For those who struggle with hyperthyroidism or thyroid cancer, radioactive iodine treatment (RAI) can be a life-changing treatment option. But despite the promise of RAI, there is often a downside: you are likely to develop transient or permanent hypothyroidism after completing treatment. If you have had RAI or are about to start, this potential outcome can be a serious concern, and it’s important to have the right resources in place to address it. By connecting with a skilled health practitioner with expertise in hormone replacement therapy, you will have the support you need to manage hypothyroidism and achieve a healthy balance.
Understanding Hypothyroidism After Radioactive Iodine Treatment
Not everyone who has RAI, also known as I-131, will experience hypothyroidism. Your individual risk is largely determined by the dose of radioactive iodine your doctor prescribes and how much of your thyroid is affected. Research suggests that factors such as age, BMI, and prior medication history may also play a role. However, most patients do experience hypothyroidism following RAI and all patients should regard it as an expected consequence of this treatment.
Hypothyroidism occurs when your thyroid gland no longer produces enough hormones for the body to function at an optimal level. T4 and T3 hormones are used by every cell in the body’s many systems but are primarily involved in regulating metabolism. If your body doesn’t have enough of these thyroid hormones, you may experience the following symptoms:
- Puffy face and overall weight gain
- Cold sensitivity
- Dry skin and thinning hair
- Painful, stiff, or swelling joints
- Abnormal menstrual cycles
- Muscle pain or weakness
- Memory loss
- Lowered heart rate
- Thinning hair
Your doctor should monitor you for symptoms of hypothyroidism after RAI treatment. They may even preemptively schedule you to start thyroid hormone treatment within a few weeks of the RAI procedure, just to be safe.
The Standard Treatment Protocol for Hypothyroidism
Hypothyroidism is most often treated through hormone replacement therapy—a safe and effective treatment option that involves taking hormone medications to restore healthy hormone levels. Most people who develop hypothyroidism after radioactive iodine treatment can expect to take some form of hormone medication every day for the rest of their lives. This may sound extreme at first, but this vital medication is essentially doing the job of a healthy thyroid gland; it’s absolutely critical to bodily health. And while you may not feel any side effects of the medication when it’s working, whether good or bad, most patients say they notice an immediate difference when they stop taking their medication. To feel well every day and avoid all the symptoms of hypothyroidism, this simple step usually feels like a no-brainer.
Most people who experience the symptoms of hypothyroidism are prescribed levothyroxine, a medication that delivers a steady supply of T4 thyroid hormone. Everyone’s body is different, so doses will range from 50-200 mcg per day depending on your weight, age, and bodily needs. Most of our patients get used to taking the medications pretty quickly and don’t mind working this quick step into their daily routine. We recommend taking your hormone medication at the same time each day on an empty stomach.
Ongoing Maintenance and Possible Treatment Changes
Hypothyroidism is typically simple and easy to treat, even after RAI. However, it can take a little while for you and your doctor to find the appropriate dose for your thyroid medication. Too little, and your hypothyroidism symptoms, such as deep fatigue and hair loss, may compromise your quality of life. Too much, and you might experience the familiar racing heart and nervous energy that you needed RAI to resolve. It’s also possible for hypothyroidism to worsen over time, which is why ongoing monitoring is critical to ensuring the best outcomes. After years of taking one dose of hormones, you might need to increase to a higher dose.
Additionally, if you’re still struggling with symptoms after increasing your dose of T4 hormones, you may be one of the individuals who need more advanced treatment to feel balanced. The human body naturally converts T4 hormones into T3 through the process of monodeiodination. But some people struggle to process this conversion and may require T3 supplementation in order to feel their best. T3 medications are a possible treatment option for you if your body hasn’t responded to T4 treatment alone.
In any case, it’s important to keep up with your hormone health by getting your levels checked regularly. If you’re at the beginning of treatment, we recommend testing roughly every six weeks. Those who have found a working dose of hormone medication should get blood work done at least every six months to make sure their condition is stable and make any necessary treatment changes.
The Best Way to Treat Hypothyroidism After RAI
After the stress of your original thyroid condition—whether it’s an autoimmune disorder like Graves’ disease or a variant of thyroid cancer—the last thing you want to do is take on another set of symptoms. But if you’re working with medical professionals with expertise in hormone disorders, they’ll know to prepare you for the possibility of hypothyroidism and be ready with effective treatment options.
No matter which hormone medications you need to take in order to treat hypothyroidism after radioactive iodine treatment, the best route is to consult with a hormone health specialist and get expert counsel. Maintaining a stable dose of thyroid medication is a job any primary care physician would be able to take on. But finding the right dose in the first place and making the necessary adjustments over time may require the help of a specialist.
Practitioners in the BodyLogicMD network are among the most experienced and highest qualified medical professionals who practice in the field of hormone health, and our holistic approach has changed the lives of patients across the country. We know that with proper care and maintenance, hypothyroidism can be managed and your quality of life can be restored. If you have any questions or concerns about your thyroid health or treatment options, reach out to a BodyLogicMD-affiliated pracitioner today and take the next step toward healing.
At BodyLogicMD, we’re proud to be experts in the field of hormone health. The practitioners within our network use a combination of bioidentical hormone replacement therapy, nutrition, and lifestyle coaching to help our clients address their symptoms and restore their quality of life. As specialists in integrative medicine, we are dedicated to helping you feel well and stay healthy for years to come—not just in response to hypothyroidism after radioactive iodine treatment. Contact a local practitioner to schedule your first appointment and prepare to address hypothyroidism head on. Or take the BodyLogicMD Hormone Balance Quiz to learn more about how thyroid hormones may be impacting your health.
Disclaimer: These statements have not been evaluated by the Food and Drug Administration. All content on this website is for informational purposes only. The content is not intended to diagnose, treat, cure or prevent diseases.
Charlotte is a patient care coordinator specializing in bioidentical hormone replacement therapy. She is committed to helping patients who struggle with the symptoms of hormonal change and imbalance explore their treatment options and develop effective strategies to optimize wellness.