Hypo after RAI?
"RAI will cure Graves, as it destroys the thyroid. However, most people become hypoT after a few years, and there is no cure for this--just meds to take for life. Maybe some people do not become hypoT --I would be interested to know how this could be, as RAI destroys the thyroid. Maybe in some people some of the gland is still functioning? Can anyone explain this to me? AJ" Hi AJ, Radioactivity only mutates and eventually kills cells, so regretfully radiation doesn't cure anything. It's only mutagenic. Many mutations lead to cancers. One can ask, why is it then used against cancer when it actually produces it? This is 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, believing that this will surpass the stochastic effects.
These are official medical DOGMAS that we, who are yatrogenic (alt. spelling for iatrogenic, i.e. medically caused) hypothyroid patients, know by heart. They’re often used by NUMBers doctors, i.e. those who faithfully believe in thyroid hormone panels, rather than believing in how the person is feeling. So, doses used for Graves' don't ablate the gland, like in thyroid cancer where higher doses are given, 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:
Many factors depend on the characteristics of the gland, which differ among individuals. Given dose is also important, because it's often very badly calculated. How many people have an eco-doppler color study done prior RAI?. Almost nobody!. How many have a iodine uptake prior RAI to fine tune the dose? Very few. More often than not, doses are given on an "estimation" basis upon a supposed weight of gland. And there are 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 are hypothyroid. We know of some persons who feel better 1, 2 or 3 years after RAI, specially because they feel relieved from hyper symptoms. We don't want to rain on others' parades, but as soon as hypothyroidism is present, most of them invariably miss and long for their old hyper days. |
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The interesting questions below, have recently been posted at thyroid Forum. We have though it could be helpful to bring them here, with our reply, for visitors of this site having similar queries.
Graves' is not cured with RAI either. It destroys, damages tissue, thus with less thyroid cells to produce hormones,
there are fewer hyper symptoms. This is what doctors think, …as they also think that afterwards "hypo is easier to control", "one pill a day and you'll be OK", "T4 is exactly the same hormone your body produces" and finally "it's all in your head".