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RAI or not RAI?

This is probably the hottest question on the treatment of Graves' Disease (hyperthyroidism) today.

RAI is RadioActive Iodine treatment in which the hyperthyroid patient is given a "cocktail" with radioactive iodine which goes to the thyroid and destroys much of its function.

Most doctors in the U.S. push RAI very heavily and try to get their patients to undergo it ASAP.  Most doctors in Europe don't push RAI but favor maintenance on antithyroid drugs (ATDs) because of the high rate of "spontaneous" remissions and the possibility that RAI causes permanent damage to the body and may significantly increase the risk of cancer.

I think RAI is barbaric and insane and should never even be considered.  Hopefully someday it will lie among the skeletons in the medical treatment closet.  I also think that getting the radioiodine uptake test is a mistake and can cause damage to the thyroid and eyes.  I really don't see the need for performing it.

The Atomic Women are a group of women (and hopefully some men) who have undergone RAI and now regret it.  Read about their thoughts. New website (11-29-00) (

Following is a quote from John Gofman.  Please read his credentials because he is very knowledgeable about the use of radiation in medicine:

"In radiation research, nearly all the work is sponsored by the governments which are defending and promoting nuclear power . . . Ionizing radiation may well be the most important single cause of cancer, birth defects and genetic disorders . . . The stakes for human health are very, very high in radiation matters. It is essential that people take no chance that conflict-of-interest is producing radiation databases which cannot be trusted.””


John William Gofman is Professor Emeritus of Medical Physics at the University of California at Berkeley, and Lecturer at the Department of Medicine, University of California School of Medicine at San Francisco.

He is the author of several books and more than a hundred scientific papers in peer-review Journals, in the fields of nuclear/physical chemistry, coronary heart disease, ultracentrifugal analysis of the serum lipoproteins, the relationship of human chromosomes to cancer, and the biological effects of ionizing radiation with particular reference to cancer-induction.

In 1971 Gofman founded the Committee for Nuclear Responsibility, a small, non-profit, public interest association with three Nobel Laureates on its Board.

Among other Recent Honors and Awards, he received in December 1992, in Stockholm, Sweden: “The Right Livelihood Award” of the Right Livelihood Foundation, widely known as "The Alternative Nobel Prize".

Dr. Jakob von Uexkull's statement, in presenting the award for John Gofman's "pioneering work in exposing the health effects of low-level radiation," was:

"The Right Livelihood Award for vision and work forming an essential contribution to making life more whole, healing our planet, and uplifting humanity."

For more information on radiation, see:


Lancet 1999 Jun 19;353(9170):2111-5

Cancer incidence and mortality after radioiodine treatment for hyperthyroidism: a population-based cohort study.

Franklyn JA, Maisonneuve P, Sheppard M, Betteridge J, Boyle P

Department of Medicine, University of Birmingham, UK.

BACKGROUND: Radioiodine is used increasingly as first-line treatment for hyperthyroidism, but concerns remain about subsequent risk of cancer, especially in those treated at a young age. We investigated cancer incidence and mortality in patients treated with radioiodine for hyperthyroidism. METHODS: We did a population-based study in 7417 patients treated in Birmingham, UK, between 1950 and 1991. We compared details of all cancer diagnoses and deaths in 1971-91 from the UK Office for National Statistics with data on cancer incidence and mortality for England and Wales specific for age, sex, and period. FINDINGS: During 72,073 person-years of follow-up, 634 cancer diagnoses were made, compared with an expected number of 761 (standardised incidence ratio [SIR] 0.83 [95% CI 0.77-0.90]). The relative risk of cancer mortality was also decreased (observed cancer deaths 448, expected 499; standardised mortality ratio [SMR] 0.90 [0.82-0.98]). Incidence of cancers of the pancreas, bronchus, trachea, bladder, and lymphatic and haemopoietic systems was lowered. Mortality from cancers at all these sites was also reduced but findings were significant only for bronchus and trachea. There were significant increases in incidence and mortality for cancers of the small bowel (SIR 4.81 [2.16-10.72], SMR 7.03 [3.16-15.66]) and thyroid (SIR 3.25 [1.69-6.25], SMR 2.78 [1.16-6.67]), although absolute risk of these cancers was small. INTERPRETATION: The decrease in overall cancer incidence and mortality in those treated for hyperthyroidism with radioiodine is reassuring. The absolute risk of cancers of the small bowel and thyroid remain low, but the increased relative risk shows the need for long-term vigilance in those receiving radioiodine.


