Hypothyroidism After Radioactive Iodine Treatment

In hypothyroidism, as the name indicates, there is a decline in the functioning of the thyroid gland. The gland is either damaged as a result of an autoimmune disease of the thyroid gland, or in the case of an overactive thyroid gland, when more than the required amount of antithyroid drug has been administered. Similarly, hypothyroidism may occur following radio-iodine treatment or surgery, in cases of an overactive thyroid gland.
Subclinical hypothyroidism.

The most characteristic feature of an underactive thyroid gland is that it remains asymptomatic for a long period, and there are only vague symptoms in the beginning. Sometimes the diagnosis is made when a person is undergoing routine tests for a general medical check-up.

The hidden nature of the disease is clear enough. Such early cases of hypothyroidism are suspected, diagnosed/investigated and labelled under the head ‘Subclinical Hypothyroidism’. They may, however, still be in the infancy stage and have only minimal symptoms. This truly highlights the need for early diagnosis and treatment of all cases of hypothyroidism.

When to suspect subclinical hypothyroidism?

The disease may be suspected when the patient feels lethargic, especially in the case of a patient suffering from hyperthyroidism who is undergoing antithyroid drug treatment, or radio-iodine therapy, or has undergone surgery of the thyroid gland. Or, the condition may occur in cases which have a positive family history of hypothyroidism.

How to diagnose subclinical hypothyroidism?

Once suspected, estimation of the thyroid-stimulating hormone (TSH) in the blood should be carried out. The levels of this test will be elevated significantly, although the levels of T4 may be just on the lower side of the normal, or just below the normal level. T3 does not playa significant! diagnostic role in the detection of hypothyroidism, and its level may be found within normal limits.

What is TSH?

It is a hormone secreted by the pituitary gland, lying in the brain, which controls the activity of the thyroid gland. This hormone has got a highly stimulating action on thyroid activity, so that as soon as the activity of the thyroid gland decreases (hypothyroidism), and the quantity of the thyroid hormone, the major being T4, or even when it touches the lower limit of its normal range, there will be an increase in the secretion of TSH from the pituitary gland.

Hence there is a close relationship between the pituitary and thyroid glands so that a normal level of thyroid hormones may be maintained in the blood as far as possible. (However, it may be said in passing, that if hypothyroidism occurs as a result of the involvement/ disease of the pituitary gland, the levels of TSH will not be elevated, although T4 may be on the lower side).

Since the raised levels of TSH the blood is the most sensitive/ earliest index for the decreased function of the thyroid gland, this test, along with T4 must be carried out whenever there is the slightest suspicion regarding the underactivity of the thyroid gland.

Does subclinical hypothyroidism require treatment?

Difficulty does arise in such cases. However, it may be said that in the absence of significant, rather troublesome symptoms, the physician will have to make his own judgement for the initiation of therapy. If no therapy is considered necessary for the time being, the patient must be monitored at least 3-6 monthly, so that the disease does not progress unnoticed.

As regards the size of the thyroid gland, in cases of hypothyroidism, it may be noted that the gland may be either enlarged or atrophied, or may remain normal in size. Hence the size of the thyroid does not indicate the activity of the gland, and, therefore, one has to depend on the levels of thyroid function tests in the blood.

Frequently Asked Questions

    Would taking diet pills cause serious complications if taken with Synthroid?
    I have Graves Disease. I originally had severe Hyperthyroidism that nearly caused heart failure. I had to have radioactive iodine treatment. After the treatment I am left with Hypothyroidism that must be treated with Synthroid for the rest of my life. My prescription is 150 MCG of Synthroid daily. Am I able to take diet pills?

    • ANSWER:
      I would not recommend doing that. There are too many unknowns with supplements.

    2ª) What is the treatment for this?
    The first question and some notes (question answered):

    1ª) What is the name of the disease that a person feels strong fumigations all over your body?
    Several doctors have looked all over my friend did not identify the disease yet.
    My friend drank radioactive iodine for his hyperthyroidism, causing hypothyroidism.
    He take a hormone (T3 and T4) every day for his own good.
    My friend feel very uncomfortable, and constant pain in the skin, a doctor has a remedy, which is amato, relieving a little the fumigations.
    Stress and heat (like the sun) intensifies the fumigations even with the amato in the blood.
    He also takes 2mg of rivotril (clonazepam) for day. (because of his heart that without it his heart acelerate.)
    My friend calls the fumigation of (perfuration of hot needles all over the skin).
    My friend lives with me at work and the disease is not contagious.
    There is no stain or redness on his skin. Noting that there is no muscle pain.
    Only pain in the skin.(only skin pain).
    I’ll appreciate and I will be grateful to the person who know the name of the disease.


