect It is achieved due to beta particles with high speed and low mileage in tissues (2 mm). Their radioactivity contributes to the destruction of the residual cells of the thyroid gland and the tumor, which spread beyond its limits.

Gamma particles do not possess the healing effect, but at the same time are characterized by a high penetrating ability. Due to this, with the help of special gamma chambers, it is possible to identify the presence and location of metastases, in which the accumulation of radioactive iodine is recorded.

The essence of the method of radio pooodterepia

This treatment method is used for patients who conducted the operational removal of the thyroid gland. The procedure is used after an expiration of 4 weeks after the operation.

When the radioactive iodine is introduced into the body, residual cells of the organ and tumors are captured and accumulated. Due to this, their destruction occurs, which allows you to stop the development of the disease. As a result, the function of the thyroid gland is completely oppressed. The adjacent tissue action isotope does not apply.

The required dosage of the substance is selected by an experimental specialist on the basis of the form and stage of the pathological process.

Indications for holding

The radiocoderpium of the thyroid gland is prescribed only when its efficiency is fully justified.

Main readings for the procedure:

• hypertheriosis against the background of the increased activity of the thyroid gland;
• thyrotoxicosis;
• nodal goiter;
• papillar, follicular, anaplastic view of cancer;
• the presence of metastases.

Experts share all patients suffering from thyroid cancer, three main risk groups. Each of them means the degree of probability of re-development of the disease, as well as the appearance of metastases.

Based on this data, the necessary dosage of radioactive iodine in Milliquury is determined, as well as the expediency of the procedure.

1. Low risk group. The size of the tumor does not exceed 1-2 cm, so the neoplasm does not go beyond the limits of the thyroid gland, as well as there are no metastases. Radioiodterepia in this case is not assigned.
2. Middle risk group. The diameter of the tumor exceeds 3 cm, so it sprout into the capsule. The dosage of radioactive iodine is 30-100 mKi.
3. High risk group. The size of the tumor is rapidly increasing, which leads to its germination into neighboring tissues, as well as remote metastases. The number of radioactive iodine is assigned from 100 MKS.

Contraindications

According to the reviews, the treatment of "thyroid" by radioactive iodine is very effective, but this therapy is not useful not to everyone.

Basic contraindications:

• pregnancy;
• large or multicate goiter;
• individual intolerance to iodine;
• lactation;
• threw after childbirth;
• psychiatric diseases;
• liver, renal failure;
• heavy form decompensated sugar diabetes;
• hypoplastic, aplastic anemia;
• stomach ulcer duodenal gut In the period of exacerbation.

Radio moderapics is allowed only to patients reaching 18 years of age.

Advantages of radio poodeterapia

Judging by the reviews, the treatment of "thyroid" with radioactive iodine has several advantages. This is confirmed by specialists who argue that with the help of this method, it is possible to point to the thyroid gland and the neoplasms present in it, not involving the adjacent tissues into the process.

The main advantages of radio pooodterepia:

• no need for anesthesia;
• low percentage of relapses;
• there are no scars after the procedure;
• minimum number of contraindications;
• short rehabilitation period.

Preparation for procedure

In order for the therapy to be the most efficient, it is necessary to prepare a patient in advance to the use of isotope. The main role in the effectiveness of treatment is discharged by thyrotropic hormone (TSH), which is synthesized by the pituitary. Since it is he who is responsible for the accumulation of iodine with a thyroid gland.

Malignant cells are characterized by less absorbing ability, so it is necessary to create an elevated level of TSH in the body in order to improve the capture of radioactive iodine tumor.

There are two main ways to increase the level of thyrotropic hormone to the required indicator.

1. Suspending replacement therapy. Reception of medicines should be stopped for 3-6 weeks before radioiodterepia. In this case, TSH reaches a mark of 30 and above, which is far superior to the level of the normal range. The disadvantage of this method is the emergence of hypoteriosis accompanied by unpleasant symptoms.
2. Injections "Tirogen" (the recombinant of human TSH). The introduction of the drug is carried out a few days before the use of the isotope, which makes it possible to significantly speed up the increase in the level of the hormone.

Both methods of increasing TSH are effective, but which one of them choose, the doctor defines, depending on the individual characteristics of the patient.

In addition, it is necessary to observe some general recommendations In the preparation of the body to the effects of isotrop.

1. Eliminate the effect of iodine from the outside. This means that you should not swim in salted water, breathe with sea air, lubricate wounds with iodine. All of these requirements must be respected for four days before the start of radioiodatery.
2. Stop receiving vitamins, hormonal products and food additives 1 month before the procedure.
3. Women to pass the examination for pregnancy, as the isotope is negatively affecting the development of the fetus.
4. Stop receiving medicines from hypestheria 7 days before the procedure.

Required diet

Power adjustment is also an important condition for the preparation of the patient for conducting radioiodatery. The diet implies a significant decrease in the diet of products containing iodine. This is a necessity to create a deficit of this component in the body. As a result, this will lead to the active absorption of radioactive iodine cells of the tumor.

Adhere to the diet must be 2 weeks before therapy and within 5-7 days after it.

Permissible products:

• fresh meat (no more than 140 g per day);
• fresh apples, oranges, lemons, grapefruits;
• pasta;
• egg squirrels.

Also resolve also unsalted nuts, vegetable oil, sugar, honey, fruit jam, tea, compotes based on raisins, peanut butter.

Prohibited products during this period:

• any seafood;
• egg yolks;
• chocolate;
• milk products;
• iodized salt;
• soy and products based on it;
• sausage;
• all products having an orange, brown and red shade;
• coffee;
• ice cream.

How is the treatment?

Radiotherapy is carried out in a hospital. The patient needs to swallow the capsule or water solution Radioactive iodine and powered by plenty of water (at least 400 ml).

After that, the patient is isolated in a separate room, since irradiation from it is dangerous for others. Therefore, it is initially necessary to bring with them a minimum of things, as they subsequently subject to disposal.

Within 2 hours after the procedure, the reception of solid food is prohibited, since during this period, the yodium absorption with the thyroid gland and tumor cells occurs.

At least 1 times a day, the radiation is performed, and while this figure does not fall to a normal level, the patient will be in isolation from others. On average, this period lasts from 3 to 7 days.

Side effects

The consequences of the treatment with radioactive yoda of the thyroid gland can be different. Every person is expressed in different ways depending on the age and volume of the introduced isotrop.

The most likely side effects of the thyroid radoiodicide:

• nausea;
• vomiting;
• general weakness;
• decline in appetite;
• eveniness on the neck.

Radiotherapy in 30% of patients is accompanied by inflammation of the salivary glands. This unpleasant symptom manifests itself 24 hours after the procedure and is often caused by the introduction of isotrop in large quantities against the background of residual tissues of the thyroid gland.

According to reviews, the treatment of "thyroid" by radioactive iodine in a third of patients causes a change in taste sensations. In this case, the food becomes tasteless or acquires a metal taste. This symptom passes independently after 10-15 days.

