RAI & salivary glands - repost from the Dr. Ain

[Guest guest]

Below is a letter from Dr. Ain on post-RAI salivary gland problems.

As an aside, I came across this in " Prescription for Nutritional Healing " :

" Excessive iodine intake (over thirty times the RDA) can produce a metallic

taste and sores in the mouth, swollen salivary glands, diarrhea and vomiting. "

It certainly makes sense that the radioactivity itself is doing the damage, but

I can't help wondering if it is possible that these symptoms that so many

experience are due to the large amounts of iodine rather than the radioactivity?

Of course, ultimately it doesn't really matter, since the iodine is an

inextricable part of RAI.

-

NYC (TT 2/99 dx pap/foll; RAI 100 mCi 3/99 & 4/00; currently off meds in

preparation for a scan)

===============================================================

Dear ThyCa Members:

One of the potential nuisances (as opposed to dangers) of radioiodine

therapy is permanent damage to the salivary glands. This may result

in diminished flow rates of saliva. There are a few medical

consequences and solutions:

1) Decreased saliva may make eating certain foods difficult. This

can be helped by using frequent small sips of water while eating.

2) Decreased salivary flow produces increased risk of tooth decay

because saliva is critical to wash food particles off of teeth after

eating. I advise patients to carry a small travel toothbrush kit in

their pocket or purse. They should brush their teeth after EVERY

meal. Sometimes this produces an added benefit by reducing between

meal snacking.

3) Decreased salivary flow predisposes to " salivary stones. " This

refers to the swelling of one or more salivary glands (located under

the ears and under the lower jaw) due to partial blockage of the

corresponding salivary duct by dried saliva. This can be startling

and worrisome if not recognized for what it is. I do not advocate

immediate use of antibiotics unless there is fever and elevated white

blood cell counts. Instead, this problem usually responds to

swishing warm water (or tea, coffee, broth, etc) in the mouth while

gently massaging the swollen salivary gland. Usually, there is a

sudden sour taste as the stale saliva is released and the swelling

goes away. If this does not work or if rapidly and frequently

recurrent, then it is important to go to your physician. Usually

this problem happens periodically and is then quiescent for a long

time.

**************PLEASE BE ADVISED*********************

THE INFORMATION CONTAINED IN THIS COMMUNICATION IS INTENDED

FOR EDUCATIONAL PURPOSES ONLY. IT IS NOT INTENDED, NOR SHOULD

IT BE CONSTRUED, AS SPECIFIC MEDICAL ADVICE OR DIRECTIONS. ANY

PERSON VIEWING THIS INFORMATION IS ADVISED TO CONSULT THEIR OWN

PHYSICIAN(S) ABOUT ANY MATTER REGARDING THEIR MEDICAL CARE.

************************************************

B. Ain, M.D.

Associate Professor of Internal Medicine

Director, Thyroid Nodule & Oncology Clinical Service

Director, Thyroid Cancer Research Laboratory

Division of Endocrinology and Molecular Medicine

Department of Internal Medicine, Room MN524

University of Kentucky Medical Center

800 Rose Street, Lexington, Kentucky 40536-0298

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Laurel Schoonover wrote:

> This is Laurel again and I am in need of some info from anyone including the

> Doctors. I have my next appt. with an ENT Dr. this thursday for my salivary

> gland problem. Never had any problems before RAI Ablation for pap.ca.-150

> mci. Had a sialogram done showing narrowing of the parotid salivary duct.

> ENT and Endo both said it had nothing to do with the thyca but neither one

> of them addressed the issue of RAI. So my Question is could this be an

> aftermath of the radioactive ablation. And could you please send any medical

> documentation or anything the doctors have written concerning this. The ent

> doctor is saying the only cure if it does not resolve itself is surgery to

> remove the gland. I would like to show her some info connecting the to if

> this is the case. Thanks everybody. Have a beautiful.

> laurel