Review

Health Implications of Radioactive Iodine Therapy for Thyroid Related Diseases Patients: A systematic Review

Abstract

After thyroid surgery, radioiodine therapy remains the main course of treatment; giving radioactive iodine is an essential component of the therapeutic regimen for persons with thyroid conditions. The rates of death, recurrence, and metastasis can be significantly decreased with the use of radioactive iodine as a therapy. Both sexes have experienced a noticeable rise in the incidence of thyroid cancer in almost all nations. The most typical kind of differentiated thyroid cancer, which includes papillary and follicular subtypes, is surgery followed by radioactive iodine when necessary. Thyroid hormone suppression medication after treatment can lower cancer-related mortality and recurrence. Iodine therapy has some possible drawbacks in addition to its benefits, including the risk of pulmonary fibrosis, radiation thyroiditis, bone marrow suppression, gastrointestinal problems, sialadenitis/xerostomia, gonadal damage, dry eye, genetic implications, and secondary malignancies. Additionally, the cumulative iodine intake is linked to these negative effects. Ionizing radiation has been shown to accelerate the development of atherosclerosis and other illnesses in the human body when internal organs are exposed to it. A study revealed that the cumulative radioactive iodine exposure marginally increased the incidence of atrial fibrillation in addition to the established negative consequences. It is believed that the direct and indirect effects of radiation on bodily cells caused by radioactive iodine delivered to the patient are the cause of the known risks. Despite this, it is clear from the literature that there is little information on whether RAI can directly harm the heart, blood vessels, or other organs, just that it can cause indirect harm by producing reactive oxygen species through the radiolysis of water. A systematic review of the literature from Google Scholar, Research Gate, and other sources was conducted to identify studies reporting the health implications (either long-term or short-term effects) of RAI treatment in patients with thyroid disorders like differentiated thyroid cancer (DTC), Grave Diseases (GD), and papillary thyroid cancer. The number of publications during a particular time period represents the research trends that have been developing in the field of iodine therapy. Formal dosimetry studies should be considered in patients with very low lesional uptake to determine whether a therapeutic radiation dose can be given to the tumor with a very high RAI uptake. This will help to prevent excessive whole-body radiation exposure and associated bone marrow and pulmonary issues. Short- and long-term effects were examined in patients with smallvolume, non-progressive, non-life-threatening residual malignant illnesses. RAI therapy's immediate and long-term side effects in these patients, who have a minimal risk of dying from DTC, might not be necessary.

Keywords: Radioactive iodine, therapy, thyroid cancer, thyroidism and Iodine health implication