BRIEF COMMUNICATION

Year : 2017  |  Volume : 14  |  Issue : 3  |  Page : 122-123

Patients' instuction list for radioactive iodine I-131 treatment (for hyperthyroidism management)

Rashmi Aggarwal¹, Sanjay Kalra^2
1 Department of Thyroid and Endocrine Research, Institute of Nuclear Medicine and Allied Sciences, DRDO, Ministry of Defence, New Delhi, India
² J of Social Health in Diabetes (JoSH Diabetes), Bharti Hospital and B.R.I.D.E., Karnal, India

Correspondence Address:
Rashmi Aggarwal
Department of Thyroid and Endocrine Research, Institute of Nuclear Medicine and Allied Sciences, DRDO, Ministry of Defence, New Delhi - 110 054
India

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/trp.trp_13_17

This patient information guide sets out instructions for patients who plan to undergo radioactive iodine ablation for the management of uncontrolled hyperthyroidism. This information, shared in a reader-friendly format, will benefit both patients and health-care providers.

Keywords: Antithyroid drugs, Graves' disease, medication counseling, patient counseling, radioablation

Patient Instructions

• Take a low-iodine diet for 7–14 days before radioactive iodine (RAI) therapy to improve radioiodine uptake by the gland. A low-iodine diet is one which contains <50 mcg of iodine per day
• Discontinues antithyroid medications (propylthiouracil, carbimazole, or methimazole) should be 5–7 days before RAI therapy
• Avoid using iodized salt, seafood, seaweed and kelp, and other iodine-containing food for 7–14 days before RAI therapy
• Stop iodine-containing multivitamins and cough syrups 7–14 days before RAI therapy
• Do not use iodine-containing radiographic contrast agents 3–4 weeks before RAI therapy
• Withhold amiodarone (C₂₅H₂₉I₂ NO₃), an antiarrhythmic drug, which contains iodine 3–6 months before therapy
• Pregnancy and lactation are absolute contraindications to RAI therapy.

• Do not eat anything after 8 am
• Do not eat or drink anything 60 min after receiving RAI
• After therapy, you can directly go home. If possible, drive back home alone.

• Flush the toilet twice after use; keep the lid down during flushing
• Males should sit down during urination to prevent contamination of the toilet
• After brushing teeth, rinse the sink with plenty of water ^[1]
• Sleep alone
• Avoid kissing and close physical contact with others
• Avoid contact with pregnant and lactating females as well as infants and children up to 12 years of age
• Do not share utensils of the patient and wash them separately
• Do not share towels, bed linen, and undergarments
• Wash clothes separately, especially if they are stained with saliva, urine, or other body secretions ^[2]
• Wipe the mouthpiece of the telephone after use using a damp wipe and dump it in a plastic bag.

• Breastfeeding should be discontinued 6 weeks before RAI therapy
• Breastfeeding should not be restarted after RAI therapy
• Breastfeeding is allowed if the woman conceives after 6–12 months of therapy.

References

1.	Zanzonico PB. Radiation dose to patients and relatives incident to 131I therapy. Thyroid 1997;7:199-204.
2.	Alexander EK, Larsen PR. High dose of (131) I therapy for the treatment of hyperthyroidism caused by Graves' disease. J Clin Endocrinol Metab 2002;87:1073-7.

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