The use of isotrop can provoke exacerbation chronic diseases, such as cystitis, pyelonephritis, gastritis. Symptomatic therapy is prescribed to eliminate unpleasant consequences.

There are still no reasonable data on the fact that radioiodatery has a negative impact on the conception and tooling the child. But the planning of children is recommended only a year after this procedure.

Recovery period

The duration of rehabilitation after the radiocoderpies of the thyroid gland is about 1st month. During this period, a person must adhere to the recommendations of the doctor who will help protect others from the possibility of irradiation, as well as accelerate the restoration of the patient.

1. It is necessary to increase water consumption up to 1.5-2 liters per day, which will speed up the process of removal of isotope from the body.
2. Take a shower must not less than 2 times a day.
3. It is necessary to approach the surrounding and pets, it is not more than 1 m, it is forbidden to kiss and hug children.
4. Sleep it alone and in a separate room.
5. Men should hold urinate sitting.
6. After visiting the toilet, wash off the tank is required twice with the toilet paper, as well as thoroughly wash your hands with soap.
7. All personal hygiene items should be kept in a polyethylene package.
8. It is recommended to use separate dishes.
9. Bed linen and clothing must be washed daily.
10. If possible, limit contact with close people for the entire period of rehabilitation.
11. The doors of their room should be kept closed.

All restrictions are temporary, after 30 days, a person will be able to return to the lifestyle familiar to him.

The iodine is a chemical substance that was opened back in 1811 by the French chemist Bernarr Kurto when mixing ash algae and sulfuric acid. After a couple of years, his compatriot, chemist Gay-Loussak, studied the resulting substance in more detail and suggested the name "iodine". Translated from the Greek "iodine" means "violet", due to the appearance of purple color when combining it.

Iodine and thyroid gland

The main function of the thyroid gland is the production of thyroxine hormone. Tyroxin is a very important hormone in

our body, participating in all exchange processes, Supporting the work of the muscles, brain and all internal organs. Tyroxin can be compared with the fuel for the body, like gasoline for the machine. Troinsin is formed in the thyroid cells with the participation of iodine and the aimino acid tyrosine. The thyroxine molecule contains four iodine atoms. The peculiarity of the thyroid cells is that they have the ability to capture iodine from blood flow and carry it inside the follicle ( structural unit thyroid gland). Already inside the follicle under the influence of special enzymes from Tyrosine amino acids and four iodine atoms, thyroxine is formed. On the ability of thyroid cells to capture iodine based on radioactive iodine treatment.

What is radioactive iodine

Each chemical element has one or more isotopes, whose kernels are unstable and with radioactive decay form electromagnetic radiation, which can be alpha, beta or gamma. Isotopes are called chemical elements that have the same number of protons, but a different number of neutrons, while isotopes differ from each other by physical properties. 37 iodine isotopes are known. Stable is I-127, and the most frequently used radioactive iodine isotopes used in medicine - I-131, I-123, I-124. The iodine is adopted to signify the letter I. When the isotope is noted next to the letter I indicates the number of protons and neutrons in its atom. It is important to note that the number of protons in the iodine atom constantly - they are always 53. If we are talking about the radioactive iodine Iodine isotope 131 (I-131), this means that the proton atom 53 and 78 neutrons (their sum is equal to 131, which is It is indicated in the digital part of the isotope designation). If iodine 123, then in its atom also 53 proton, but already 70 neutrons, etc. It is the amount of neutrons determines the properties of the isotope and, as a result, various diagnostic and therapeutic purposes. An important characteristic of the radioactive iodine is the half-life. For example, at the I-131 this period is 8 days, I-124 - 4 days, and I-123 - 13 hours. The half-life is the period for which the activity of iodine falls twice. When decaying the radioactive iodine (I-131), xenon, beta particles and gamma radiation are formed.

Principle of operation of radioactive iodine in the treatment of thyroid cancer

The treatment with radioactive iodine should be prescribed only to those patients who have completely removed the thyroid gland.

If part or half of the thyroid gland is removed, the treatment with radioactive iodine is meaningless. Thyroid cells have the property to capture iodine from the blood. It is important to note that the thyroid cancer cells (papillar, follicular) are less actively, but can also capture iodine. Tumor cells when radioactive iodine gets digested under the influence of beta radiation. The penetrating ability of beta radiation is from 0.6 to 2 mm, which allows the cells to destroy the cells in which the accumulation of iodine occurred, but it does not damage the surrounding tissues. One of the tasks of treatment with radioactive iodine is the destruction of the residual tissue of the thyroid gland, which is even after the perfectly performed operation. Often, the surgeon-endocrinologist can intentionally leave a small amount of healthy tisside tissue, both in the area of \u200b\u200bthe return Gundy nerve (for the preservation of the voice) and in the area of \u200b\u200bthe near-odded glands (for their normal functioning). Thus, the radioactive iodine destroys not only possible cancer metastases, but also the residual tissue tissue, which allows in the postoperative period to more accurately monitor the level of thyreoglobulin. Gamma radiation, which is formed during the decay of radioactive iodine, fluently penetrates through all the tissues of the body and can be fixed using a gamma chamber. Gamma radiation does not carry the healing effect, and is used to diagnose. The scan result indicates which part of the body a radioactive iodine has accumulated, which may indicate the presence of thyroid cancer metastases. As a rule, when scanning the entire body after the radio poiodterapia, the accumulation of the drug is detected on the front surface, in the place where the thyroid gland was. The accumulation of iodine occurs in salivary glands, along the digestive tract and in the bladder. Sometimes iodine can accumulate in lactic glands, in which in small quantities there are receptors for iodine.

When scanning the whole body it is important to check if there are no remote metastases. Most often metastases detect lymph nodes Neck and mediastinum, in lungs and even bones.

Indications for treatment with radioactive iodine

According to international and Russian clinical guidelines, three risk groups are distinguished among patients with thyroid cancer. Depending on the risk group, the surgeon-endocrinologist determines the need to appoint treatment with radioactive iodine. The risk group is determined by the probability of the presence of remote metastases and progression of the tumor process.

Low risk group.

A group of low risk can be attributed to patients with a tumor, the size of which does not exceed 1-2 cm and if it does not go beyond the thyroid gland. There are no metastases in the lymph nodes of the neck and other organs. Patients of low-risk groups do not prescribe radioactive iodine therapy.

Middle risk group.

The middle risk group includes patients with a thyroid tumor of more than 2-3 cm in diameter, when germinating the gland capsule and adverse histological versions. Patients of this group, as a rule, assign radioactive iodine therapy. At the same time, the dosage can be from 30 to 100 milliquui (MKI).

High risk group.

This group includes patients with aggressive growth of the thyroid cancer when there is germination to the surrounding tissues (muscles, vessels, trachea), the lymph nodes of the neck and there are remote metastases. Patients of this group necessarily show the treatment with radioactive iodine at a dose of 100 MKI and more.