  • Comment in: Lancet 1999 Sep 25;354(9184):1122

PMID: 10382695, UI: 99310068

Success Rate of Radioiodine Therapy in Graves' Disease: The Influence
of Thyrostatic Medication by Sabri O, Zimny M, Schulz G
J Clin Endocrinol Metab 84(4):1229-1234, April 1999
The usual treatment for Graves' disease is radioiodine (131I) therapy,
but the use of thyrostatic medication with this therapy may decrease
its effectiveness. This study attempted to determine the rate of
effectiveness of 131I with and without concomitant use of carbimazole
by prospectively studying 207 patients with Graves' disease. One
hundred six patients were treated with 131I therapy and carbimazole and
101 were treated with 131I only. Patients were evaluated at 3, 6, and
12 months after therapy. The non-carbimazole group had a success
(euthyroid 6 months after therapy) rate of 93% and the carbimazole
group had a success rate of 49%. Logistic regression indicated that
there was an association between failure and the administration and
dose of carbimazole despite the increased dose of 131I when given

Acta Endocrinol (Copenh) 1990 Feb;122(2):233-40

Peripheral blood T cell activation after radioiodine treatment for Graves' disease.

Teng WP, Stark R, Munro AJ, Young SM, Borysiewicz LK, Weetman AP

Department of Medicine, University of Cambridge Clinical School, Addenbrooke's Hospital, UK.

Radioiodine therapy for Graves' thyrotoxicosis produces a rise in thyroid autoantibodies in the first three months after treatment, but little is known of its effects on T cells. We have therefore followed the changes in T cell subsets in sequential samples from 23 patients with Graves' disease treated with radioiodine, using dual-colour flow cytometry. In the first month after treatment there was a significant rise in activated T cells, identified by the markers HLA-DR (la) and CDw26/Ta1 (p less than 0.025 in both cases). CD45RO-positive T cells, which are the primed population containing memory cells, also increased (p less than 0.025), but there was no change in CD45R-positive, resting T cells or in the CD4 to CD8 (helper to cytotoxic/suppressor) ratio. Vicia villosa-binding T cells, containing the contrasuppressor population, showed a more variable response, but the trend was to an overall increase from pre-treatment values (p less than 0.025). The changes did not appear to be related to antithyroid drug treatment, since they were seen irrespective of whether patients continued such therapy. These results suggest that T cell activation and enhanced contrasuppressor activity may in part be responsible for the rise in autoantibodies after radioiodine. The T cell changes could also contribute to the worsening of ophthalmopathy seen in some radioiodine-treated patients.

PMID: 2316311, UI: 90195418


The following letter is from: (Elaine Moore)

If you're thinking of becoming pregnant, you don't want to have RAI. 
Recent studies show that chromosomal changes caused by radioiodine can be passed to the next generation. Like DES and other hormonal 
disruptors, the effects are stronger and more significant when passed 
on to children, and often, these changes aren't evident for 30 years 
or so. Also, several recent studies show a slight but significant risk 
of increased cancer mortality for several types of cancer in patients 
who had RAI. I had RAI which I regret and now have an atrophied 
pancreas. One study shows an increase of pancreatic cancer after RAI. 

Also, the antibodies which increase after RAI persist for years and 
may be transferred to the fetus, causing transient thyroid problems. 
Eleven years after RAI, I have high levels of thyroid antibodies and 
mitochondrial antibodies. See Dr. Stoll's site for examples of what 
happens when you don't address the underlying causes of autoimmunity. 
Remember, the thyroid is the victim, not the cause.

You do, however, need to get your thyroid levels under control before 
you become pregnant since there is a chance that your symptoms will 
worsen in early pregnancy and in the postpartum period. For the most 
part, pregnancy brings relief of symptoms since there's immune system 

ATD's can be used during pregnancy, but there is a slight risk of 
fetal hypothyroidism, especially with Tapazole. If you can at least 
lower your dose, it would help, and there are many things you can do 
to help in this regard. Diet and stress reduction seem to be the most 
important. Eat plenty of goitrogens, foods which act like ATD's 
(cabbage, cauliflower, almonds, peaches, soy, peanuts, etc.) Reduce 
your dairy, saturated fats, sugar, and iodine. GD is associated with 
many nutrient deficiencies, particularly free fatty acids, vitamins 
C, E, B, copper, magnesium, etc. See John's supplement list on 
this site. 

Stress reduction methods, either meditation, tai chi, or yoga and energy healing, like acupuncture, etc. are all of great value. Sometimes, though, there's lots of stress involved with trying to get everything right. Then, surgery is a viable option if your symptoms seem to be life threatening. By the way, your levels are high but not extremely high. What's important, though, is how much they have changed and if you're seeing improvement with your ATD's.

Following is a great, must-read historical review of the use of radiation in medicine.  It's an unbelievable history and it makes you not want to be a part of it.

