Radioactive Iodine Therapy for Thyroid Disorders: A Case Study & Medical Insight
🧠 By Team Suryavanshi IAS – Empowering UPSC Aspirants with Current Medical Affairs
Case in Point: An Unexpected Neck Swelling and the Science Behind the Diagnosis
A 36-year-old banker noticed swelling in her neck, brought to her attention by a customer. Although she ignored it initially, subtle signs like hand tremors and unintentional weight loss led her to consult a doctor friend. The eventual diagnosis? Hyperthyroidism—a condition where the thyroid gland becomes overactive, producing excess thyroid hormones.
Despite initial drug therapy, she faced side effects including rashes and nausea. Advised surgery or radioactive iodine therapy, she feared the word “radioactive.” However, with support and detailed consultations, she chose radioiodine treatment and eventually recovered, leading a healthy, balanced life.
What Is Radioactive Iodine and How Does It Work?
Iodine in the Human Body:
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Daily requirement:
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Adults: 150 µg/day
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Pregnant/lactating women: 250–300 µg/day
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Children: ~120 µg/day
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Major role: Synthesizes thyroxine (T4) and triiodothyronine (T3) — critical for metabolism.
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Storage site: 80% of body’s iodine is in the thyroid gland.
Radioactive Iodine (¹³¹I):
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Discovered: In 1938 by Glenn Seaborg & John Livingood.
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Properties: Emits beta particles (for therapy) and gamma rays (for imaging).
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Half-life: ~8 days.
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Mechanism:
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Overactive thyroid tissue absorbs ¹³¹I.
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Beta emissions destroy excess thyroid cells.
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Gamma rays help track progress via scans.
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🇮🇳 Indian Clinical Practice: Thyroid Scans & Treatments
| Purpose | Isotope Used | Dose |
|---|---|---|
| Benign thyroid scan | Technetium-99m (99mTcO₄) | ~Low |
| Hyperthyroidism treatment | Iodine-131 (¹³¹I) | 370–740 MBq |
| Thyroid cancer scan | ¹³¹I | 37–74 MBq |
| Cancer ablation therapy | ¹³¹I | 2.5–5.6 GBq |
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Monitoring: Done in isolation wards until radiation falls below 50 microSv/hour.
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Post-discharge: 110-day safety protocol to protect families.
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Not for: Pregnant or lactating women (absolute contraindication).
Important Terms for UPSC
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Theranostics – Combination of therapy and diagnostics (seen in nuclear medicine).
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Hyperthyroidism – Overactive thyroid, symptoms include tremors, weight loss, anxiety, goitre.
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Hypothyroidism – Underactive thyroid; patient may need thyroxine supplementation after treatment.
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Radioisotopes – Iodine-123, 124, 125 (diagnostic); Iodine-131 (therapeutic & diagnostic).
Ethics & Radiation Safety Guidelines
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Strict regulation: Doses administered under a Level 3 Radiological Safety Officer.
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Symptoms post-treatment: Include mild nausea, dry mouth, skin itching—usually self-limiting.
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Patient care: Follow-up every 6–8 weeks, especially in cancer cases, where hormone levels are kept slightly higher to prevent recurrence.
Global and Indian Context
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India: Uses I-131 extensively for both benign and malignant thyroid diseases.
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Global health: WHO classifies iodine deficiency as <100 µg/L in urine; overdose as >300 µg/L.
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Medical evolution: What began as a research question in 1936 is now a cornerstone of non-invasive endocrine cancer treatment.
Key UPSC Takeaways
Mains GS Paper II/III:
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Role of science & tech in medicine
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Non-invasive interventions in healthcare
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Public health and awareness in NCDs
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Radiation safety, ethical considerations, and patient rights
Conclusion: A Modern Miracle in Medicine
This real-life story highlights how early detection, scientific clarity, and trust in evidence-based medicine can save lives. Thyroid diseases are common but manageable. Regular check-ups, awareness, and access to specialized care—alongside scientific breakthroughs like radioiodine therapy—offer hope to millions.
✍️ Compiled by:
Team Suryavanshi IAS | UPSC Mains Booster Series
📍 Rahul Vihar, Indira Nagar, Lucknow
📞 Contact: 6306446114
🌐 suryavanshiias.blogspot.com
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