The increase in the level of TSH TTH is a thyrotropic hormone, which is produced in the pituitary gland and normally regulates the work of the thyroid gland. One of the important properties of TSH is to stimulate the growth of thyroid cells. It is known that TSH also stimulates the growth of tumor cells of the thyroid gland. It is important to note that the cells of the thyroid cancer capture iodine worse than healthy thyroid cells. However high level TSG tumor cells of the thyroid gland are better captured by radioactive iodine, and hence it is better destroyed. To increase the level of TSH, two techniques are used: cancellation of L-thyroxine intake for four weeks or the introduction of recombinant TG (artificially created drug of human TSH).

Cancellation of Tyroxina

To increase the level of TSH before treatment with radioactive iodine, patients cancel the reception of thyroxine for a period of three to four weeks. At the same time, the TSTG level should be higher than 30 MU / L. In fact, the higher the TG, the better the cells of the thyroid tumor will be collapsed. In addition to stimulating the cells of the thyroid gland, the cancellation of Tyroxin receives, if you can put it, to the "starvation" in the yod of the tumor cells. After all, it is not necessary to forget that in thyroxine there are four iodine atoms and when taking a tumor cell tablets take part of this iodine. If an iodine is not received in the body for three to four weeks, then the tumor cells, when the radioactive iodine is destructive for them, begin to actively capture it. As it was written earlier, after entering the radioactive iodine inside the cell, its destruction occurs.

The main disadvantage of the cancellation of thyroxin is the emergence of hypothyroidism. Hypothyroidism is a lack of a thyroid hormone, which may be accompanied by various symptoms. It is important to note that the manifestation of hypothyroidism against the background of the cancellation of thyroxine before treatment with radioactive iodine, all patients are manifested in different ways. There are patients who practically do not feel the abolition of thyroxine, at the same time there are patients who already two weeks after the abolition of the drug complain about sharply occurred weakness, apathy and swelling of the face or other manifestations of hypothyroidism.

Manifestations of hypothyroidism:

Leather: It may be dry, pale and cold to the touch.

Hair: become brittle and falling out.

Gastrointestinal tract: Patients feel a decrease in appetite, taste, possibly the appearance of constipation.

Respiratory system: In some patients, the aperture can occur in some patients and, as a result, respiratory disorders appear (shortness of breath, breathing weakness).

Nervous system: Impairment of memory and decline in attention, the appearance of headaches, the development of depressive states is possible.

The cardiovascular system: The pulse becomes rare (bradycardia), can arise soft arterial hypertension (Enhance arterial pressure), some patients can progress atherosclerosis.

Hooping system: It is possible to occur with light anemia (reducing the level of hemoglobin in the blood), an increase in the time of bleeding during cuts and injuries.

Muscular system: In hypothyroidism, patients feel weakness in the muscles, exercise is heavier. It is important to note that after the start of reception of Tyroxin, the symptoms arising against the background of hypothyroidism pass and the properly selected dosage do not appear again.

The use of recombinant TSH

Recombinant TSH is TG in the form of a pharmacological preparation for intravenous administration, which was synthesized artificially. The use of recombinant TSH is the second method of increasing the level of TSH in the patient's body before treatment with radioactive iodine. Unfortunately, in Russia, recombinant TSH is not registered, and cannot be officially used to prepare for treatment with radioactive iodine. The nearest countries where the recombinant TSH is officially obtained is Ukraine, Estonia, Finland.

Low iodine Diet (Beyd Diet)

All patients in preparation for treatment with radioactive iodine are prescribed a daisy diet. The idea of \u200b\u200bthe idiot diet consists in maximum exclusion from the daily diet of iodized salts and products containing iodine. The daily intake of iodine must be minimized not exceeding 50 micrograms per day. Duration diet - from one to three weeks before the treatment with radioactive iodine and one or two days after treatment.

What is the effect of "starvation" and why do you need a rayody diet

Recommended by the treatment with radioactive iodine, the specialist doctor understands that the patient has the risk of the presence of thyroid cancer metastases (in the lymph nodes of the neck, lungs, liver, bone). It is important not to forget that the cells of the thyroid cancer have lost the properties of healthy cells, but in the overwhelming number they did not lose the ability to capture iodine.

Imagine a patient with thyroid cancer metastasis, for example, in lungs. The patient for one or three weeks limits himself in the consumption of iodine (the obligatory stage in the preparation for the treatment of iodine is the abolition of L-thyroxine), while the whole organism misses iodine. The most important thing is that the cells of the thyroid cancer, which are in the lungs, are also experiencing "hunger" in yode.

Preparation for therapy with radioactive iodine

The day of receiving a dose of radioactive iodine occurs, while the cells of the thyroid cancer "do not understand", they entered them radioactive iodine or ordinary. Against the background of a long "starvation", they are greater force to capture radioactive iodine from the blood. The more active the cancer cells capture radioactive iodine, the more destructive it acts on them. Against the background of a properly sustained daiety diet and cancellation of thyroxine, the effectiveness of treatment with radioactive iodine will be maximum.

Conducting treatment with radioactive iodine

After the preparation is the abolition of L-thyroxine (or the administration of the recombinant TSH) and the idiot diet - determine the necessary dose of iodine and begin directly to treatment. Dosage of radioactive iodine define specialists radiologists. There are several most frequently used doses of radioactive iodine: 30, 100 and 150 mKi (MCI). The choice of one or another dosage is carried out depending on the prevalence and aggressiveness of the thyroid cancer. For example, if the tumor sprout only in a capsule of the thyroid gland, the dose of iodine will be less than if the cancer spread to the lymph nodes of the neck, light or bone. After selecting a dose of radioactive iodine, the patient takes the drug under the control of specialists. Radioactive iodine can be in two forms: in the form of a capsule or a form of liquid. Therapeutic and diagnostic effect of capsule or liquid form does not differ in principle.

It is important to note that the main ways of excretion of radioactive iodine from the human body are the urinary system, gastrointestinal tract, salivary and sweat glands. The patient will give detailed recommendations for nutrition, fluid consumption and personal hygiene features while in the clinic and by returning home. After receiving a radioactive iodine from the patient, radiation occurs, which to some extent can be dangerous to those surrounding people. In this regard, all patients who received the dose of radioactive iodine explain in detail how they should lead themselves with others. The main recommendation is to avoid communicating with children and pregnant women, at least a week after receiving the dose of radioactive iodine. Very often I hear from patients that the term of isolation from the surrounding people after treatment with radioactive iodine should reach the month and more. This information is not true. Give data prepared in 2011 by the American Thyroid Association (ATA) in conjunction with the International Commission on Radiation Protection (ICRP). The maximum isolation period (in one bed with pregnant women, newborns or children), equal to 21 days, refers to patients who received a dose of radioactive iodine equal to 200 mki. At the same time, the insulation periods for the most frequent situations faced by patients when discharge from the clinic after treatment with radioactive iodine, such as, for example, access to work, communication with friends, walks in places of cluster of people do not exceed one day. Patients who comply with the indicated recommendations and the basics of personal hygiene are not dangerous to others and can absolutely calmly be in society and lead a normal lifestyle.

