Interesting reading about RAI

[Guest guest]

RAI or not RAI?So I guess Topper is an Atomic Woman...read on....

RAI or not RAI?

RAI or not RAI?

This is probably the hottest question on the treatment of Graves' Disease

(hyperthyroidism) today.

RAI is RadioActive Iodine treatment in which the hyperthyroid patient is

given a " cocktail " with radioactive iodine which goes to the thyroid and

destroys much of its function.

Most doctors in the U.S. push RAI very heavily and try to get their

patients to undergo it ASAP. Most doctors in Europe don't push RAI but favor

maintenance on antithyroid drugs (ATDs) because of the high rate of

" spontaneous " remissions and the possibility that RAI causes permanent damage to

the body and may significantly increase the risk of cancer.

I think RAI is barbaric and insane and should never even be considered.

Hopefully someday it will lie among the skeletons in the medical treatment

closet. I also think that getting the radioiodine uptake test is a mistake and

can cause damage to the thyroid and eyes. I really don't see the need for

performing it.

The Atomic Women are a group of women (and hopefully some men) who have

undergone RAI and now regret it. Read about their thoughts. New website

(11-29-00) (http://suite101.com/myhome.cfm/atomicwomen

Following is a quote from Gofman. Please read his credentials

because he is very knowledgeable about the use of radiation in medicine:

" In radiation research, nearly all the work is sponsored by the

governments which are defending and promoting nuclear power . . . Ionizing

radiation may well be the most important single cause of cancer, birth defects

and genetic disorders . . . The stakes for human health are very, very high in

radiation matters. It is essential that people take no chance that

conflict-of-interest is producing radiation databases which cannot be trusted. " "

JOHN GOFMAN

Gofman is Professor Emeritus of Medical Physics at the

University of California at Berkeley, and Lecturer at the Department of

Medicine, University of California School of Medicine at San Francisco.

He is the author of several books and more than a hundred scientific

papers in peer-review Journals, in the fields of nuclear/physical chemistry,

coronary heart disease, ultracentrifugal analysis of the serum lipoproteins, the

relationship of human chromosomes to cancer, and the biological effects of

ionizing radiation with particular reference to cancer-induction.

In 1971 Gofman founded the Committee for Nuclear Responsibility, a small,

non-profit, public interest association with three Nobel Laureates on its Board.

Among other Recent Honors and Awards, he received in December 1992, in

Stockholm, Sweden: " The Right Livelihood Award " of the Right Livelihood

Foundation, widely known as " The Alternative Nobel Prize " .

Dr. Jakob von Uexkull's statement, in presenting the award for

Gofman's " pioneering work in exposing the health effects of low-level

radiation, " was:

" The Right Livelihood Award for vision and work forming an essential

contribution to making life more whole, healing our planet, and uplifting

humanity. "

For more information on radiation, see:

http://www.ratical.org/radiation/NRBE/NRBE8.html

STUDIES:

Lancet 1999 Jun 19;353(9170):2111-5

Cancer incidence and mortality after radioiodine treatment for

hyperthyroidism: a population-based cohort study.

lyn JA, Maisonneuve P, Sheppard M, Betteridge J, Boyle P

Department of Medicine, University of Birmingham, UK.

BACKGROUND: Radioiodine is used increasingly as first-line treatment for

hyperthyroidism, but concerns remain about subsequent risk of cancer, especially

in those treated at a young age. We investigated cancer incidence and mortality

in patients treated with radioiodine for hyperthyroidism. METHODS: We did a

population-based study in 7417 patients treated in Birmingham, UK, between 1950

and 1991. We compared details of all cancer diagnoses and deaths in 1971-91 from

the UK Office for National Statistics with data on cancer incidence and

mortality for England and Wales specific for age, sex, and period. FINDINGS:

During 72,073 person-years of follow-up, 634 cancer diagnoses were made,

compared with an expected number of 761 (standardised incidence ratio [sIR] 0.83

[95% CI 0.77-0.90]). The relative risk of cancer mortality was also decreased

(observed cancer deaths 448, expected 499; standardised mortality ratio [sMR]

0.90 [0.82-0.98]). Incidence of cancers of the pancreas, bronchus, trachea,

bladder, and lymphatic and haemopoietic systems was lowered. Mortality from

cancers at all these sites was also reduced but findings were significant only

for bronchus and trachea. There were significant increases in incidence and

mortality for cancers of the small bowel (SIR 4.81 [2.16-10.72], SMR 7.03

[3.16-15.66]) and thyroid (SIR 3.25 [1.69-6.25], SMR 2.78 [1.16-6.67]), although

absolute risk of these cancers was small. INTERPRETATION: The decrease in

overall cancer incidence and mortality in those treated for hyperthyroidism with

radioiodine is reassuring. The absolute risk of cancers of the small bowel and

thyroid remain low, but the increased relative risk shows the need for long-term

vigilance in those receiving radioiodine.