From: (Julia)

Hi you all,
The long paper below, might seem being out of track at a hyperthyroidism board. But those considering RAI or already RAI'ed are couteously suggested to read it carefully. Some of the data it contains have sometimes been quoted at our atomicwomen mailing-list and yahoo club. (links at the bottom). Drs. Wood, Cooper and Rigdeway, in their book "Your thyroid a home reference", quote how over 2.000.000.- children and adolescents in USA were given X-rays between 1920's and 1960's for problems like enlarged tonsils or adenoids, birthmarks, whooping cough, acne and ringworm of the scalp. They add: ""Subsequent large-scale studies of thyroid cancer frequency in radiated and non radiated control groups have established beyond doubt the relationship between radiation exposure and thyroid cancer"".


The Major Cause Of Cancer, Part 1
Rachel's Environment And Health Weekly #691 3-21-00

When Wilhelm Roentgen first discovered X-rays, in 1895, "doctors and physicians saw the practical potential of X-rays at once, and rushed to experiment with them."[1,pg.7] Many physicians built their own X-ray equipment, with mixed results: some home-brew X-ray machines produced no radiation whatsoever, others produced enough to irradiate everyone in the next room.

The ability to see inside the human body for the first time was a marvelous, mysterious and deeply provocative discovery. Roentgen trained X-rays on his wife's hand for 15 minutes, producing a macabre image of the bones of her hand adorned by her wedding ring. Roentgen's biographer, Otto Glasser, says Mrs. Roentgen "could hardly believe that this bony hand was her own and shuddered at the thought that she was seeing her skeleton. To Mrs. Roentgen, as to many others later, this experience gave a vague premonition of death," Glasser wrote.[1,pg.4]

Within a year, by 1896, physicians were using X-rays for diagnosis and as a new way of gathering evidence to protect themselves against malpractice suits. Almost immediately -- during 1895-96 -- it also became clear that X-rays could cause serious medical problems. Some physicians received burns that wouldn't heal, requiring amputation of their fingers. Others developed fatal cancers.

At that time, antibiotics had not yet been discovered, so physicians had only a small number of treatments they could offer their patients; X-rays gave them a range of new procedures that were very "high tech" -- bordering on the miraculous -- and which seemed to hold out promise to the sick. Thus the medical world embraced these mysterious, invisible rays with great enthusiasm. Understandably, physicians at thetime often thought they observed therapeutic benefits where controlled experiments today find none.

At that time -- just prior to 1920 -- the editor of AMERICAN X-RAY JOURNAL said "there are about 100 named diseases that yield favorably to X-ray treatment." In her informative history of the technology, MULTIPLE EXPOSURES; CHRONICLES OF THE RADIATION AGE, Catherine Caufield (see REHW #200, #201, #202), comments on this period: "Radiation treatment for benign [non-cancer] diseases became a medical craze that lasted for 40 or more years."[1,pg.15] "...[L]arge groups of people [were] needlessly irradiated for such minor problems as ringworm and acne.... Many women had their ovaries irradiated as a treatment for depression."[1,pg.15] Such uses of X-rays would today be viewed as quackery, but many of them were accepted medical practice into the 1950s. Physicians weren't the only ones enthusiastic about X-ray therapies. If you get a large enough dose of X-rays your hair falls out, so "beauty shops installed X-ray equipment to remove their customers' unwanted facial and body hair," Catherine Caufield reports.[1,pg.15]

Roentgen's discovery of X-rays in 1895 led directly to Henri Becquerel's discovery of the radioactivity of uranium in 1896 and then to the discovery of radium by Marie Curie and her husband Pierre in 1898, for which Becquerel and the Curies were jointly awarded the Nobel prize in 1903. (Twenty years later Madame Curie would die of acute lymphoblastic leukemia.)

Soon radioactive radium was being prescribed by physicians alongside X-rays. Radium treatments were prescribed for heart trouble, impotence, ulcers, depression, arthritis, cancer, high blood pressure, blindness and tuberculosis, among other ailments. Soon radioactive toothpaste was being marketed, then radioactive skin cream. In Germany, chocolate bars containing radium were sold as a "rejuvenator."[1,pg.28] In the U.S, hundreds of thousands of people began drinking bottled water laced with radium, as a general elixir known popularly as "liquid sunshine." As recently as 1952 LIFE magazine wrote about the beneficial effects of inhaling radioactive radon gas in deep mines. Even today The Merry Widow Health Mine near Butte, Montana and the Sunshine Radon Health Mine nearby advertise that visitors to the mines report multiple benefits from inhaling radioactive radon,[2] even though numerous studies now indicate that the only demonstrable health effect of radon gas is lung cancer.

Thus the medical world and popular culture together embraced X-rays (and other radioactive emanations) as miraculous remedies, gifts to humanity from the foremost geniuses of an inventive age.