Regarding the timing of children's planning after treatment with radioactive iodine, there are the following recommendations: for men - in 2-3 months, for women - in 6-12 months. I advise all patients who suffered treatment with radioactive iodine, within two or three months with the intersection of borders or points of inspection equipped with devices to identify radiation, to have documents from the clinic. In this time, you are definitely not dangerous for anyone, but modern devices can fix the radiation from you and give a signal to the relevant services. Most often, such situations are at the points of inspection at airports, in this regard, plan your time with the possible delay.

Action of radioactive iodine on the body

It is important to understand that radioactive iodine is not vitamin complex, and its appointment should be carried out strictly

indications, according to international and Russian clinical recommendations. Before the course of treatment with radioactive iodine, the patient should familiarize themselves with possible adverse effects that may occur immediately or after a while after taking the drug radio. Patients can be divided into three groups, depending on the frequency and severity of the flow side effects. The first groups may fall patients who have performed diagnostic scanning with small doses of the radioode. In the second group, the most numerous, patients who have passed radioiodohydrate after surgery and received a dose of iodine from 30 to 200 mKi. To the third group of patients, fortunately a few, can be attributed to those who have received high doses of radioactive iodine repeatedly.

In diagnostic scanning, the dose of radioactive iodine does not exceed 1-5 mKi, and in such cases unwanted effects are extremely rare. When conducting treatment with radioactive iodine, depending on the type of cancer, the prevalence of the thyroid gland and the size of the tumor, the dose may vary from 30 to 200 mKi. In such cases, side effects are possible, and their probability is the higher, the higher the dose of the obtained radioactive iodine. The most common unwanted symptoms after obtaining the therapeutic dose of radioactive iodine are as follows. Edema and pain. In some patients, after receiving the dose of radioactive iodine, there is swelling on the neck (in the area where the thyroid gland was). This phenomenon can be explained by the destruction of the residual tissue of the thyroid gland. At the same time they react the surrounding tissues (muscles, lymph nodes, fatty fiber), which are involved in swelling, increasing in size. As a rule, swelling takes place in a few days and does not require treatment. In pronounced discomfort, anti-inflammatory funds with a good healing effect can be prescribed to the patient. Nausea and vomiting. Nausea and vomiting may appear in a few hours or a few days after receiving the therapeutic dose of radioactive iodine. More active data symptoms can manifest itself in patients with chronic diseases of the gastrointestinal tract. As a rule, in the clinic, where the treatment with radioactive iodine is tested, they are told about the right water mode and, if necessary, prescribe the protective stomach and intestines are prescribed preparations (antacids).

Inflammation of the salivary glands (sialogenite).

The person has three pairs (right and left) salivary glands. The largest is the variety of salivary iron, which is located on the side surface of the face - just below and the kaperi from the ear. Other two are subband and pyline glands. The obtained therapeutic dose of radioactive iodine partially accumulates in salivary glands and, as a result, causes their inflammation. The most sensitive to iodine is the parole salivary iron. There is almost 30% of patients who have been treated with radioactive iodine. It is unpleasant that power adapter can arise both every other day and a few months after receiving a radioactive iodine. The manifestation of the power adapter is pain and swelling in the salivary area, the temperature rise, a decrease in the number of saliva. Usually the pain is enhanced when eating.

Treatment of Salyagenit - a difficult task. First of all, it is important to inform your attending doctors about the emergence of problems with salivary glands. Your doctor will definitely recommend that you need to seek help.

Depending on the situation, various schemes for the treatment of sialogenite can be applied. The main recommendations in its occurrence are as follows:

1. The use of acidic candies, chewing gum, that is, reinforcing salivation. This will lead to a more active excavation of radioactive iodine from the salivary glands, which should reduce the likelihood of their further inflammation.

2. Consumption of a large amount of fluid. When a large amount of liquid is received, a larger amount of saliva will be produced, with a current of which will be better output by radioactive iodine.

3. The use of anti-inflammatory drugs. Anti-inflammatory drugs reduce swelling and thereby reduce pain in the salivary area.

4. Massage of the parole salivary gland.

The technique of massage of the parole salivary gland is as follows: Finger tips The first movement takes place from the bottom up from the corner of the jaw, when touched palm lower jaw The second movement of the fingers is made towards the nose. This simple manipulation improves saliva outflow from the gland.

It is very important not to engage in self-medication, but in the shortest possible time to seek help from a specialist. As a rule, patients fall to consult a maxillofacial surgeon, which, after inspection and the necessary research, determines the therapeutic tactics. Dry mouth syndrome (xerostomy). The occurrence of dryness in the mouth after treatment with the radioactive massage of the variety of salivary gland with iodine is associated with a decrease in saliva production. This symptom may arise in a week or several months from the day therapy. Then inflammation in the salivary glands usually passes and the salivation is restored.

Changing taste. At least a third of patients feel the change in taste sensations after treatment with radioactive iodine. For them, food can give a metal flavor or not to have taste at all. As a rule, changes in the taste sensations pass in a couple of weeks without special treatment.

Conjunctivitis, inflammation of the tear jellyzy..

According to some data, the occurrence of inflammation of the conitual (fine smooth fabric, which covers eye outside) is found only in 1-5% of patients who have been treated with radioactive iodine. The inflammation of the tear gland is as rare. In the event of any uncomfortable experience in the eye area, it is necessary to apply for advice to the ophthalmologist as soon as possible.

Hypoparatyosis.

Parasitovoid glands are responsible for the production of a paranthormon, which, in turn, controls the exchange of calcium. It is extremely rare, but after obtaining a radioactive iodine, a decrease in the function of the parachitoid glands (hypoparathyroidism) may occur. The main symptoms of the hypoparatyroid are tingling on the face, the feeling of goosebumps in the field of face and fingers. It is important not to confuse these symptoms with the exacerbation of the cervical osteochondrosis. With the slightest doubts you need to check the level of the parathgamon and ionized calcium. If the indicators are normal, then the patient has no hypoparathiraosis.

Hair loss (alopecia).

In contrast to chemotherapy and other types of cancer treatment, the reception of radioactive iodine does not cause hair loss. Most often, the problem with hair is associated with a low level of thyroid hormones in preparation for treatment with radioactive iodine. When renewing the reception of L-thyroxine complaints of hair loss pass.

Impact on childbearing functions.

Until now, there is no scientific data on the negative impact of radioactive iodine to conceive or entering children. In women after radio pooodterepia, the risk of infertility, problems with the hatching or the development of congenital anomalies in children is not higher than the average in the population. Recommended children's planning a year after radio pooderapics.

If a multiple receipt of high doses of a radioode is expected, then women can recommend the cryopreservation of their own eggs, and men are crying sperm.