Comments:

Comment in: Lancet 1999 Sep 25;354(9184):1122

PMID: 10382695, UI: 99310068

Success Rate of Radioiodine Therapy in Graves' Disease: The Influence

of Thyrostatic Medication by Sabri O, Zimny M, Schulz G

J Clin Endocrinol Metab 84(4):1229-1234, April 1999

The usual treatment for Graves' disease is radioiodine (131I) therapy,

but the use of thyrostatic medication with this therapy may decrease

its effectiveness. This study attempted to determine the rate of

effectiveness of 131I with and without concomitant use of carbimazole

by prospectively studying 207 patients with Graves' disease. One

hundred six patients were treated with 131I therapy and carbimazole and

101 were treated with 131I only. Patients were evaluated at 3, 6, and

12 months after therapy. The non-carbimazole group had a success

(euthyroid 6 months after therapy) rate of 93% and the carbimazole

group had a success rate of 49%. Logistic regression indicated that

there was an association between failure and the administration and

dose of carbimazole despite the increased dose of 131I when given

carbimazole.

Acta Endocrinol (Copenh) 1990 Feb;122(2):233-40

Peripheral blood T cell activation after radioiodine treatment for Graves'

disease.

Teng WP, Stark R, Munro AJ, Young SM, Borysiewicz LK, Weetman AP

Department of Medicine, University of Cambridge Clinical School,

Addenbrooke's Hospital, UK.

Radioiodine therapy for Graves' thyrotoxicosis produces a rise in thyroid

autoantibodies in the first three months after treatment, but little is known of

its effects on T cells. We have therefore followed the changes in T cell subsets

in sequential samples from 23 patients with Graves' disease treated with

radioiodine, using dual-colour flow cytometry. In the first month after

treatment there was a significant rise in activated T cells, identified by the

markers HLA-DR (la) and CDw26/Ta1 (p less than 0.025 in both cases).

CD45RO-positive T cells, which are the primed population containing memory

cells, also increased (p less than 0.025), but there was no change in

CD45R-positive, resting T cells or in the CD4 to CD8 (helper to

cytotoxic/suppressor) ratio. Vicia villosa-binding T cells, containing the

contrasuppressor population, showed a more variable response, but the trend was

to an overall increase from pre-treatment values (p less than 0.025). The

changes did not appear to be related to antithyroid drug treatment, since they

were seen irrespective of whether patients continued such therapy. These results

suggest that T cell activation and enhanced contrasuppressor activity may in

part be responsible for the rise in autoantibodies after radioiodine. The T cell

changes could also contribute to the worsening of ophthalmopathy seen in some

radioiodine-treated patients.

PMID: 2316311, UI: 90195418

The following letter is from: daisy@... (Elaine )

If you're thinking of becoming pregnant, you don't want to have RAI.

Recent studies show that chromosomal changes caused by radioiodine can be

passed to the next generation. Like DES and other hormonal

disruptors, the effects are stronger and more significant when passed

on to children, and often, these changes aren't evident for 30 years

or so. Also, several recent studies show a slight but significant risk

of increased cancer mortality for several types of cancer in patients

who had RAI. I had RAI which I regret and now have an atrophied

pancreas. One study shows an increase of pancreatic cancer after RAI.

Also, the antibodies which increase after RAI persist for years and

may be transferred to the fetus, causing transient thyroid problems.

Eleven years after RAI, I have high levels of thyroid antibodies and

mitochondrial antibodies. See Dr. Stoll's site for examples of what

happens when you don't address the underlying causes of autoimmunity.

Remember, the thyroid is the victim, not the cause.

You do, however, need to get your thyroid levels under control before

you become pregnant since there is a chance that your symptoms will

worsen in early pregnancy and in the postpartum period. For the most

part, pregnancy brings relief of symptoms since there's immune system

suppression.

ATD's can be used during pregnancy, but there is a slight risk of

fetal hypothyroidism, especially with Tapazole. If you can at least

lower your dose, it would help, and there are many things you can do

to help in this regard. Diet and stress reduction seem to be the most

important. Eat plenty of goitrogens, foods which act like ATD's

(cabbage, cauliflower, almonds, peaches, soy, peanuts, etc.) Reduce

your dairy, saturated fats, sugar, and iodine. GD is associated with

many nutrient deficiencies, particularly free fatty acids, vitamins

C, E, B, copper, magnesium, etc. See 's supplement list on

this site.

Stress reduction methods, either meditation, tai chi, or yoga and energy

healing, like acupuncture, etc. are all of great value. Sometimes, though,

there's lots of stress involved with trying to get everything right. Then,

surgery is a viable option if your symptoms seem to be life threatening. By the

way, your levels are high but not extremely high. What's important, though, is

how much they have changed and if you're seeing improvement with your ATD's.

Following is a great, must-read historical review of the use of radiation

in medicine. It's an unbelievable history and it makes you not want to be a

part of it.

From: j_alicia39@... ()

Hi you all,

The long paper below, might seem being out of track at a hyperthyroidism

board. But those considering RAI or already RAI'ed are couteously suggested to

read it carefully. Some of the data it contains have sometimes been quoted at

our atomicwomen mailing-list and yahoo club. (links at the bottom). Drs. Wood,

and Rigdeway, in their book " Your thyroid a home reference " , quote how

over 2.000.000.- children and adolescents in USA were given X-rays between

1920's and 1960's for problems like enlarged tonsils or adenoids, birthmarks,

whooping cough, acne and ringworm of the scalp. They add: " " Subsequent

large-scale studies of thyroid cancer frequency in radiated and non radiated

control groups have established beyond doubt the relationship between radiation

exposure and thyroid cancer " " .

