#2 Med. Refs Vs RAI

[Guest guest]

Here's some more References for the top 20!

FROM: Werner and Ingbar’s The Thyroid A Fundamental and Clinical Text,

Eighth Edition.

Page 703

Hypothyroidism:

“Hypothyroidism may be considered an inevitable consequence of RAI therapy,

rather than a side effect” This section goes on to state that Hypothyroidism

may develop in as many as 90% of patients within the first year after

therapy (Ref 243 Cunnien AJ, Hay ID, Gorman CA et al. Radioiodine induced

hypothyroidism in Graves’ disease: factors associated with the increasing

incidence. J Nucl Med 1982; 23:978), with a continuing rate of 2% to 3% per

year thereafter.

Cancer: Page 703

“One report from the Co-operative Thyrotoxicosis follow up study, with a

mean length of 21 years, did find an excess risk of death from thyroid

carcinoma in patients receiving RAI for hyperthyroidism due to toxic

multinodular goiter (262 Ron E, Doody MM, Becker DV, et al. Cancer mortality

following treatment for adult hyperthyroidism. JAMA 1998: 280; 347).

Page 704

Exposure of the rest of the body to RAI 131-I.

“The whole body is exposed to radiation after RAI therapy with gonadal

radiation of particular concern because of gamma irradiation from RAI in

urinary bladder”

Eyes:

Page 704 -705.

“Based on these results, patients with Graves’ thyrotoxicosis should be

counselled that eye disease is more likely to occur after radioiodine

therapy than antithyroid drug (or surgical) therapy. They should also be

counselled about the risks and benefits of adjunctive glucocorticoid

therapy. "

Alot of the stuff I've been reading seems to imply that the risk of

complications or cancer caused by RAI is not very big compared to the risk

of leaving hyperthyroidism untreated. This always seems a bit of an odd

thing to say to me, as no-one thinks it should be left untreated, just that

there are more appropriate and less drastic measures that should be taken

instead, or at the very least first before subjecting the individual to RAI!

Enough from me, cheers

DAWN ROSE

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[Guest guest]

Hey Dawn Marie,

Thanks for the references! I'm still really confused though. My ex-endo, the

one who radiated twice, denied when I called him to tell him that I HAD

exopthalmos that it was possible. Well of course it was possible and even

probable. But that was his excuse for not even offering steroids, or anything

else for that matter. He claimed that an eye problem should be treated by an

opthamologist and demanded the I get an appointment within a day. This was, of

course, without any help on his part. Just get an appointment.

The question is this: Is it reasonable to miss all the symptoms of Graves' if

one is an endocrinologist? He seemed to behave as though what I had was a

simple multinodular goiter and then when problems started claimed it was due to

" the bursting " of the individual nodules. Is that reasonable?

Thanks to all of you guys this is starting to make some sense.

Laurel

#2 Med. Refs Vs RAI

Here's some more References for the top 20!

FROM: Werner and Ingbar’s The Thyroid A Fundamental and Clinical Text,

Eighth Edition.

Page 703

Hypothyroidism:

“Hypothyroidism may be considered an inevitable consequence of RAI therapy,

rather than a side effect†This section goes on to state that Hypothyroidism

may develop in as many as 90% of patients within the first year after

therapy (Ref 243 Cunnien AJ, Hay ID, Gorman CA et al. Radioiodine induced

hypothyroidism in Graves’ disease: factors associated with the increasing

incidence. J Nucl Med 1982; 23:978), with a continuing rate of 2% to 3% per

year thereafter.

Cancer: Page 703

“One report from the Co-operative Thyrotoxicosis follow up study, with a

mean length of 21 years, did find an excess risk of death from thyroid

carcinoma in patients receiving RAI for hyperthyroidism due to toxic

multinodular goiter (262 Ron E, Doody MM, Becker DV, et al. Cancer mortality

following treatment for adult hyperthyroidism. JAMA 1998: 280; 347).

Page 704

Exposure of the rest of the body to RAI 131-I.

“The whole body is exposed to radiation after RAI therapy with gonadal

radiation of particular concern because of gamma irradiation from RAI in

urinary bladderâ€

Eyes:

Page 704 -705.

“Based on these results, patients with Graves’ thyrotoxicosis should be

counselled that eye disease is more likely to occur after radioiodine

therapy than antithyroid drug (or surgical) therapy. They should also be

counselled about the risks and benefits of adjunctive glucocorticoid

therapy. "

Alot of the stuff I've been reading seems to imply that the risk of

complications or cancer caused by RAI is not very big compared to the risk

of leaving hyperthyroidism untreated. This always seems a bit of an odd

thing to say to me, as no-one thinks it should be left untreated, just that

there are more appropriate and less drastic measures that should be taken

instead, or at the very least first before subjecting the individual to RAI!

Enough from me, cheers

DAWN ROSE

_________________________________________________________________

MSN Photos is the easiest way to share and print your photos:

http://photos.msn.com/support/worldwide.aspx

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