The emergence of other malignant tumors.

One of the first questions that patients are asked when discussing the topic of treatment with radioactive yoda of the thyroid cancer: "Does the radioactive iodine cause other bodies?". If the total dose of radioactive iodine reaches 600 MKI and more, the patient slightly increases the likelihood of leukemia development (tumor of the hematopoietic system originating from bone marrow cells), compared with the average values \u200b\u200bin the population. A group of foreign scientists conducted observation for more than 500 patients to identify the effect of combined action of radioactive iodine and remote radiation therapy. As a result, the development of leukemia in the studied group was identified only in three patients, which was 0.5%. It is important to note that at present there are no convincing scientific data that treatment with radioactive iodine increases the risk of developing malignant tumors of any other bodies.

Consultation of a specialist in the treatment of radioactive iodine

Compiler: Baranovsky O.A., Deputy Chief Doctor for the Radiological Service of the Minsk City Clinical Oncology Dispensary

Treatment with radioactive iodine is required to control possible changes in organs and systems related to the disease of your thyroid gland.

We hope that the information presented below will respond to many of your questions, but may also call others. If you have any questions that are not covered in the accompanying sections, or you do not understand any expressions - contact your doctor or any employee of the nuclear medicine department. If you suffer hyperthyroidism (increased thyroid function), then one of the types of treatment recommended for you may be treatment with radioactive iodine.

1. What is radioactive iodine?
Radioactive iodine (i131) is a radioactive form of iodine, which is used to examine and treat various diseases of the thyroid gland of a person.
Iodine is an element necessary for normal thyroid work. It is located at the base of the neck, on the front surface, and participates in the processes of the exchange of almost all vital organs and body systems. Like ordinary iodine, radioactive iodine penetrates and accumulates in thyroid cells. This allows you to use it in testing, diagnosing and treatment of thyroid diseases. Therapeutic effect Based on radioactivity I131, which irradiates from the inside of the entire Beta and Gamma radiation gland. 90% of the therapeutic effect is due to the beta radiation with a mileage of radioactive particles in 2-3 mm. Radioactivity destroys both gland cells (residues of the tissue itself) and tumor cells spreading out of its limits. Treatment passes almost painlessly.

2. What is the test with radioactive iodine-131 need?
This survey is prescribed to patients subjected to operational thyroid gland. After the operation, thyroid hormones are not assigned. After 4 weeks, the sick is injected with a radio station. Possible remains of the tissue of the thyroid gland and tumor cells have the ability to capture iodine and increasing it. A day after the reception of the radioode capsules on the special apparatus presented in the photo below, with the neck area, they receive information about the presence or absence of a functioning tissue.
Immediately the gamma chamber is performed in order to visually determine the location of the possible location of the tissue. If the test is positive, then in the future it is necessary to conduct a ringiooderapy. The latter is also carried out according to other surveys on the prevalence of your disease (ultrasound, radiological, laboratory).

3. How is radioactive iodine introduced?
The reception of radioactive iodine is usually carried out through the mouth, by swallowing the usual species and sizes of gelatin capsules containing the radioactive element itself. Capsules without taste and smell are swallowed, not chewing, and driven by one - two glasses of water (not juice). In exceptional cases, you may be offered a liquid form of a radioode with similar characteristics. In this case, after reception, it is necessary to rinse the oral cavity with water, and the last to drink immediately. If you wear removable dentures, most likely you will be asked to remove them before taking a liquid iodine.

4. Is radioactive iodine really dangerous for others?
Radiation application for your treatment is used for your benefit. Nevertheless, it is harmful to those who are in contact with you. To reduce the risk of irradiation of others, you will be placed in a separate chamber or a ward with a patient with a similar disease. The service medical staff will not be able to stay with you longer than the time needed to manifest attention to your needs, and will wear gloves and other protective clothing.

5. Is the radio water-free for you harmless?
Therapy using a radioode is widely known as an effective agent in the treatment of thyroid diseases. Side effects Weakly pronounced and bought independently subject to the implementation of recommendations for their prevention. In order to protect the gastric mucosa 30 minutes before receiving the isotope, you will be given an antacid drug (for example, an almagel or gefal). After receiving the radiode capsules, it is necessary to additionally drink 2 glasses of mineral water. In the near future, it is possible "Throat", nausea, vomiting, weakness and lack of appetite, local swelling on the neck, it is later possible to exacerbate chronic diseases, phenomena of acute gastritis, cystitis and sialogenite (inflammation of the salivary glands). The inflammation of the salivary glands occurs in 30% of patients and can be sharp and chronic. Symptoms of sialodenitis can manifest itself for 24 hours and more characteristic of patients who have received greater activity of the radioode, if there are small residues of the functioning tissue of the thyroid gland. For the prevention of the development of this complication, the use of chewing gum, lollipops, lemons, applying cold compresses and abundant drinking is recommended. It is also possible to appear temporary pain in the language or decrease in taste sensitivity. In percentage ratio, transient gastritis is observed in 30%, a decrease in leukocyte levels and platelets - in 70%, a local tumor on the neck with pain syndrome - 10-20% of patients. Literary data on development subsequently leukemia, fibrosis of lungs, lesions of the gonad and bone marrow is very rare, in our practice such complications have not met. Performing recommendations for an increased water load, stimulating saliva, as well as appointed drugs for the protection of the gastric mucosa and anti-ansulistic means bring the risk of these reactions to the minimum.

6. What medications can I take?
Tablets hormone thyroid gland - Levothyroxin prevent treatment or survey with a radioode. Given this, you need to stop taking them 4 weeks before the planned reception of the radioode (hospitalization). During this time you can feel tired or weak, especially in the second half of the day, an increase in weight, personnel of the face and limbs is also possible, the rehabilitation of the voices, the appearance of constipation, strengthening the manifestations of the lack of calcium (if earlier they were). Refusal from receiving Levothyroxin, as a rule, leads to this (this is normal).
In addition, the following experiences and sensations are possible:
- Depression,
- forgetfulness,
- dry skin and hair,
- Heavyness,
- weight gain,
- constipation,
- violation of the menstrual cycle in women
- decline in attention
- apathy,
- fast fatiguability.
The data of manifestations will disappear within 1-2 weeks after the start of the Levothyroxine reception again.
Many cough medicines, mineral and nutritional supplements, as well as cardiac means contain a significant amount of iodine. The latter is captured by the remnants of the thyroid gland or tumor cells as well as the radio station. At the same time, the efficiency of radioioddddiagnosis or radiooiodterepia decreases, and the result of the survey is distorted. When receiving calcium preparations, it is necessary to refuse to use within 1 month before the treatment of "marine calcium". Please bring with you any other pills and medicines that you have taken in the last 4 weeks, and show them to your doctor. Also report x-ray studieswhich you have been performed, as some of them require the use of iodine-containing substances. Fixed assets recommended for cancellation, and cancellation times are presented in the following table.