The Major Cause Of Cancer, Part 1

's Environment And Health Weekly #691 3-21-00

When Wilhelm Roentgen first discovered X-rays, in 1895, " doctors and

physicians saw the practical potential of X-rays at once, and rushed to

experiment with them. " [1,pg.7] Many physicians built their own X-ray equipment,

with mixed results: some home-brew X-ray machines produced no radiation

whatsoever, others produced enough to irradiate everyone in the next room.

The ability to see inside the human body for the first time was a

marvelous, mysterious and deeply provocative discovery. Roentgen trained X-rays

on his wife's hand for 15 minutes, producing a macabre image of the bones of her

hand adorned by her wedding ring. Roentgen's biographer, Otto Glasser, says Mrs.

Roentgen " could hardly believe that this bony hand was her own and shuddered at

the thought that she was seeing her skeleton. To Mrs. Roentgen, as to many

others later, this experience gave a vague premonition of death, " Glasser

wrote.[1,pg.4]

Within a year, by 1896, physicians were using X-rays for diagnosis and as

a new way of gathering evidence to protect themselves against malpractice suits.

Almost immediately -- during 1895-96 -- it also became clear that X-rays could

cause serious medical problems. Some physicians received burns that wouldn't

heal, requiring amputation of their fingers. Others developed fatal cancers.

At that time, antibiotics had not yet been discovered, so physicians had

only a small number of treatments they could offer their patients; X-rays gave

them a range of new procedures that were very " high tech " -- bordering on the

miraculous -- and which seemed to hold out promise to the sick. Thus the medical

world embraced these mysterious, invisible rays with great enthusiasm.

Understandably, physicians at thetime often thought they observed therapeutic

benefits where controlled experiments today find none.

At that time -- just prior to 1920 -- the editor of AMERICAN X-RAY JOURNAL

said " there are about 100 named diseases that yield favorably to X-ray

treatment. " In her informative history of the technology, MULTIPLE EXPOSURES;

CHRONICLES OF THE RADIATION AGE, Caufield (see REHW #200, #201, #202),

comments on this period: " Radiation treatment for benign [non-cancer] diseases

became a medical craze that lasted for 40 or more years. " [1,pg.15] " ...[L]arge

groups of people [were] needlessly irradiated for such minor problems as

ringworm and acne.... Many women had their ovaries irradiated as a treatment for

depression. " [1,pg.15] Such uses of X-rays would today be viewed as quackery, but

many of them were accepted medical practice into the 1950s. Physicians weren't

the only ones enthusiastic about X-ray therapies. If you get a large enough dose

of X-rays your hair falls out, so " beauty shops installed X-ray equipment to

remove their customers' unwanted facial and body hair, " Caufield

reports.[1,pg.15]

Roentgen's discovery of X-rays in 1895 led directly to Henri Becquerel's

discovery of the radioactivity of uranium in 1896 and then to the discovery of

radium by Marie Curie and her husband Pierre in 1898, for which Becquerel and

the Curies were jointly awarded the Nobel prize in 1903. (Twenty years later

Madame Curie would die of acute lymphoblastic leukemia.)

Soon radioactive radium was being prescribed by physicians alongside

X-rays. Radium treatments were prescribed for heart trouble, impotence, ulcers,

depression, arthritis, cancer, high blood pressure, blindness and tuberculosis,

among other ailments. Soon radioactive toothpaste was being marketed, then

radioactive skin cream. In Germany, chocolate bars containing radium were sold

as a " rejuvenator. " [1,pg.28] In the U.S, hundreds of thousands of people began

drinking bottled water laced with radium, as a general elixir known popularly as

" liquid sunshine. " As recently as 1952 LIFE magazine wrote about the beneficial

effects of inhaling radioactive radon gas in deep mines. Even today The Merry

Widow Health Mine near Butte, Montana and the Sunshine Radon Health Mine nearby

advertise that visitors to the mines report multiple benefits from inhaling

radioactive radon,[2] even though numerous studies now indicate that the only

demonstrable health effect of radon gas is lung cancer.

Thus the medical world and popular culture together embraced X-rays (and

other radioactive emanations) as miraculous remedies, gifts to humanity from the

foremost geniuses of an inventive age.

In the popular imagination, these technologies suffered a serious setback

when atomic bombs were detonated over Japan in 1945. Even though the A-bombs

arguably shortened WW II and saved American lives, Hersey's description of

the human devastation in HIROSHIMA forever imprinted the mushroom cloud in the

popular mind as an omen of unutterable ruin. Despite substantial efforts to cast

The Bomb in a positive light, radiation technology would never recover the

luster it had gained before WW II.

Seven years after A-bombs were used in war, Dwight Eisenhower set the U.S.

government on a new course, intended to show the world that nuclear weapons,

radioactivity and radiation were not harbingers of death but were in fact

powerful, benign servants offering almost-limitless benefits to humankind. The

" Atoms for Peace " program was born, explicitly aimed at convincing Americans and

the world that these new technologies were full of hope, and that nuclear power

reactors should be developed with tax dollars to generate electricity. The

promise of this newest technical advance seemed too good to be true --

electricity " too cheap to meter. " [3]

The Atomic Energy Act of 1946 created the civilian Atomic Energy

Commission but as a practical matter the nation's top military commanders

maintained close control over the development of all nuclear technologies.[4]

Thus by a series of historical accidents, all of the major sources of

ionizing radiation fell under the purview of people and institutions who had no

reason to want to explore the early knowledge that radiation was harmful. In

1927, Hermann J. Muller had demonstrated that X-rays caused inheritable genetic

damage, and he received a Nobel prize for his efforts. However, he had performed

his experiments on fruit flies and it was easy, or at least convenient, to

dismiss his findings as irrelevant to humans.