In the popular imagination, these technologies suffered a serious setback when atomic bombs were detonated over Japan in 1945. Even though the A-bombs arguably shortened WW II and saved American lives, John Hersey's description of the human devastation in HIROSHIMA forever imprinted the mushroom cloud in the popular mind as an omen of unutterable ruin. Despite substantial efforts to cast The Bomb in a positive light, radiation technology would never recover the luster it had gained before WW II.

Seven years after A-bombs were used in war, Dwight Eisenhower set the U.S. government on a new course, intended to show the world that nuclear weapons, radioactivity and radiation were not harbingers of death but were in fact powerful, benign servants offering almost-limitless benefits to humankind. The "Atoms for Peace" program was born, explicitly aimed at convincing Americans and the world that these new technologies were full of hope, and that nuclear power reactors should be developed with tax dollars to generate electricity. The promise of this newest technical advance seemed too good to be true -- electricity "too cheap to meter."[3]

The Atomic Energy Act of 1946 created the civilian Atomic Energy Commission but as a practical matter the nation's top military commanders maintained close control over the development of all nuclear technologies.[4]

Thus by a series of historical accidents, all of the major sources of ionizing radiation fell under the purview of people and institutions who had no reason to want to explore the early knowledge that radiation was harmful. In 1927, Hermann J. Muller had demonstrated that X-rays caused inheritable genetic damage, and he received a Nobel prize for his efforts. However, he had performed his experiments on fruit flies and it was easy, or at least convenient, to dismiss his findings as irrelevant to humans.

In sum, to physicians, radiation seemed a promising new therapy for treating nearly every ailment under the sun; for the military and the Joint Commmission on Atomic Energy in Congress it unleashed hundreds of billions of dollars, a veritable flood of taxpayer funds, most of which came with almost no oversight because of official secrecy surrounding weapons development; and for private-sector government contractors like Union Carbide, Monsanto Chemical Co., General Electric, Bechtel Corporation, DuPont, Martin Marietta and others -- it meant an opportunity to join the elite "military-industrial complex" whose growing political power President Eisenhower warned against in his final address to Congress in 1959.

Throughout the 1950s the military detonated A-bombs above-ground at the Nevada Test Site, showering downwind civilian populations with radioactivity.[5] At the Hanford Reservation in Washington state, technicians intentionally released huge clouds of radioactivity to see what would happen to the human populations thus exposed. In one Hanford experiment 500,000 Curies of radioactive iodine were released; iodine collects in the human thyroid gland. The victims of this experiment, mostly Native Americans, were not told about it for 45 years.[6,pg.96] American sailors on ships and soldiers on the ground were exposed to large doses of radioactivity just to see what would happen to them. The military brass insisted that being showered with radiation is harmless.

In his autobiography, Karl Z. Morgan, who served as radiation safety director at the Oak Ridge National Laboratory (Clinton, Tennessee) from 1944 to 1971, recalls that, "The Veterans Administration seems always on the defensive to make sure the victims are not compensated."[6,pg.10 1] Morgan recounts the story of John D. Smitherman, a Navy man who received large doses of radiation during A-bomb experiments on Bikini Atoll in 1946. Morgan writes, "The Veterans Administration denied any connection to radiation exposure until 1988, when it had awarded his widow benefits. By the time of his death, Smitherman's body was almost consumed by cancers of the lung, bronchial lymph nodes, diaphragm, spleen, pancreas, intestines, stomach, liver, and adrenal glands. In 1989, a year after it had awarded the benefits, the VA revoked them from Smitherman's widow."[6,pg.101]

Starting in the 1940s and continuing into the 1960s, thousands of uranium miners were told that breathing radon gas in the uranium mines of New Mexico was perfectly safe. Only now are the radon-caused lung cancers being tallied up, as the truth leaks out 50 years too late.

In retrospect, a kind of nuclear mania swept the industrial world. What biotechnology and high-tech computers are today, atomic technology was in the 1950s and early 1960s. Government contractors spent billions to develop a nuclear-powered airplane -- even though simple engineering calculations told them early in the project that such a plane would be too heavy to carry a useful cargo.[4,pg.204] Monsanto Research Corporation proposed a plutonium-powered coffee pot that would boil water for 100 years without a refueling.[4,pg.227] A Boston company proposed cufflinks made of radioactive uranium for the simple reason that uranium is heavier than lead and "the unusual weight prevents cuffs from riding up."[4,pg.227]