7. Is it possible to take visitors?
All visitors after receiving a radio approach are excluded. That is, you can not have physical contact with your visitors. The only communication with visitors is possible through medical staff and transmission. You should not pass anything, including food, drinks, printed products or clothing. Please ask the medical staff with doubts about this or that item.
Pregnant and children under 18, any visits to patients receiving both treatment and a survey with a radioode are prohibited.

8. What to do after receiving a radioactive iodine?
For better suction, obtaining a good therapeutic effect with a smaller radial load on the stomach after receiving a capsule or liquid radioode for the first hour to use additionally food and drinking food. After swallowing the radioode capsule, it accumulates in the thyroid gland, its possible remnants (after surgery) or in other modified organs. Its removal is carried out with urine, feces, saliva, then with breathing. As a result, radioactivity can settle on the surrounding items: clothes, beds, walls and personal belongings - on everything you come into contact. Therefore, each patient can take with them only strictly necessary personal belongings and will be provided with underwear and hospital clothing. Considering this, it is necessary to adhere to the following rules of behavior.
8.1 You must be predetermined to the hospital lingerie.
8.2. When carrying out the morning toilet or using water, sinking and when cleaning the teeth, make sure that the water does not sprinkle outside the washbasin shell.
8.3. Be sure to carefully rush your toothbrush after each use.
8.4. When visiting the bathroom, make sure that the urine does not spray outside the toilet, and wash off the full tank of water twice. All patients (and men) from the start of treatment before discharge use only sitting toilet.
8.5. If you accidentally scatter something or poured, please inform the nurse or nurse.
8.6. With nausea and vomit, use polyethylene bags in the ward or toilet, with a mandatory message on duty personnel. When using the toilet form, robbed masses twice. When vomiting in the ward - only in the bag, in extreme cases - to bed, but not in the sink.
8.7. It is necessary to wash your hands, both before meals and in front of other manipulations.
8.8. Do not use reusable cloth scarves, it is desirable to have disposable paper.
8.9. We wash off to the toilet paper in the toilet.
8.10. Your entrance door must be constantly closed.
8.11. Chewing gum Immediately by disappearance of taste, throw in plastic bags of garbage buckets. All remnants of used food also fold only in packages.
8.12. Do not feed through the open windows of birds and animals.
8.13. Do not forget to take a shower every day.
8.14. It is necessary to have a chair every day, if it is absent, inform the personnel - the laxatives will be offered.
8.15. Before the discharge, the exit from the department is only in shoe boilers.

9. Duration of stay in the hospital
In our country, the conduct of radioiodterepia is impossible. Reception, treatment and further examination is associated with radiation safety requirements. In this regard, each patient after receiving i131 for a certain period is placed in the ward of the closed type, without the possibility of free output and movement.
All medical personnel are specially trained in working with radioactive materials and radiation aspects of your therapy.
From the 3 days from the beginning of treatment, the dosimetrist will make daily measurements - measurements of radioactivity remaining in your body. The data obtained is communicated to the staff of doctors and nurses. When the level of radioactive iodine becomes low enough, you will be examined on the gamma chamber. And only if your doctor is satisfied with your condition and survey results, you will be discharged.
The average duration of stay in the hospital is from four to seven days. As soon as you can go home, depends only on the level of residual radioactivity in your body. Most of the radioactive components are captured by the thyroid gland during the first 24 hours. As soon as radioactivity in your body has achieved a safe level, your extract is possible to resolve your doctor.

10. What is a scintigraphic study on a gamma chamber?
A scintigraphic study allows you to determine the location of the radioactive iodine fixation in your body. When conducting scintigraphy (scanning), it is necessary that you still lay on the surface of the gamma chamber table during the entire study. This painless procedure lasts a maximum of 60 minutes. If you can not lie long on a flat surface or afraid of closed spaces, please inform it in advance. The device does not irradiate, on the contrary, you are a source of radiation.
As a result, on the display screen or on another carrier, a radiode distribution image will be obtained in your body. It helps to identify the effectiveness of the preceding treatment and establish the prevalence of the process. According to scintigraphy and other indicators, the patient's treatment and maintenance and maintenance tactics are selected.

11. Are repeated treatment courses needed?
The condition of some patients requires two and more treatment courses. Each case of a thyroid disease is individual. At discharge, the doctor will discuss with you the need for repetitive therapy and the estimated time frame. The latter can undergo changes based on the results of your survey (the level of the tumor marker in the blood - thyroglobulin, the ultrasound examination and / or x-ray).

12. Radio and pregnancy
Pregnancy is an absolute contraindication to survey and treatment with the use of all radioactive substances and a radioode, in particular. Each woman of childbearing age without menstruation is considered pregnant until the opposite is proven.
If you have an operation on the thyroid gland and after it was recommended to the treatment with a radioode, then women are advised to plan a pregnancy no earlier than a year after such treatment, and men are no earlier than in 2 months.

13. Nutrition Recommendations
When preparing for radioiodterepia, patients usually recommend adhere to a low iodine diet.
The goal of a low-water diet is to reduce the content in the iodine body and, thus, increase the effectiveness of the diagnostic or therapeutic effects Radioactive iodine. When complying with such a diet, by the time of the radiode, the cells capable of absorbing it, are experiencing iodine hunger. Therefore, they are able to absorb radioactive iodine more active. In a healthy person, the main organ absorbing iodine is the thyroid gland. If, as a result of the operation, the thyroid gland was removed, the detection of the foci of the absorption of the radioode in other organs (for example, in lymph nodes, lungs) will help more accurately determine the spread of the disease and choose optimal treatment options. And since the radioactive iodine is able to kill the "bad" cells, it is used in such situations and for treatment.
Low content diet is assigned to a relatively short period of time: this is usually happening 2 weeks before receiving a radioode and continues throughout the course of diagnostics or treatment.
The following are the recommendations for compliance with the low-water diet. However, for each patient, an individual approach is required, so the final recommendations you need to hear from the doctor.
Remember that a low-water diet does not mean abolishing, that is, you do not need to abandon the use of salt. You can use the neural salt and put food as you are used to.
Low diet does not mean the complete absence of iodine in your diet. Under this diet, it should eliminate the products with a high content of iodine (more than 20 μg in 1 portion) and maximize the products with a moderate content of iodine (5-20 μg in 1 serving).
You can eat products in which iodine content does not exceed 5 μg in 1 portion. There are many products in which iodine content is so low that their use does not affect the result of your survey and treatment.
We invite you to familiarize yourself with the list of products that should not be used while compliance with the low-water diet and which should be limited.