    Soya, the tingling (fumigations) may be due to the hypothyroidism which the treatment has caused, something which physicians are aware of when they treat hyperthyroidism. Perhaps there are other symptoms of low thyroid function. Without enough thyroid hormone, the body becomes tired and run down. Every organ system slows—the brain slows down making it difficult to concentrate, the gut slows down causing constipation, and metabolism slows down causing weight gain. Aggressive treatment of hyperthyroidism may cause an underactive thyroid gland, the resulting effect on the body is the same.

    Many of the symptoms of hypothyroidism are very subtle. A lot of physicians overlook the symptoms of fatigue, weight gain and depression and attribute them to other causes. Physicians should check to see if thyroid disease is the cause of these everyday symptoms. Patients who are treated for hypothyroidism can regain full control of their lives and eliminate these symptoms entirely.
    Another common cause of hypothyroidism is the use of radioactive iodine. This destruction sometimes results in hypothyroidism. This type of hypothyroidism may be difficult to detect immediately, because there may be just a small amount of thyroid tissue that is not destroyed right away. This small piece of thyroid may produce enough thyroid hormone for the body for a little while. However, if this piece of thyroid burns out or gives up, hypothyroidism may result.

    Because this hypothyroidism can occur anywhere from months to years after treatment with radioactive iodine, you may not immediately recognize the subtle symptoms of fatigue, weight gain and difficulty concentrating. Your friend should visit the doctors regularly and have routine thyroid function blood tests. By checking these blood tests once a year, hypothyroidism may be discovered in its earliest stages before symptoms like fatigue and weight gain.
    Secondary Hypothyroidism
    The symptoms of hypothyroidism are mainly dependent on the amount of decrease in thyroid hormone and duration of time that the decrease has been present. For most patients, the symptoms are mild and can often be confused with other problems.
    a medical professional

    2ª) The second question is: What is the treatment for this?
    My friend still suffering and taking drugs to not feel pain. I feel sad about him.
    This pain who he feels isn’t normal. The pain is strong, he said.
    He is taking a new drug: Floral ( from plants: it’s a detoxifier and a normalizing body )
    But I think isn’t a toxin, because it’s been months that he takes, and won’t get better.
    I think it’s a psychological illnesses.

    • ANSWER:
      The PURPOSE of the use of the radioactive iodine is to make one who is HypERthyroid (overactive/low TSH level), become HypO (underactive/hi TSH level) THEN one is commonly treated w/ Synthroid to bring the person up to the right level thus bringing the TSH level down hopefully to within the ‘normal’ range of .3 – 3 (w/ most feeling best @ < 2). It may take several months to get the dose regulated ...even then, A LOT of people still DO NOT experience much relief...sorry. God bless

    Normal Thyroid Levels?
    I was diagnosed with Grave’s Disease in January of this year. I underwent the radioactive iodine treatment I-131 to kill my thyroid in February. After a visit to the doctor this last week I found out that I am now hypothyroid with a TSH level of 36. They tell me that normal is .2 to 5.0. I have gained nearly 23 lbs in one month but they say that it is water retention.

    I’m assuming I still have the Graves Disease as I believe it never goes away. What are some of the symptoms of the hypothyrodism? My endocrinologist isn’t much help and tells me to research the internet for help instead of getting answers from her. How frustrating.

    My question is, my level seems awful high? How long does it take to get regulated once you are on synthroid? What are some of the symptoms of hypothyroidism?

    • ANSWER:
      I went through the same thing about ten years ago. You still have Grave’s disease. I found that out for sure when I had serious eye problems from it years later. Most people end up hypo active after radio iodine. They’ll adjust your medicine to make your levels normal. I gained weight, had water retention, sleep a lot, and was crying over nothing until my dosage was straightened out. I was also cold, cold, cold. I still seem to have some mild symptoms of both conditions. I don’t know if it’s in my mind. I feel much more sane and healthy with normal thyroid levels. Be sure to let your doctor know any symptoms you’re having as they are adjusting the medicine. Don’t let them go by the “numbers” alone.

    What were some of the biggest problems you faced after a thyroidectomy or lobectomy?
    I was recently informed by my doctor that I will be undergoing a lobectomy to remove a suspicious tumor on my thyroid. I do not have hyper- or hypothyroidism. My doctor hasn’t specifically told me that it’s papillary carcinoma, but I’ve done plenty of research on my own, and, given my family history and other factors, I’m fairly certain that that will be the ultimate conclusion, especially considering that my doctor has already told me I will “most likely” need to take a radioactive iodine solution post-op.