In 1957, the Atomic Energy Commission established its Plowshare Division -- named of course for the Biblical "swords into plowshares" phrasing in Isaiah (2:4).[4,pg.231] Our government and its industrial partners were determined to show the world that this technology was benign, no matter what the facts might be. On July 14, 1958, Dr. Edward Teller, the father of the H-bomb, arrived in Alaska to announce Project Chariot, a plan to carve a new harbor out of the Alaska coast by detonating up to six H-bombs. After a tremendous political fight -- documented in Dan O'Neill's book, THE FIRECRACKER BOYS[7] -- the plan was shelved. Another plan was developed to blast a new canal across Central America with atomic bombs, simply to give the U.S. some leverage in negotiating with Panama over control of the Panama Canal. That plan, too, was scrapped. In 1967, an A-bomb was detonated underground in New Mexico, to release natural gas trapped in shale rock formations. Trapped gas was in fact released, but -- as the project's engineers should have been able to predict -- the gas turned out to be radioactive so the hole in the ground was plugged and a bronze plaque in the desert is all that remains visible of Project Gasbuggy.[4,pg.236]

In sum, according to NEW YORK TIMES columnist H. Peter Metzger, the Atomic Energy Commission wasted billions of dollars on "crackpot schemes," all for the purpose of proving that nuclear technology is beneficial and not in any way harmful.[4,pg.237]

The Plowshare Division may have been a complete failure, but one lasting result emerged from all these efforts: A powerful culture of denial sunk deep roots into the heart of scientific and industrial America.

[To be continued April 13.]

Descriptor terms: radiation; nuclear weapons; nuclear power; x-rays; cancer; carcinogens; karl z. morgan; downwinders; nevada test site; hanford;

============== [1] Catherine Caufield, MULTIPLE EXPOSURES; CHRONICLES OF THE RADIATION AGE (New York: Harper & Row, 1989). ISBN [2] Jim Robbins, "Camping Out in the Merry Widow Mine," HIGH COUNTRY NEWS Vol. 26, No. 12 (June 27, 1994), pgs. unknown. See And see [3] Arjun Makhijani and Scott Saleska, THE NUCLEAR POWER DECEPTION; U.S. NUCLEAR MYTHOLOGY FROM ELECTRICITY "TOO CHEAP TO METER" TO "INHERENTLY SAFE" REACTORS (New York: The Apex Press, 1999). ISBN 0-945257-75-9. [4] H. Peter Metzger, THE ATOMIC ESTABLISHMENT (New York: Simon & Schuster, 1972). ISBN 671-21351-2. [5] Michael D'Antonio, ATOMIC HARVEST (New York: Crown Publishers, 1993). ISBN 0-517-58981-8. And: Chip Ward, Canaries on the Rim: Living Downwind in the West (New York: Verso, 1999). ISBN 1859847501. [6] Karl Z. Morgan and Ken M. Peterson, THE ANGRY GENIE; ONE MAN'S WALK THROUGH THE NUCLEAR AGE (Norman, Oklahoma: University of Oklahoma Press, 1999). ISBN 0-8061-3122-5. [7] Dan O'Neill, THE FIRECRACKER BOYS (New York: St. Martin's Press, 1994). ISBN 0-312-13416-9.


Some lines from "Your thyroid", by Dr Lawrence Wood et al.: In the 1920's physicians began to use radiation (X rays) to treat non cancerous disorders. One of the more common problems that was treated in this manner was an enlargement of the thymus gland in newborns. The thymus gland is located behind the breastbone and is important for normal immune function.

Other conditions treated in this manner included enlarged tonsils or adenoids, birthmarks, whooping cough, acne, and ringworm of the scalp. Treatment was given by meanss of an X-ray machine ("external beam irradiation") or by placing radioactive material, such as radium, directly in or on the tissue to be treated. For many years radiation was considered good medical therapy for some of these problems. For example deafness was improved when radium treatments shrank enlarged lymph tissue compressing the internal ear canal. Acne could be markedly improved by radiation, resulting in less facial scarring.

In short, radiation therapy was used because it seemed safe and effective. Unfortunately the thyroid gland, located as it is in front of the neck, often received radiation inadvertently during treatment for these conditions.  In the 1950's physicians began to notice an increased number of benign and malign thyroid tumors among patients who had been given radiation therapy years earlier. The fact that the radiation had caused the thyroid tumors was substantiated when it was found that many individuals exposed to atomic-bomb radiation or fallout also developed thyroid tumors in later years. When these facts became known, these forms of radiation therapy were of course discontinued.

Nevertheless it is estimated that two million people in the United States received radiation treatments in childhod or adolescence between 1920 and the early 1960s. Subsequent large-scale studies of thyroid-cancer frequency in radiated and nonradiated control groups have established beyond doubt the relationship between radiation exposure and thyroid cancer.


Subj: [hyperthyroidism] Re: Back to the Basics -- (Again) 
Date: 1/31/00 8:16:19 PM !!!First Boot!!!
From: (julia c amado)


>From: Doug 
Date: Wed, 16 Feb 2000 20:13:56 -0500

Dear AntJoan,
In your previous message to Mary, you wrote: "RAI seems to cause a lot of problems down the road, which the doctors don't warn us about." Can you send us a pretty comprehensive list of problems? Our doctors say that by taking synthoid, life returns to normal forever. What do you know that they're not telling?


Hi Doug, 
    I got ophthalmopathy ten months after having RAI. I was not even warned about the possibility!. I did not have ophthalmopathy prior RAI, but developed it some 10 months later, and was clearly induced by it. Although there are endos that don't relate TAO/TED to RAI, most of them accept it does.

The current (1998) edition of Williams' Texbook of Clinical Endocrinology states that RAI is responsible for the development of TED and pretibial myxedema and exacerbates these conditions when they're already present. Current medical books are now listing ATD's as the treatment of choice. The Williams Text had already demoted RAI from first place, back in 1994, but found occasions where it was the best choice, f.i. for patients allergic to ATDs who are poor surgical candidates, (2nd choice after ATDs) due to advanced age or a coexisting disease making these patients a surgical risk. An article in the New England Journal of Medicine (Jan 8, 1998--Vol. 338, No. 2) that studied the occurrence of TED after RAI showed in its results that 15% of the 150 treated with RAI developed or worsened the TED. The patient's they studied had slight or NO TED before having the RAI. With the group that took the RAI and steroids (145 patients) 50 of the 75 that had TED had improvement and NO patient had progression.

DeGroot et al quote:
"I131 therapy causes an increase in titers of TSH-RAbs, and anti-TG or TPO antibodies, which reflects an activation of autoimmunity. It probably is due to release of thyroid antigens by cell damage, or destruction of intrathyroidal T cells. "Although completely satisfactory statistical proof is lacking, many thyroidologists are convinced that 131I therapy can lead to exacerbation of infiltrative ophthalmopathy, perhaps because of this immunologic response. "Tallstedt and associates have published data indicating that 131-I therapy causes exacerbation of ophthalmopathy innearly 25% of patients, while surgery is followed by this response in about half as many. Thus, as described below, patients with significant ophthalmopathy may receive corticosteroids along with 131I, or may be selected for surgical management."

A study in the Lancet Journal of Medicine from June 1999 reports that those of us who had RAI have a significantly higher incidence of thyroid and small bowel cancer. That is not strange: guts and thyroid share the same embryogenic origin. This subject had been already reported at The New England Journal of Medicine -- March 12, 1998 -- Vol. 338, No. 11 , whose study was conducted in a cohort of 7209 subjects with hyperthyroidism, treated with radioactive iodine between 1950 and 1989, which is certainly a high figure of people for these kind of studies in a rare disease like ours.  Not to speak about radiation received by other organs, germinal cells included. And all related to becoming hypo after RAI, increasing each year and reaching 80% of cases ten years later.

It's good another RAI group has been created. The more the best, to get the word out and help people to take as informed decissions as possible. As I've already announced here, yet there is a yahoo club founded on Jan 6th.

Those interested can join it at

More from Julia:

Radioactivity only mutates and lately kills cells, so regretfully 
radiation doesn't cure anything. It's only mutagenic, many
mutations leading to cancers. One can ask, why is it then used 
against cancer when it actually produces it?. Because of its 
stochastic effects. And what does this mean?. Stochastic effects are 
effects that occur on a random basis with its effect being 
independent of the size of dose. The effect typically has no 
threshold and is based on probabilities, with the chances of seeing 
the effect increasing with dose. Cancer is thought to be a stochastic 
effect. So doctors use *high* doses of radioactivity against a 
tumor, considering that this will surpass the stochastic effects. 

Graves' is not cured either. It destroys, damages tissue, thus
with less thyroid cells to produce hormones, fewer hyper symptoms. 
This is what doctors think, …as they also think that after words
"hypo is easier to control", "one pill a day and you'll be OK", "T4 
is exactly the same hormone your body produces" and "it's all in your head". 

These are official medical DOGMAS that we, iatrogenic (i.e. medically 
caused) hypothyroid know by heart. 

So, doses used for Graves' don't ablate the gland, like in
cancer, but partially destroy its tissues. The destruction is 
achieved with beta particles and high energy gamma radiation emitted 
by I-131 on its decay.

And the amount of tissue actually destroyed depends on several 

- iodine uptake by the gland 
- bulk of tissue to be destroyed 
- length of time radioactive iodine is retained in the gland 
- distribution within the tissue 
- radiosensitivity of thyroid cells
- dose
- high iodine diet can interfere
- different opinions re. Thyroid blockers role
- degree of hyperthyroidism, etc

Many factors depend on the characteristics of the gland, that differ 
among individuals. Given dose is also important, because it's
often very badly calculated. How many people have an eco-doppler 
study done prior RAI?. Almost nobody!. How many have a iodine uptake 
prior RAI?.Very few. More often than not, doses are given on an
"estimation" basis upon a supposed weight of gland. And even
two or 
three protocols, depending on the dose, but there are a number of 
doctors who opt for dosing at large to ensure quick hypothyroidism.

Among those who use lower doses, RAI doesn't instantaneously 
eradicate the thyroid. It's a process that continues to progress
over several years. There may be a small number of patients that 
don't become hypothyroid immediately, but it's been proven
that, within 10 years after RAI, 100% of RAI'ed people is

I know of some persons who feel better 1, 2 or 3 years after RAI, 
specially because they feel relieved from hyper symptoms. I don't 
want to rain over other's parade, but as soon as hypothyroidism
is present, most of them invariably miss and long for their old hyper 

There is some more information at AtomicWomen's site. You might 
consider visiting it here:



From May 30, 2000:


According to researchers in the UK and Russia, reporting in the May 4,
2000 issue of "Nature," the dangerous health impact of radiation may be
passed down from one generation to the next. The study of mice found
that offspring of mice exposed to radiation had an increased number of
genetic mutations, as did their offspring--even though the two
generations of younger mice had not been exposed to radiation. The
research indicates that some radiation effects may be delayed, leading
to genetic disorders years or decades after exposure. (Source: Nature

July 6, 2000
I don't know if doctors get an actual kickback, but RAI has such bad side 
effects, including rendering the patient hypo for life, that the doctor has a 
patient for life--lots of guaranteed income. I am SO GLAD that I listened to 
my own instincts, and not the idiot endo, and did not destroy my thyroid. So 
much of the time Graves disease goes into remission all by itself--why 
wouldn't anyone just go on meds and explore alternate healing, rather than 
opt for a "final solution," which is no solution at all, as you will end up 
sicker than when you started? I am certainly not upset about hurting the 
poor doctor's feelings w/all of my questions and opinions--I have only one 
body, and one life, which are entrusted to me to care for and save, and are 
SO MUCH more important than the doctor's ego. Let's see--weigh the doctor's 
need to feel like he is playing God and is all-knowing against my need to 
survive and be healthy. I don't really see a choice here.  AntJoan

Subj: [hyperthyroidism] Re: WHY?!?! RAI better than surgery?!?!
Date: 7/7/00 
From: (Christine Cline)

The following is an excerpt from an American medical journal. It 
shows the difference between the American doctors' way of thinking 
compared to other countries. It also points out there is a 40 to 50 
percent remission rate with ATD's. 

The New England Journal of Medicine -- January 25, 1996 -- Vol. 334, No. 4 

Immunosuppression of Graves' Hyperthyroidism -- Still an Elusive Goal

Fifty years have passed since radioactive iodine and antithyroid drugs became available for the treatment of hyperthyroidism caused by Graves' disease. Despite the efficacy of both treatments, opinions still diverge widely as to which is better. A course of antithyroid-drug therapy requires prolonged daily treatment, but 40 to 50 percent of patients treated for a year remain euthyroid after therapy is discontinued. Therapy with iodine-131, on the other hand, is simple and fast (one dose usually suffices), but the treatment causes hypothyroidism in a large proportion of patients. In a survey of endocrinologists, 69 percent of the responding physicians in the United States preferred iodine-131 for the treatment of a typical patient with Graves' hyperthyroidism, but an antithyroid drug was preferred by 77 percent of the respondents in Europe and by 88percent in Japan. (1) Obviously, doctors in the United States are disappointed by the high rate of recurrence of hyperthyroidism after the discontinuation of antithyroid-drug therapy, whereas those in Europe and Japan are more inclined to give the patient a chance to have a spontaneous remission, thereby avoiding lifelong treatment with thyroxine (T4). 

>>>>The entire article can be found at the following:

Subj: RAI
Date: 9/2/00 2:41:22 AM Pacific Daylight Time

Haven't written in awhile but am having lots of difficulties. Had RAI in 
1996 for Toxic Multi-nodular Goiter. Was on PTU for a few months previous to 
RAI and started to feel better then I had in years. After RAI I have never 
felt well. I have developed double vision in my eyes which is due to a 
muscular problem (I'm told) they hurt all the time and my lids are puffy and 
feel like they have sand under them. My optometrist won't renew my eye 
glasses until the problem is fixed. If I read or drive the problem gets 
worse. My primary care doc had a CAT scan of my head done, which was fine, I 
was then referred to a neurologist who did an MRI and that was fine. He did 
blood work too and found my TSH was .3 My primary then reduced my Levoxyl to 
.75 mcg. from .88 mcg She then sent me to an endo doc who swore I am not 
hyper thyroid again nor could the nodules have grown back, because RAI makes 
the thyroid atrophy. She said is unlikely my eye problem has any connection 
to my thyroid, or medication because only Graves patients get eye problems. 
She did however do a thyroid antibody test (I have never had one before) just 
in case I could have Graves as well as having Toxic Multi-Nodular.