Products and nutritional supplements that should be excluded when complying with a low-water diet.
1. Any seafood: marine fish, crabs and crab sticks, shrimps, mussels, seaweed (cabbage, etc.) and preparations containing seaweed ("phytospides", etc.).
2. Dairy products (cheeses, sour cream, yogurt, butter, ice cream, dry dairy porridge, etc.).
3. Egg yolk, eggs with iodine, as well as dishes, when cooking, egg yolk is used in large quantities. Egg protein does not contain iodine, while complying with a low-water diet, it can be used without restrictions,
If you do not have other contraindications for it (if it is impossible to refuse eating eggs, it is necessary to reduce their consumption to 3 per week).
4. Industrial bakery products containing preservatives with iodine. Cornflakes. You can be sure that there is little iodine in your diet, if you use homemade baking prepared using a neural salt and without ingredients rich in iodine (for example, egg yolks).
5. All products and dishes having red, orange and brown color, as well as medicines that use the dyes of these shades. Many of them contain an iodine dye (erythrosine - E127), which is not always indicated on the product label. Therefore, it is better to use such painted foods in food.
6. Milk chocolate. Ice cream. You can use in a small amount of cocoa powder and some varieties of dark chocolate. However, it is necessary to control the composition of chocolate products, carefully reading information on the package.
7. Soyware products (sauces, milk, tofu cheese). In them, iodine may be contained in fairly large quantities.
8. Red, purple, Pestro painted bean varieties. Iodine-containing vitamins and nutritional supplements; Preparations containing iodides or iodats.
9. If you need to comply with the low-water diet in the reception of vitamins, take those that do not contain iodine. The composition of the drug is always indicated on the packaging.
10. Salty nuts, chips, canned fruits and canned food, salami, instant coffee, oriental food, pizza, ketchup, potato fries, apple puree, bananas, cherries, dried apricots.
11. Green: dill, parsley, leaf salad, cress salad; Cauliflower, green pepper, baked potatoes in "uniform", zucchini, olives, persimmon.

Products and ingredients containing minimum iodine
- fresh fruits and juices: apple, avocado, musk melon, grapefruit and other citrus, peach, raisins, pineapple;
- vegetables raw and freshly prepared (except for dark beans, soy products and potatoes with peel), frozen vegetables without salt;
- Coconut, unsolved peanuts and peanut butter;
- in moderate quantities - products from grain (dishes from croup, pasta), poultry meat (turkey, chicken) and other fresh varieties of meat (beef, veal, lamb), freshwater fish;
- sugar, but better - honey, jelly, fruit syrups, jams;
- black pepper, fresh and dried herbs,
- vegetable oils (except soybean) and salad refills containing permitted components;
- egg noodle, brown and white rice;
- homemade dishes from low iodine products using a neural salt;
- Non-alcoholic beverages carbonated (Cola, Dietary Cola, Lemonade, Drinks, not containing erythrogen dye), filtered coffee, tea.

14. Recommendations after discharge
After the patient is discharged, it is recommended to adhere to the rules outlined below.
- At home or at work, try to sit and stand in a sufficient distance from others - at least in the 1st meter. When in close proximity, a long time (more than 1 hour), follow the distance of 2 meters.
- Avoid sex contacts and sleep alone for three days (within one week, if your wife is pregnant).
- Within 8 days, do not close more than 1-2 meters to children younger age (up to 3 years); If your children are from 3 to 10 years old, if possible, avoid close contacts with them, such as long-term hugs, do not wear them in hand; If you need to perform the care of children up to 2 years, someone else should be careful for them (if possible, agree on the temporary placement of children from relatives and friends).
- Thoroughly wash your hands with soap each time after visiting the toilet.
- Rinse the bath (sink, shower cabin) several times after use.
- When using a toilet, drain the water 2-3 times for 2 weeks after receiving a radioode., Men are recommended to sit down when urine to avoid splashing urine and use toilet paper.
- It is recommended to use the methods of contraception acceptable for you (women - for 6-12 months, men - no less than the first 2 months). Additional information can be obtained from a doctor.
- If you fed the baby with breasts before receiving a radioactive iodine, then after a course of diagnosis or treatment, breastfeeding is interrupted, and the child is transferred to artificial feeding.
- All personal clothes used by staying in the hospital is erased separately, placed in a separate plastic bag (package) and not used for 1.5 months.
- continue to use as often as possible chewing gum, lemon and sour sucking candies during the week (for the fastest cleansing of salivary glands from radioactive iodine).
- If possible, it is necessary to avoid or limit contacts with pregnant women, try to stay from them at a distance of at least 2 meters.
- educators of kindergartens, teachers and other workers who have close contact with children up to 10 years old must be removed from work for the period established by your doctor-oncologist.
- In small quantities after discharge, radioactive iodine will continue to stand out at saliva and sweating. Therefore, cutlery, washcloths, towels, sheets, etc. Must be strictly individual. After normal washing, these things are cleaned. At the same time, there is no particular need to erase such things separately.
- If you suddenly had to go to the hospital, or you were delivered there in an emergency order, please inform your doctor that you recently took a radioactive iodine. This is required in those cases, even if you were taken to the same hospital where you passed a course of radioiodterepia.
You can independently find more information on the Internet, the library's medical section or in the bookstore. Due to the fact that not all the information found may be accurate, remember that your attending physician is the best source of information.

With thyroid cancer, diffuse toxic goiter, other severe pathologies of probe, doctors often apply the non-operational technique with high efficiency. Radioiodterepia - modern method Destroying atypical cells. The use of iodine isotopes - 131 allows you to quickly destroy the tissues of malignant neoplasms. The risk of recurrences, hormonal disorders and complications are lower than with the traditional method of surgical treatment with the removal of the problem body.

To achieve a positive result, it is necessary to properly prepare for radioiodterepia: to change the diet, stop the reception of certain preparations. Important nuances associated with the use of radioactive iodine, the advantages of the method, indications, features postoperative period Describes in the article.

Radioiodtere: what it is

The unique technique stops progression, beta radiation is limited to the affected area, prevents the dissemination of destruction on new areas. Studies of processes for oncopathology - papillary adenocarcinoma confirmed the assumptions of physicians about the active seizure of Iodine isotopes with cancer cells - 131. Atypical cells producing, sensitive to the effects of radiation. The optimal dose of radiation affects the affected areas, which leads to the death of the affected elements. Beta radiation acts directly on the problem area, healthy gland fabrics practically do not have a negative impact.

The first stage is to stimulate secretion (TSH). It is important to ensure that the hormone level increases to 25 mg / ml. The second stage is the reception of a small capsule with iodine - 131. With a yodode deficiency, cancer cells quickly capture iodine. The powerful impact of radioactive isotopes provokes the death of papillary carcinoma tissues, the development of the tumor is terminated. Radionuclides in 8 days are derived from the body.

After a certain period (more often, six months after the procedure) you need to spend the skeleton scintigraphy. Scanning of the skeleton departments on a modern Spect / CT tomograph allows you to identify the stations of the accumulation of radioactive iodine. Metastases develop in these zones. It is important to detect remote foci on time for the timely passage of radiation or chemotherapy to eliminate complications against oncopathology.

