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Iodine Therapy – Thyroid Treatment with Iodine

Iodine therapy uses iodine to treat thyroid disorders. It includes radioiodine therapy and targeted iodine supplementation for conditions such as hyperthyroidism or iodine deficiency.

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Things worth knowing about "Iodine Therapy"

Iodine therapy uses iodine to treat thyroid disorders. It includes radioiodine therapy and targeted iodine supplementation for conditions such as hyperthyroidism or iodine deficiency.

What is Iodine Therapy?

Iodine therapy refers to the medical use of iodine to treat or support the treatment of various conditions, most notably thyroid disorders. Iodine is an essential trace element required by the thyroid gland to produce its hormones thyroxine (T4) and triiodothyronine (T3). The therapy can be administered in several forms: as oral iodine (tablets or solution) or as radioiodine therapy using radioactive iodine-131.

Indications

Iodine therapy is used in a variety of clinical situations:

Radioiodine therapy for hyperthyroidism: Radioactive iodine-131 is selectively taken up by the thyroid gland and destroys overactive thyroid tissue.
Radioiodine therapy for thyroid cancer: After surgical removal of the thyroid, iodine-131 is used to eliminate any remaining thyroid tissue or metastases.
Iodine supplementation for iodine deficiency: In iodine-deficient regions or in patients with inadequate iodine intake, targeted supplementation helps prevent hypothyroidism and goiter (enlarged thyroid).
Iodine administration during radiation emergencies: Potassium iodide tablets are used as a protective measure in nuclear accidents to block the uptake of radioactive iodine into the thyroid gland.

Mechanism of Action

Iodine is absorbed in the gastrointestinal tract and transported via the bloodstream to the thyroid gland, which actively takes it up. The thyroid is the only organ that stores and utilizes significant amounts of iodine. In radioiodine therapy, iodine-131 emits beta radiation that destroys surrounding thyroid tissue within a range of only a few millimeters, which minimizes damage to adjacent structures.

How Radioiodine Therapy is Performed

Radioiodine therapy is carried out in specialized nuclear medicine facilities. The process typically involves the following steps:

Preliminary examinations to assess thyroid function and morphology (ultrasound, scintigraphy)
Discontinuation of iodine-containing medications and adoption of a low-iodine diet before treatment
Oral administration of an iodine-131 capsule or solution
Inpatient stay until radiation exposure levels fall below regulatory limits
Follow-up examinations to evaluate treatment success

Side Effects and Risks

Iodine therapy is generally well tolerated, but may cause the following side effects:

Hypothyroidism: A common consequence after radioiodine therapy, often requiring lifelong hormone replacement with levothyroxine.
Radiation sialadenitis: Inflammation of the salivary glands following radioiodine therapy.
Temporary swelling of the thyroid with possible pressure sensation in the neck.
Radiation protection requirements: Patients are temporarily mildly radioactive after treatment and should avoid close contact with pregnant women and young children.
With excessive doses of stable iodine: iodine-induced hyperthyroidism (Jod-Basedow phenomenon) or allergic reactions may occur.

Contraindications

Iodine therapy is generally contraindicated in the following situations:

Pregnancy and breastfeeding (radioiodine therapy is absolutely contraindicated)
Known hypersensitivity to iodine
Severe renal insufficiency (in certain forms of therapy)

References

Deutsche Gesellschaft fur Nuklearmedizin (DGN) – Guideline on Radioiodine Therapy for Benign Thyroid Diseases (2023). Available at: www.nuklearmedizin.de
Dietlein M, Dressler J, Grunwald F et al. – Procedural guidelines for radioiodine therapy of differentiated thyroid cancer. Nuklearmedizin 2007; 46: 213–225.
World Health Organization (WHO) – Assessment of iodine deficiency disorders and monitoring their elimination. 3rd edition, Geneva 2007.

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