For one I am sorry I ever had RAI. I have also developed high blood pressure 
in the last two years which I NEVER NEVER had. I am either hanging off the 
ceiling or don't have the pep to tie my sneakers. Anyone out there feel 
similar? People are right, read, read, read before you make a decision.

From Zoey:

In May I was diagnosed with HyperT and Graves. 5 Docs(3 endos and 2
internists) urged me to have RAI - the only thing that would work. I told
them RAI was not an option. I began taking 20 mgs of Tapazole a day ( which
was considerably less than they recommended) and within 3 weeks my T4, T3,
TSH, etc. were at the lower (hypo) end of normal range. For the past 2
months or so I have been taking only 2 1/2 mgs of Tapazole a day and my
bloodwork has been stable, normal, and euthyroid. The doctors told me only
RAI would work. I am so thankful I didn't listen to them. I hope you will
take some time to consider your options. Destroying your thyroid gland is
final and frequently causes more problems than it corrects. Please let us
know your decision. with all my best, Zoey

Curr Opin Ophthalmol 1999 Oct;10(5):358-61

New insights into pathogenesis and potential therapeutic options for Graves orbitopathy.

Warwar RE

Department of Ophthalmology, Wright State University School of Medicine, Dayton, Ohio 45429, USA.

Graves disease is an autoimmune disorder that affects the seemingly heterogeneous tissues of the thyroid and orbit. Evidence suggests that these tissues share a common antigen: the thyroid-stimulating hormone receptor protein. It is speculated that this antigen (which is present in orbital tissue in both normal patients and patients with Graves disease), together with the humoral factors present in the serum of patients with Graves disease, forms the basis for the immunologic attack seen in Graves ophthalmopathy. Once the immune response has been activated, a series of pro-inflammatory cytokines propagate inflammation, leading to the clinical findings typical of Graves ophthalmopathy. Knowledge of the specific inflammatory mediators involved may someday lead to the development of specific, clinically available immunomodulatory therapies for Graves eye disease.
Lancet 2000 Apr 29;355(9214):1505-9

Radiotherapy for Graves' orbitopathy: randomised placebo-controlled study.

Mourits MP, van Kempen-Harteveld ML, Garcia MB, Koppeschaar HP, Tick L, Terwee CB

Donders Institute of Ophthalmology (Orbital Unit), University Medical Centre, Utrecht, The Netherlands.

BACKGROUND: The best treatment (steroids, irradiation, or both) for moderately severe Graves' orbitopathy, a self-limiting disease is not known. We tested the efficacy of external beam irradiation compared with sham-irradiation. METHODS: In a double-blind randomised clinical trial, 30 patients with moderately severe Graves' orbitopathy had radiotherapy (20 Gy in ten fractions), and 30 were assigned sham-irradiation (ten fractions of 0 Gy). Treatment outcome was measured qualitatively by changes in major and minor criteria and quantitatively in several ophthalmic and other variables, such as eyelid aperture, proptosis, eye movements, subjective eye score, and clinical-activity score at 24 weeks. FINDINGS: The qualitative treatment outcome was successful in 18 of 30 (60%) irradiated patients versus nine of 29 (31%) sham-irradiated patients at week 24 (relative risk [RR]=1.9 [95% CI 1.0-3.6], p=0.04). This difference was caused by improvements in diplopia grade, but not by reduction of proptosis, nor of eyelid swelling. Quantitatively, elevation improved significantly in the radiotherapy group, whereas all other variables remained unchanged. The field of binocular single vision was enlarged in 11 of 17 patients after irradiation compared with two of 15 after sham-irradiation. Nevertheless, only 25% of the irradiated patients were spared from additional strabismus surgery. INTERPRETATION: In these patients with moderately severe Graves' orbitopathy, radiotherapy should be used only to treat motility impairment.

From: (Horten, Mona)

Good morning....last night a neighbor came over and we chatted while handing
out candy to the trick-or-treaters. He was rendered hypo several years ago.
He had RAI. They never bothered to try any of the ATDs. Now he is always
tired, hasn't slept well since RAI and when he gets sick, he stays sicker
longer. He also told me since the RAI his saliva has changed and he can't
lick an envelope or stamp because they won't stay stuck! Weird huh? I have
also noticed he seems "down" lately. I think his thyroid levels are off so
he's going in for blood work. He hates the way he feels! He's 39 years old
and likes all kinds of outdoor activities with his kids and wishes he felt
better. He also told me it took OVER A YEAR before the thyroid was
destroyed and in the meantime had to take meds. Just thought I'd share
this. Mona