Indications for Radioiodterepia:

• papillary and follicular shapes of clutch cancer, other types of malignant process in an important element of the endocrine system;
• diffuse toxic;
• identification of metastases in which iodine is accumulated - 131;
• recurrences after resection of the tissue of the pin surgical treatment Diffuse goiter.

Contraindications

During pregnancy, the radio pooderate is not carried out. The development of the fetus in the mother's womb is an absolute limitation not only for receiving a capsule with iodine - 131, but also for all types of surveys and procedures using iodine isotopes. After radioiodterepia, it is possible to plan pregnancy not earlier than 12 or 24 months.

Another restriction for local irradiation of the tissue of the pin with the use of beta particles is a lactation period. There are no other contraindications for destination.

Advantages of a modern non-operation technique

The modern method of treatment has many positive sides:

• high efficiency: relapses rarely happen;
• there is practically no effect on healthy tissue tissue: radioactive iodine is captured by only altered gland cells, the radius of the iodine isotopes - 131 is from 0.5 to 2 mm;
• the rapid removal of the residues of radionuclides from the body: half-life - 8 days;
• the ability to avoid the operation on the thyroid gland;
• minimum list of restrictions;
• the discomfort in the clutch after the procedure is quickly running after the use of local means and symptomatic treatment;
• there are no lowesthetic scars on the neck, as after the operation;
• the weight of the larynx rarely occurs;
• for the procedure is not needed general anesthesia, the use of which is prohibited in many violations;
• other organs practically do not suffer from the effects of radiation;
• specific rehabilitation period with minimal discomfort: the basic rule is the radiation safety of the surrounding and family members;
• complications arise significantly less frequently than in the surgical treatment of threshing cancer.

disadvantages

It is important to know about the nuances of the application of radioactive iodine:

• will have to abandon breastfeeding, wait with pregnancy planning;
• possible complications in the zone of salivary glands, violation of vision, other side effects;
• after radioiodatery, hypothyroidism is most often developing, a long-term reception of hormonal drugs is needed.

How to prepare for radioiodate

When issuing a direction for radioiodoiodtere the endocrinologist gives the patient a memo with a list of rules required for execution. Violation of requirements reduces the effectiveness of treatment, increases the risk of complications.

The main task of the preparatory stage is to reduce the number of iodine in the body using the correction of medication and diet. The stronger than the iodine deficiency, the more active the cancer cells in the bridge are captured by radioactive isotopes.

2 weeks before the procedure, the patient must limit the following names in the diet:

• milk products;
• preparations with marine algae extracts;
• greens of all kinds;
• seafood;
• bread and buns with food additives containing iodine;
• egg yolk;
• iodized salt;
• sea cabbage;
• beans, especially varieties with bright shades of peel and pulp;
• pizza, mayonnaise, ketchups, sausages, meat and fruit canned food;
• spices;
• japanese and Chinese dishes;
• cherries, bananas, kuragu, apples and mashed potatoes, faja, persimmon, olives;
• cereals, cereals, rice;
• sea fish, black and red caviar;
• vegetables: zucchini, sweet pepper, green peas, cauliflower, potatoes;
• dry dairy porridge;
• meat, turkey.

Learn about diseases, as well as about the structure and functions of important organs in the human body.

On the norm of glycated hemoglobin in men, as well as the reasons and symptoms of deviations, is written page.

Go to and read about the features of the treatment of the thyroid gland in women folk remedies At home.

Reception of drugs:

• refuse iodine-containing bars and medicines: potassium iodide, iodbalance, antistroin;
• temporarily impossible to take amiodarone and cordaron, NSAIDs, progesterone, salicylates;
• a month before the start of therapy, the reception is canceled, in 10 days - triiodothyronine to actively increase the values \u200b\u200bof the thyrotropic hormone;
• for 20-30 days before the procedure, it is forbidden to make a iodine mesh, using an iodine alcohol solution for processing wounds and scratches.

Important! For accommodation by the sea for 7-10 days, it is necessary to leave the radiooiodterepia to leave the habitual area so that the content of the iodine is reduced in the body, which is rich in the seaside air and water in a natural salt reservoir.

How treatment is carried out

The patient passes radioiodohydrate in the hospital. The first stage is the reception of the capsule, which contains the optimal dose of iodine isotopes - 131.

After the procedure, the patient is in a special chamber, through the walls of which the radioactive radiation does not penetrate. Indoors have an isolated system so that the patient can satisfy the basic needs and physiological functions without negative impact on the medical staff and other patients.

Restoration

The rehabilitation period after the radioOiodatery is less hard than after the operation. Complications and unpleasant sensations arise less often.

After discharge from the hospital, it is important to follow the rules of radiation safety:

• when communicating, observed the optimal distance: to adults - from 1 to 2 m;
• care for kids conducts another family member. You can not approach children up to 3 years closer than 2 meters. It is necessary to dramatically limit communication so that the baby does not receive a radiation impact dose;
• before discovering from the hospital, doctors advise to dispose of all clothes, hygiene objects and bedding, so as not to carry home radiation sources. In the medical institution there are special lead containers, delaying radioactive particles;
• at home you need to thoroughly rinse the bathroom, sink, toilet, shower, tile on the floor and walls after the daily hygienic procedures;
• be sure to thoroughly wash your hands, use a lot of water so that iodine particles remain left on the palms - 131;
• be sure to highlight a patient after radioiodatery a separate cutlery, room shoes, towel, washcloth, comb, other accessories;
• if the procedure was held by an employee of a children's institution, then contact with the wards was allowed only to indicate a doctor after a certain period;
• be sure to prevent pregnancy for 12-24 months after carrying out the non-operational treatment of oncopathologies in the tissues of the thyroid gland;
• when developing severe infectious diseases, an acute state at which hospitalization is required is, it is important to prevent physicians about the recent local irradiation of the affected organ. It is necessary to comply with the rules that other patients and the hospital medical staff receive an unnecessary dose of radiation.

Consequences and complications

After the procedure and local irradiation of the thyroid gland, side effects are possible:

• unpleasant feelings in the throat;
• unfortunate weakness;
• weight fluctuations;
• vision impairment;
• nausea attacks;
• aggravation of liver diseases, stomach;
• narrowing of the salivary glands;
• weakness I. painful feelings in muscles.

The use of local means and drugs for symptomatic therapy quickly eliminates negative manifestations. Unlike an operation on an eye on a cancer tumor, the reception of the capsule with iodine isotopes is less affected by the well-being. Be sure to get high-quality products, follow the regularity of food intake, avoid overeating or refusing food against the background of nausea.

When identifying oncopathologists, thyrotoxicosis, nodal zoba, other severe lesions of the endocrine organ of a good alternative operation is radio pooderate. The use of modern methods using iodine isotopes - 131 is an efficient and safe method of thyroid cancer therapy, other hard diseases without pain and serious consequences for the body. Compliance with all radiation safety rules during the recovery period avoids the impact of radiation on physicians and family members.

In the next roller, the meaning of the use of a radioode is briefly highlighted in the treatment of thyroid cancer: