top 22 reasons list

[Guest guest]

I thought, myself being the lazy sort who rarely goes to the home page, that

many of you might not yet have seen this list. So here it is. This group

wrote the list and found the citations. I only started the work. I find it a

good reminder to read it once in a while.

Terry

Top Reasons Why I¹ll Never Have RAI

1. It¹s permanent; if you don¹t like the results, too bad

2. Since the science is inexact and dosage a guess at best, it may take

years to be fully effective, or it may have to be repeated (1)

3. Can bring on (induce or cause) thyroid storm as the dying gland " dumps "

(releases) excess thyroid hormone and thyroid antibodies into the body;

RAI also stimulates immune cells within the thyroid gland to produce more

thyroid antibodies. (2)

4. Graves disease is an auto-immune disease, not a disease of the thyroid,

so killing the thyroid doesn¹t stop the disease process; without adequate

thyroid tissue, the antibodies that cause hyperthyroidism may go on to

affect orbital or dermal tissue, causing Graves¹ ophthalmopathy and

pretibial myxedema.

5. Results in hypothyroidism (3)

Whoever said hypothyroidism is easy to treat, was mistaken. Because of the

effects of thyroid antibodies, radiation-induced hypothyroidism is more

difficult to treat than naturally occurring hypothyroidism. Hypothyroidism

caused by treatment for *hyperthyroidism*** is known to cause depression and

anxiety. In one large Dutch study, " over one third of patients with a

full-time job were unable to resume the same work after treatment. It

appears that many of these patients are in need of psychological support.

***this is a correction of an error on the original. Needs to be fixed in

files, if anyone can do that!

6. Being hypothyroid is neither less debilitating nor less dangerous than

hyperthyroid. With hypothyroidism one is at risk of myxedema coma which

can be more deadly than thyroid storm. This results from improper monitoring

and labs tests, keeping us in a hypO state. After radiation-induced

hypothyroidism develops, it takes only 6 weeks without thyroid replacement

hormone for patients to fall into myxedema coma.

7. Increased antibody titers after RAI skew lab test results, adding to

treatment difficulties. In particular, the widely-used TSH test is

influenced by TSH receptor antibodies, causing falsely decreased levels.

8. RAI, aka spent nuclear fuel ( " nuclear waste " , in other words) is absorbed

by other organs and can cause cell death or DNA mutations. RAI is absorbed,

in smaller amounts, by other organs besides the thyroid, including breast

tissue, the genitals, pancreas, and the gastric mucosa.

9. For up to 4-8 weeks after dosage, we¹re exposing those around us to

radioiodine. This is demonstrated by patients registering measurable

radioidine in airport and other screening devices. (7)

10. Studies show an increase in cancers, especially of the thyroid gland and

small bowel, after RAI. (4)

11. Possibility of damaging the parathyroid, causing hypoparathyroidism.

12. RAI can cause difficulty with future attempts to become pregnant and

carry pregnancies to term. RAI is known to affect the ovaries, which is why

patients are recommended to avoid becoming pregnant for at least 6 months

after RAI. The 6 months recommendation was increased to at least one year in

early 2002

13. Chance of thyroid eye disease developing increases dramatically, as RAI

doesn¹t stop antibody production (6)

14. Chance of significant, unhealthy weight gain is increased Studies show

that weight gain is inevitable after radioiodine-induced hypothyroidism (7)

15. Replacement hormone products currently on the market, both synthetic and

glandular, are not comparable to our own hormone, and in some people, never

feel " right " .

16. Ongoing problems as the gland gradually dies, necessitating close

medical surveillance and replacement hormone dosage adjustments which

usually does not happen unless a patient is educated and proactive in their

disease and treatment. Within one year after RAI, most patients are on a

dose of replacement hormone equivalent to 0.1mg levothyroxine; 5-6 years

post RAI, most patients are on 0.175 mg levothyroxine because of the

progression to autoimmune thyroid failure.

17. Increased risk of developing fibromyalgia like symptoms

18. For most GD patients, medication with ATD¹s creates a euthyroid state

similar to " normal life " , and can lead to long-term remission as well. (8)

19. As modern science explores the human genome, a cure for GD could be

found, but after RAI kills the thyroid, it wouldn¹t work. Current research

is directed at modulating the cytokines, immune system chemicals released

during the immune response and necessary for autoantibody production.

Treatments of this nature are already being used successfully in Crohn¹s

disease.

20. I131 is so dangerous it¹s transported in a lead container and kept at

the hospital only for the briefest time before being dispensed by a doctor

shielded in lead from head to toe.