    I’m not afraid of the surgery or post-op treatment. If anything, I’m glad it’s nothing more serious. However, I am concerned about making adjustments to my lifestyle. I’m not sure what to expect – Will I gain weight? Will I be able to work out regularly, or will I feel fatigued? Will I be able to continue with my normal routine of school and study and work? What was the biggest challenge you faced after your surgery? Did you have a hard time readjusting, or were you able to get back into the swing of things without too much ado?

    Any advice is appreciated. Thank you.

    • ANSWER:
      I was able to get back into the swing of things immediately, just glad it was over I had a great Dr who put me at ease and a perfect surgery!! Im sure the same will go for you, theres no worry involved, only happines its OVER Best health and happiness to you !!

    Anyone know anything about Hashimoto’s Thyroidism and its symptoms?
    I was diagnosed around age 11/12 with Hashimoto disease at Toronto sick Kids Hospital. A large goiter was found at my annual check up. My thyroid was then hyperactive, and I was treated with radioactive iodine at approx age 14/15 – which resulted in Hypothyroidism. From a very early age I suffered with joint problems, and throughout the years they have progressively gotten worse. I suffer from many symptoms that coincide with Hashimoto disease (especially Musculoskeletal symptoms, dry skin, muscle weakness, weight gain, chronic fatigue, migraines) , and I have also been diagnosed with Fibromyalgia. I have been X-rayed by three different doctors, each giving me a different diagnoses. Due to my many debilitating symptoms, I’m looking to apply for the Ontario disability Support Program. Unfortunately I was told by the last Dr. I saw, that symptoms of Hashimoto’s disease would not affect me now – due to my past treatment of radioactive iodine, even though many of my symptoms started after the treatment.
    I was wondering if there is any truth to this statement? – as many things that I have read have contradicted this.
    Is there any literature that you can provide/recommend for me, that can help to back up my claim; As well as help me to understand this disease and it’s symptoms better?

    Any advice or suggestions will be greatly appreciated

    • ANSWER:

    Is hyper-thyroidism or hypo-thyroidism worse for a person’s health ?
    A friend of mine is getting radioactive iodine next week for Grave’s (hyper-thyroidism). There is a good chance that a few months after this treatment he may have hypo-thyroidism and have to take a pill every day for that.

    So I just don’t understand what would be the benefit in exchanging the hyperthyroidism for hypothyroidism.

    Any ideas?

    • ANSWER:
      Hyperthyroidism can have detrimental effects on your body, the worst of them being heart failure. I’m guessing your friend’s hyperthyroidism is pretty severe, usually antithyriod drugs are used to treat hyperthyroidism. Hypothyroidism is fairly common and easily treated, you won’t see many or any side effects if you’re on the right dose of Levothyroxine. Both untreated hyperthyroidism and hypothyroidism are bad for your health, both can kill you if severe enough.

    Endocrinology Center?
    Complete diagnostic in our thyroid cancer operation center to prevent thyroid gland disorders symptoms.
    Most often the first symptom of thyroid cancer is a nodule in the thyroid region of the neck. However, many adults have small nodules in their thyroids, but typically under 5% of these nodules are found to be malignant. Sometimes the first sign is an enlarged lymph node. Later symptoms that can be present are pain in the anterior region of the neck and changes in voice.Thyroid cancer is usually found in a euthyroid patient, but symptoms of hyperthyroidism or hypothyroidism may be associated with a large or metastatic well-differentiated tumor.Thyroid nodules are of particular concern when they are found in those under the age of 20. The presentation of benign nodules at this age is less likely, and thus the potential for malignancy is far greater. In the thyroid cancer operation center we do all of the diagnoses in a range that we can cure every patient. The treatment of thyroid cancer may require surgery. Common surgeries include thyroidectomy, lobectomy, and tracheostomy. Radioactive Iodine-131 is used in patients with papillary or follicular thyroid cancer for ablation of residual thyroid tissue after surgery and for the treatment of thyroid cancer. Patients with medullary, anaplastic, and most Hurthle cell cancers do not benefit from this therapy. External irradiation may be used when the cancer is unresectable, when it recurs after resection, or to relieve pain from bone metastasis. Some can cause a calcium deficiency after thyroidectomy, our after service we can manage and monitoring the symptoms.


    • ANSWER:
      If you say so!