In sum, to physicians, radiation seemed a promising new therapy for

treating nearly every ailment under the sun; for the military and the Joint

Commmission on Atomic Energy in Congress it unleashed hundreds of billions of

dollars, a veritable flood of taxpayer funds, most of which came with almost no

oversight because of official secrecy surrounding weapons development; and for

private-sector government contractors like Union Carbide, Monsanto Chemical Co.,

General Electric, Bechtel Corporation, DuPont, Marietta and others -- it

meant an opportunity to join the elite " military-industrial complex " whose

growing political power President Eisenhower warned against in his final address

to Congress in 1959.

Throughout the 1950s the military detonated A-bombs above-ground at the

Nevada Test Site, showering downwind civilian populations with radioactivity.[5]

At the Hanford Reservation in Washington state, technicians intentionally

released huge clouds of radioactivity to see what would happen to the human

populations thus exposed. In one Hanford experiment 500,000 Curies of

radioactive iodine were released; iodine collects in the human thyroid gland.

The victims of this experiment, mostly Native Americans, were not told about it

for 45 years.[6,pg.96] American sailors on ships and soldiers on the ground were

exposed to large doses of radioactivity just to see what would happen to them.

The military brass insisted that being showered with radiation is harmless.

In his autobiography, Karl Z. , who served as radiation safety

director at the Oak Ridge National Laboratory (Clinton, Tennessee) from 1944 to

1971, recalls that, " The Veterans Administration seems always on the defensive

to make sure the victims are not compensated. " [6,pg.10 1] recounts the

story of D. erman, a Navy man who received large doses of radiation

during A-bomb experiments on Bikini Atoll in 1946. writes, " The Veterans

Administration denied any connection to radiation exposure until 1988, when it

had awarded his widow benefits. By the time of his death, erman's body was

almost consumed by cancers of the lung, bronchial lymph nodes, diaphragm,

spleen, pancreas, intestines, stomach, liver, and adrenal glands. In 1989, a

year after it had awarded the benefits, the VA revoked them from erman's

widow. " [6,pg.101]

Starting in the 1940s and continuing into the 1960s, thousands of uranium

miners were told that breathing radon gas in the uranium mines of New Mexico was

perfectly safe. Only now are the radon-caused lung cancers being tallied up, as

the truth leaks out 50 years too late.

In retrospect, a kind of nuclear mania swept the industrial world. What

biotechnology and high-tech computers are today, atomic technology was in the

1950s and early 1960s. Government contractors spent billions to develop a

nuclear-powered airplane -- even though simple engineering calculations told

them early in the project that such a plane would be too heavy to carry a useful

cargo.[4,pg.204] Monsanto Research Corporation proposed a plutonium-powered

coffee pot that would boil water for 100 years without a refueling.[4,pg.227] A

Boston company proposed cufflinks made of radioactive uranium for the simple

reason that uranium is heavier than lead and " the unusual weight prevents cuffs

from riding up. " [4,pg.227]

In 1957, the Atomic Energy Commission established its Plowshare Division

-- named of course for the Biblical " swords into plowshares " phrasing in Isaiah

(2:4).[4,pg.231] Our government and its industrial partners were determined to

show the world that this technology was benign, no matter what the facts might

be. On July 14, 1958, Dr. Teller, the father of the H-bomb, arrived in

Alaska to announce Project Chariot, a plan to carve a new harbor out of the

Alaska coast by detonating up to six H-bombs. After a tremendous political fight

-- documented in Dan O'Neill's book, THE FIRECRACKER BOYS[7] -- the plan was

shelved. Another plan was developed to blast a new canal across Central America

with atomic bombs, simply to give the U.S. some leverage in negotiating with

Panama over control of the Panama Canal. That plan, too, was scrapped. In 1967,

an A-bomb was detonated underground in New Mexico, to release natural gas

trapped in shale rock formations. Trapped gas was in fact released, but -- as

the project's engineers should have been able to predict -- the gas turned out

to be radioactive so the hole in the ground was plugged and a bronze plaque in

the desert is all that remains visible of Project Gasbuggy.[4,pg.236]

In sum, according to NEW YORK TIMES columnist H. Metzger, the Atomic

Energy Commission wasted billions of dollars on " crackpot schemes, " all for the

purpose of proving that nuclear technology is beneficial and not in any way

harmful.[4,pg.237]

The Plowshare Division may have been a complete failure, but one lasting

result emerged from all these efforts: A powerful culture of denial sunk deep

roots into the heart of scientific and industrial America.

[To be continued April 13.]

Descriptor terms: radiation; nuclear weapons; nuclear power; x-rays;

cancer; carcinogens; karl z. morgan; downwinders; nevada test site; hanford;

============== [1] Caufield, MULTIPLE EXPOSURES; CHRONICLES OF

THE RADIATION AGE (New York: Harper & Row, 1989). ISBN [2] Jim Robbins, " Camping

Out in the Merry Widow Mine, " HIGH COUNTRY NEWS Vol. 26, No. 12 (June 27, 1994),

pgs. unknown. See http://www.hcn.org/1994/jun27/dir/reporters.html. And see

http://www.roadsideamerica.com/attract/MTBASradon.html [3] Arjun Makhijani and

Saleska, THE NUCLEAR POWER DECEPTION; U.S. NUCLEAR MYTHOLOGY FROM

ELECTRICITY " TOO CHEAP TO METER " TO " INHERENTLY SAFE " REACTORS (New York: The

Apex Press, 1999). ISBN 0-945257-75-9. [4] H. Metzger, THE ATOMIC

ESTABLISHMENT (New York: Simon & Schuster, 1972). ISBN 671-21351-2. [5]

D', ATOMIC HARVEST (New York: Crown Publishers, 1993). ISBN

0-517-58981-8. And: Chip Ward, Canaries on the Rim: Living Downwind in the West

(New York: Verso, 1999). ISBN 1859847501. [6] Karl Z. and Ken M.

, THE ANGRY GENIE; ONE MAN'S WALK THROUGH THE NUCLEAR AGE (Norman,

Oklahoma: University of Oklahoma Press, 1999). ISBN 0-8061-3122-5. [7] Dan

O'Neill, THE FIRECRACKER BOYS (New York: St. 's Press, 1994). ISBN

0-312-13416-9.

Some lines from " Your thyroid " , by Dr Lawrence Wood et al.: In the 1920's

physicians began to use radiation (X rays) to treat non cancerous disorders. One

of the more common problems that was treated in this manner was an enlargement

of the thymus gland in newborns. The thymus gland is located behind the

breastbone and is important for normal immune function.

Other conditions treated in this manner included enlarged tonsils or

adenoids, birthmarks, whooping cough, acne, and ringworm of the scalp. Treatment

was given by meanss of an X-ray machine ( " external beam irradiation " ) or by

placing radioactive material, such as radium, directly in or on the tissue to be

treated. For many years radiation was considered good medical therapy for some

of these problems. For example deafness was improved when radium treatments

shrank enlarged lymph tissue compressing the internal ear canal. Acne could be

markedly improved by radiation, resulting in less facial scarring.

In short, radiation therapy was used because it seemed safe and effective.

Unfortunately the thyroid gland, located as it is in front of the neck, often

received radiation inadvertently during treatment for these conditions. In the

1950's physicians began to notice an increased number of benign and malign

thyroid tumors among patients who had been given radiation therapy years

earlier. The fact that the radiation had caused the thyroid tumors was

substantiated when it was found that many individuals exposed to atomic-bomb

radiation or fallout also developed thyroid tumors in later years. When these

facts became known, these forms of radiation therapy were of course

discontinued.

Nevertheless it is estimated that two million people in the United States

received radiation treatments in childhod or adolescence between 1920 and the

early 1960s. Subsequent large-scale studies of thyroid-cancer frequency in

radiated and nonradiated control groups have established beyond doubt the

relationship between radiation exposure and thyroid cancer.

Subj: [hyperthyroidism] Re: Back to the Basics -- (Again)

Date: 1/31/00 8:16:19 PM !!!First Boot!!!

From: j_alicia39@... (julia c amado)

Reply-to: hyperthyroidismegroups

To: hyperthyroidismegroups

>From: Doug

Date: Wed, 16 Feb 2000 20:13:56 -0500

Dear AntJoan,

In your previous message to , you wrote: " RAI seems to cause a lot

of problems down the road, which the doctors don't warn us about. " Can you send

us a pretty comprehensive list of problems? Our doctors say that by taking

synthoid, life returns to normal forever. What do you know that they're not

telling?

Doug

Hi Doug,

I got ophthalmopathy ten months after having RAI. I was not even

warned about the possibility!. I did not have ophthalmopathy prior RAI, but

developed it some 10 months later, and was clearly induced by it. Although there

are endos that don't relate TAO/TED to RAI, most of them accept it does.

The current (1998) edition of ' Texbook of Clinical Endocrinology

states that RAI is responsible for the development of TED and pretibial myxedema

and exacerbates these conditions when they're already present. Current medical

books are now listing ATD's as the treatment of choice. The Text had

already demoted RAI from first place, back in 1994, but found occasions where it

was the best choice, f.i. for patients allergic to ATDs who are poor surgical

candidates, (2nd choice after ATDs) due to advanced age or a coexisting disease

making these patients a surgical risk. An article in the New England Journal of

Medicine (Jan 8, 1998--Vol. 338, No. 2) that studied the occurrence of TED after

RAI showed in its results that 15% of the 150 treated with RAI developed or

worsened the TED. The patient's they studied had slight or NO TED before having

the RAI. With the group that took the RAI and steroids (145 patients) 50 of the

75 that had TED had improvement and NO patient had progression.

DeGroot et al quote:

" I131 therapy causes an increase in titers of TSH-RAbs, and anti-TG or

TPO antibodies, which reflects an activation of autoimmunity. It probably is due

to release of thyroid antigens by cell damage, or destruction of intrathyroidal

T cells. " Although completely satisfactory statistical proof is lacking, many

thyroidologists are convinced that 131I therapy can lead to exacerbation of

infiltrative ophthalmopathy, perhaps because of this immunologic response.

" Tallstedt and associates have published data indicating that 131-I therapy

causes exacerbation of ophthalmopathy innearly 25% of patients, while surgery is

followed by this response in about half as many. Thus, as described below,

patients with significant ophthalmopathy may receive corticosteroids along with

131I, or may be selected for surgical management. "

More:

A study in the Lancet Journal of Medicine from June 1999 reports that

those of us who had RAI have a significantly higher incidence of thyroid and

small bowel cancer. That is not strange: guts and thyroid share the same

embryogenic origin. This subject had been already reported at The New England

Journal of Medicine -- March 12, 1998 -- Vol. 338, No. 11 , whose study was

conducted in a cohort of 7209 subjects with hyperthyroidism, treated with

radioactive iodine between 1950 and 1989, which is certainly a high figure of

people for these kind of studies in a rare disease like ours. Not to speak

about radiation received by other organs, germinal cells included. And all

related to becoming hypo after RAI, increasing each year and reaching 80% of

cases ten years later.

It's good another RAI group has been created. The more the best, to get

the word out and help people to take as informed decissions as possible. As I've

already announced here, yet there is a yahoo club founded on Jan 6th.

Those interested can join it at http://clubs.yahoo.com/clubs/atomicwomen.

More from :

Radioactivity only mutates and lately kills cells, so regretfully

radiation doesn't cure anything. It's only mutagenic, many

mutations leading to cancers. One can ask, why is it then used

against cancer when it actually produces it?. Because of its

stochastic effects. And what does this mean?. Stochastic effects are

effects that occur on a random basis with its effect being

independent of the size of dose. The effect typically has no

threshold and is based on probabilities, with the chances of seeing

the effect increasing with dose. Cancer is thought to be a stochastic

effect. So doctors use *high* doses of radioactivity against a

tumor, considering that this will surpass the stochastic effects.

Graves' is not cured either. It destroys, damages tissue, thus

with less thyroid cells to produce hormones, fewer hyper symptoms.

This is what doctors think, .as they also think that after words

" hypo is easier to control " , " one pill a day and you'll be OK " , " T4

is exactly the same hormone your body produces " and " it's all in your

head " .

These are official medical DOGMAS that we, iatrogenic (i.e. medically

caused) hypothyroid know by heart.

So, doses used for Graves' don't ablate the gland, like in

thyroid

cancer, but partially destroy its tissues. The destruction is

achieved with beta particles and high energy gamma radiation emitted

by I-131 on its decay.

And the amount of tissue actually destroyed depends on several

factors:

- iodine uptake by the gland

- bulk of tissue to be destroyed

- length of time radioactive iodine is retained in the gland

- distribution within the tissue

- radiosensitivity of thyroid cells

- dose

- high iodine diet can interfere

- different opinions re. Thyroid blockers role

- degree of hyperthyroidism, etc

Many factors depend on the characteristics of the gland, that differ

among individuals. Given dose is also important, because it's

often very badly calculated. How many people have an eco-doppler

study done prior RAI?. Almost nobody!. How many have a iodine uptake

prior RAI?.Very few. More often than not, doses are given on an

" estimation " basis upon a supposed weight of gland. And even

two or

three protocols, depending on the dose, but there are a number of

doctors who opt for dosing at large to ensure quick hypothyroidism.

Among those who use lower doses, RAI doesn't instantaneously

eradicate the thyroid. It's a process that continues to progress

over several years. There may be a small number of patients that

don't become hypothyroid immediately, but it's been proven

that, within 10 years after RAI, 100% of RAI'ed people is

hypothyroid.

I know of some persons who feel better 1, 2 or 3 years after RAI,

specially because they feel relieved from hyper symptoms. I don't

want to rain over other's parade, but as soon as hypothyroidism

is present, most of them invariably miss and long for their old hyper

days.

There is some more information at AtomicWomen's site. You might

consider visiting it here:

http://www.suite101.com/myhome.cfm/atomicwomen

Regards

From About.com May 30, 2000:

RADIATION DAMAGE MAY BE PASSED TO OFFSPRING

According to researchers in the UK and Russia, reporting in the May 4,

2000 issue of " Nature, " the dangerous health impact of radiation may be

passed down from one generation to the next. The study of mice found

that offspring of mice exposed to radiation had an increased number of

genetic mutations, as did their offspring--even though the two

generations of younger mice had not been exposed to radiation. The

research indicates that some radiation effects may be delayed, leading

to genetic disorders years or decades after exposure. (Source: Nature

2000;405:37.)

July 6, 2000

I don't know if doctors get an actual kickback, but RAI has such bad side

effects, including rendering the patient hypo for life, that the doctor

has a

patient for life--lots of guaranteed income. I am SO GLAD that I listened

to

my own instincts, and not the idiot endo, and did not destroy my thyroid.

So

much of the time Graves disease goes into remission all by itself--why

wouldn't anyone just go on meds and explore alternate healing, rather than

opt for a " final solution, " which is no solution at all, as you will end

up

sicker than when you started? I am certainly not upset about hurting the

poor doctor's feelings w/all of my questions and opinions--I have only one

body, and one life, which are entrusted to me to care for and save, and

are

SO MUCH more important than the doctor's ego. Let's see--weigh the

doctor's

need to feel like he is playing God and is all-knowing against my need to

survive and be healthy. I don't really see a choice here. AntJoan

Subj: [hyperthyroidism] Re: WHY?!?! RAI better than surgery?!?!

Date: 7/7/00

From: tnccline@... ( Cline)

The following is an excerpt from an American medical journal. It

shows the difference between the American doctors' way of thinking

compared to other countries. It also points out there is a 40 to 50

percent remission rate with ATD's.

The New England Journal of Medicine -- January 25, 1996 -- Vol. 334, No. 4

Immunosuppression of Graves' Hyperthyroidism -- Still an Elusive Goal

Fifty years have passed since radioactive iodine and antithyroid drugs

became available for the treatment of hyperthyroidism caused by Graves' disease.

Despite the efficacy of both treatments, opinions still diverge widely as to

which is better. A course of antithyroid-drug therapy requires prolonged daily

treatment, but 40 to 50 percent of patients treated for a year remain euthyroid

after therapy is discontinued. Therapy with iodine-131, on the other hand, is

simple and fast (one dose usually suffices), but the treatment causes

hypothyroidism in a large proportion of patients. In a survey of

endocrinologists, 69 percent of the responding physicians in the United States

preferred iodine-131 for the treatment of a typical patient with Graves'

hyperthyroidism, but an antithyroid drug was preferred by 77 percent of the

respondents in Europe and by 88percent in Japan. (1) Obviously, doctors in the

United States are disappointed by the high rate of recurrence of hyperthyroidism

after the discontinuation of antithyroid-drug therapy, whereas those in Europe

and Japan are more inclined to give the patient a chance to have a spontaneous

remission, thereby avoiding lifelong treatment with thyroxine (T4).

>>>>The entire article can be found at the following:

http://www.nejm.org/content/1996/0334/0004/0265.asp

Subj: RAI

Date: 9/2/00 2:41:22 AM Pacific Daylight Time

From: MsSlipper@...

Reply-to: hyperthyroidismegroups

To: hyperthyroidismegroups

Hi,

Haven't written in awhile but am having lots of difficulties. Had RAI in

1996 for Toxic Multi-nodular Goiter. Was on PTU for a few months previous

to

RAI and started to feel better then I had in years. After RAI I have never

felt well. I have developed double vision in my eyes which is due to a

muscular problem (I'm told) they hurt all the time and my lids are puffy

and

feel like they have sand under them. My optometrist won't renew my eye

glasses until the problem is fixed. If I read or drive the problem gets

worse. My primary care doc had a CAT scan of my head done, which was fine,

I

was then referred to a neurologist who did an MRI and that was fine. He

did

blood work too and found my TSH was .3 My primary then reduced my Levoxyl

to

.75 mcg. from .88 mcg She then sent me to an endo doc who swore I am not

hyper thyroid again nor could the nodules have grown back, because RAI

makes

the thyroid atrophy. She said is unlikely my eye problem has any

connection

to my thyroid, or medication because only Graves patients get eye

problems.

She did however do a thyroid antibody test (I have never had one before)

just

in case I could have Graves as well as having Toxic Multi-Nodular.

For one I am sorry I ever had RAI. I have also developed high blood

pressure

in the last two years which I NEVER NEVER had. I am either hanging off the

ceiling or don't have the pep to tie my sneakers. Anyone out there feel

similar? People are right, read, read, read before you make a decision.

From Zoey:

In May I was diagnosed with HyperT and Graves. 5 Docs(3 endos and 2

internists) urged me to have RAI - the only thing that would work. I told

them RAI was not an option. I began taking 20 mgs of Tapazole a day (

which

was considerably less than they recommended) and within 3 weeks my T4, T3,

TSH, etc. were at the lower (hypo) end of normal range. For the past 2

months or so I have been taking only 2 1/2 mgs of Tapazole a day and my

bloodwork has been stable, normal, and euthyroid. The doctors told me only

RAI would work. I am so thankful I didn't listen to them. I hope you will

take some time to consider your options. Destroying your thyroid gland is

final and frequently causes more problems than it corrects. Please let us

know your decision. with all my best, Zoey

Curr Opin Ophthalmol 1999 Oct;10(5):358-61

New insights into pathogenesis and potential therapeutic options for

Graves orbitopathy.

Warwar RE

Department of Ophthalmology, State University School of Medicine,

Dayton, Ohio 45429, USA.

Graves disease is an autoimmune disorder that affects the seemingly

heterogeneous tissues of the thyroid and orbit. Evidence suggests that these

tissues share a common antigen: the thyroid-stimulating hormone receptor

protein. It is speculated that this antigen (which is present in orbital tissue

in both normal patients and patients with Graves disease), together with the

humoral factors present in the serum of patients with Graves disease, forms the

basis for the immunologic attack seen in Graves ophthalmopathy. Once the immune

response has been activated, a series of pro-inflammatory cytokines propagate

inflammation, leading to the clinical findings typical of Graves ophthalmopathy.

Knowledge of the specific inflammatory mediators involved may someday lead to

the development of specific, clinically available immunomodulatory therapies for

Graves eye disease.

Lancet 2000 Apr 29;355(9214):1505-9

Radiotherapy for Graves' orbitopathy: randomised placebo-controlled

study.

Mourits MP, van Kempen-Harteveld ML, MB, Koppeschaar HP, Tick L,

Terwee CB

Donders Institute of Ophthalmology (Orbital Unit), University Medical

Centre, Utrecht, The Netherlands.

BACKGROUND: The best treatment (steroids, irradiation, or both) for

moderately severe Graves' orbitopathy, a self-limiting disease is not known. We

tested the efficacy of external beam irradiation compared with sham-irradiation.

METHODS: In a double-blind randomised clinical trial, 30 patients with

moderately severe Graves' orbitopathy had radiotherapy (20 Gy in ten fractions),

and 30 were assigned sham-irradiation (ten fractions of 0 Gy). Treatment outcome

was measured qualitatively by changes in major and minor criteria and

quantitatively in several ophthalmic and other variables, such as eyelid

aperture, proptosis, eye movements, subjective eye score, and clinical-activity

score at 24 weeks. FINDINGS: The qualitative treatment outcome was successful in

18 of 30 (60%) irradiated patients versus nine of 29 (31%) sham-irradiated

patients at week 24 (relative risk [RR]=1.9 [95% CI 1.0-3.6], p=0.04). This

difference was caused by improvements in diplopia grade, but not by reduction of

proptosis, nor of eyelid swelling. Quantitatively, elevation improved

significantly in the radiotherapy group, whereas all other variables remained

unchanged. The field of binocular single vision was enlarged in 11 of 17

patients after irradiation compared with two of 15 after sham-irradiation.

Nevertheless, only 25% of the irradiated patients were spared from additional

strabismus surgery. INTERPRETATION: In these patients with moderately severe

Graves' orbitopathy, radiotherapy should be used only to treat motility

impairment.

From: mhorten@... (Horten, Mona)

Good morning....last night a neighbor came over and we chatted while

handing

out candy to the trick-or-treaters. He was rendered hypo several years

ago.

He had RAI. They never bothered to try any of the ATDs. Now he is always

tired, hasn't slept well since RAI and when he gets sick, he stays sicker

longer. He also told me since the RAI his saliva has changed and he can't

lick an envelope or stamp because they won't stay stuck! Weird huh? I have

also noticed he seems " down " lately. I think his thyroid levels are off so

he's going in for blood work. He hates the way he feels! He's 39 years old

and likes all kinds of outdoor activities with his kids and wishes he felt

better. He also told me it took OVER A YEAR before the thyroid was

destroyed and in the meantime had to take meds. Just thought I'd share

this. Mona

[Guest guest]

Hmmmm.... I've read about half of this.. I'm gonna have to sit down and

study it... I'm still bitter about what happened to me... if the first

doc I saw was not such a moron I would have had a choice of treatments...

waiting another 10 months until another doc spotted what was wrong left

me with no choices. I was to hyper to have surgery and two hyper to do

Anti thyroid meds... I was told RAI, right now, or die.... and then given

a form to sign that said I couldn't take action against them - for

anything.

Five minutes to decide.... all because of a moron doc that didn't even

test me when I came in when the storm started.

Topper ()

On Fri, 9 Jan 2004 00:35:08 -0600 " nnichols "

writes:

> RAI or not RAI?So I guess Topper is an Atomic Woman...read on....

> RAI or not RAI?

>

>

>

>

> RAI or not RAI?

>

> This is probably the hottest question on the treatment of

> Graves' Disease (hyperthyroidism) today.

> snip<

[Guest guest]

Hmmmm.... I've read about half of this.. I'm gonna have to sit down and

study it... I'm still bitter about what happened to me... if the first

doc I saw was not such a moron I would have had a choice of treatments...

waiting another 10 months until another doc spotted what was wrong left

me with no choices. I was to hyper to have surgery and two hyper to do

Anti thyroid meds... I was told RAI, right now, or die.... and then given

a form to sign that said I couldn't take action against them - for

anything.

Five minutes to decide.... all because of a moron doc that didn't even

test me when I came in when the storm started.

Topper ()

On Fri, 9 Jan 2004 00:35:08 -0600 " nnichols "

writes:

> RAI or not RAI?So I guess Topper is an Atomic Woman...read on....

> RAI or not RAI?

>

>

>

>

> RAI or not RAI?

>

> This is probably the hottest question on the treatment of

> Graves' Disease (hyperthyroidism) today.

> snip<

[Guest guest]

Hmmmm.... I've read about half of this.. I'm gonna have to sit down and

study it... I'm still bitter about what happened to me... if the first

doc I saw was not such a moron I would have had a choice of treatments...

waiting another 10 months until another doc spotted what was wrong left

me with no choices. I was to hyper to have surgery and two hyper to do

Anti thyroid meds... I was told RAI, right now, or die.... and then given

a form to sign that said I couldn't take action against them - for

anything.

Five minutes to decide.... all because of a moron doc that didn't even

test me when I came in when the storm started.

Topper ()

On Fri, 9 Jan 2004 00:35:08 -0600 " nnichols "

writes:

> RAI or not RAI?So I guess Topper is an Atomic Woman...read on....

> RAI or not RAI?

>

>

>

>

> RAI or not RAI?

>

> This is probably the hottest question on the treatment of

> Graves' Disease (hyperthyroidism) today.

> snip<