21. When cats are given I-131, they must be kept in a contained facility for

up to 6 weeks until they no longer set off warnings on a geiger counter, yet

people, especially in the U.S.A. are released with in minutes of treatment

on an unsuspecting population. Germany keeps I-131 patients for several days

in a contained radiation facility until their radioactive numbers are in a

*safe* level. Is there REALLY anything *safe* about ingesting I-131? (9)

22. Salivary and tear duct damage from I-131 (10)

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

1 Radioiodine Therapy of Graves Disease; Milton D. Gross, E. Freitas,

C. Sisson and B. Shapiro, Chapter 11, Page 160 " Despite a clinical

experience now amounting to many hundreds of thousands of patients treated

with 131 I for GD, there is still no unanimity as to the selection of the

appropriate dose of 131 I. "

2 Graves Disease, Pathogenesis and Treatment, edited by Basil Rappoport and

M. McLachlan, published by Kluwer Academic Publishers. ISBN

0-7923-7790-7.

Chapter 11, RAI Therapy of GD, Complications and Risks of RAI, pg. 162

(Acute radiation thyroiditis; Exacerbations of thyrotoxicosis (transient));

pg. 164 (thyroid storm)

3. Werner and Ingbar¹s The Thyroid A Fundamental and Clinical Text, Eighth

Edition,

page 703: " 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 Graves¹ disease: factors associated with the increasing incidence. J Nucl

Med 1982; 23:978), with a continuing rate of 2% to 3% per year thereafter.

Also:

Graves Disease, Pathogenesis and Treatment, edited by Basil Rappoport and

M. McLachlan, published by Kluwer Academic Publishers. ISBN

0-7923-7790-7.

Chapter 11, RAI Therapy of GD, Complications and Risks of RAI, pg. 164,

" Eventual hypothyroidism is an expected consequence of 131I treatment for

many patients with Graves¹ disease and can occur within a few weeks, months,

or years after treatment. Since permenant hypothyroidism eventually occurrs

in 5-20% of patients with ATDs, 131 I appears to exaggerate the natural

history of GD " . " (REF DS. 1998 Antithyroid drugs for treatment of

hyperthyroidism. Endocrinal Metab Clin North Amer. 27: 225-248).

4 Werner and Ingbar¹s The Thyroid A Fundamental and Clinical Text, Eighth

Edition,

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 "

Also:

Women with Thyroid Cancer at Risk for Breast Carcinoma

http://thyroid.about.com/gi/dynamic/offsite.htm?site=http://www.newswise.com

/articles/2000/9/CANCER2.AAO.html

(5) Am J Surg 1984 Oct;148(4):441-5 Related Articles, Links Induction of

hyperparathyroidism by radioactive iodine. Rosen IB, Palmer JA, Rowen J, Luk

SC.

PMID: 6486309 [PubMed - indexed for MEDLINE]

(6) Werner and Ingbars The Thyroid A Fundamental and Clinical Text,

Eighth Edition. Page 704 -705.

" Based on these results, patients with Graves¹ thyrotoxicosis should be

counseled

that eye disease is more likely to occur after radioiodine therapy than

antithyroid

drug (or surgical) therapy. They should also be counseled about the risks

and benefits

of adjunctive glucocorticoid therapy. "

And

Therapy of Graves Ophthalmopathy By Leonard Wartofsky, D.Ringel, and

D. Burman,

Chapter 19, page 272: " Since our ability to predict which patient will get

worsening

ophthalmopathy is poor at best, we would urge clinicians to be sensitive to

a possible

worsening of ophthalmopathy after Radioiodine, and to counsel their patients

on the risk

and to document that counselling had been given. Based upon many reports of

rising TSH

receptor antibody titers after 131 I as important to underlying

pathophysiology, and

upon the weight of randomised prospective studies (REF 110, 120, 121) there

exists

some basis to believe that Graves¹ Ophthalmopathy may be worsened by RAI

until proven otherwise "

(7). Is excessive weight gain after ablative treatment of hyperthyroidism

due to

inadequate thyroid hormone therapy?

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_ui

ds=11201857 & dopt=Abstract

(8) According to P. Larsen, writing in ¹ Clinical Textbook of

Endocrinology,

most patients can achieve remission with anti-thyroid drugs. The drugs are

used to both

lower thyroid hormone levels and mildly suppress the immune system until

remission is

achieved. Most side effects of these drugs are related to inappropriately

high doses.

(9). Radioiodine therapy of Graves' disease--quality assurance and radiation

protection]

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_ui

ds=10355053 & dopt=Abstract

(10). Salivary and lacrimal gland dysfunction (sicca syndrome) after

radioiodine therapy.

http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=11337569 & form=6 & db=m

& Dopt=r