Low Iodine Diet for One Week Is Sufficient for Adequate Preparation of High Dose Radioactive Iodine Ablation Therapy of Differentiated Thyroid Cancer Patients in Iodine-Rich Areas

Lee, Minkyung; Lee, Yu Kyung; Jeon, Tae Joo; Chang, Hang Seok; Kim, Bup Woo; Lee, Yong Sang; Park, Cheong Soo; Ryu, Young Hoon

doi:10.1089/thy.2013.0695

Cited by 28 publications

(35 citation statements)

References 31 publications

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“…Our study corresponds with previous reports which were also from Korea . Lee et al showed that 95.9% (187/195) of patients can achieve adequate UIE for RAI treatment after 1 week of low iodine diet.…”

Section: Discussionsupporting

confidence: 92%

Pattern of urine iodine excretion with low iodine diet during preparation for radioactive iodine ablation in patients with thyroid cancer

et al. 2018

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Background The optimal period of low iodine diet during preparation for radioactive iodine (RAI) ablation in an area with iodine‐rich diet was investigated. Methods Ninety‐four patients with thyroid cancer who underwent low iodine diet and RAI were prospectively allocated into 2 groups—thyroxine withdrawal or using recombinant human thyroid stimulating hormone (rhTSH) for TSH stimulation. Their urinary iodine excretion (UIE) patterns were analyzed. Results There was no clinicopathological difference between the 2 groups except for tumor size and lymph node status. The UIE (median iodine to creatinine ratio, I/Cr) in the withdrawal group on the 7th and 14th day were 18.3 and 17.9 μg/gCr, respectively, with adequate preparation rate of 93.3% on both days (cutoff value 100 μg/gCr). In the rhTSH group, the median I/Cr on the 7th and 14th day were 48.0 and 45.7 μg/gCr (adequate preparation rates 91.8% and 93.8%), respectively. Conclusion One week of low iodine diet is sufficient preparation for RAI regardless of method of TSH stimulation.

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Section: Discussionsupporting

confidence: 92%

Pattern of urine iodine excretion with low iodine diet during preparation for radioactive iodine ablation in patients with thyroid cancer

et al. 2018

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“…Although we did not ask each centre to report when the Px-WBS occurred, it is carried out when residual activity permits imaging, typically around 2-10 days after RIA [5]. Studies that examined whether advice to follow a LID improves ablation success reported asking people to follow a LID prior to RIA but did not appear to ask people to continue after 131 I had been administered [9][10][11]13], unless a Px-WBS was carried out [12]. To our knowledge, no studies have assessed whether continuing a LID beyond the administration of RIA confers any benefit on outcomes, or what effect resuming a usual diet has on the iodine status in this immediate post-treatment period.…”

Section: Discussionmentioning

confidence: 99%

“…A study in South Korea [10] found only excessive iodine intake, measured as a urinary iodine-to-creatinine ratio (UI/Cr) > 250 μg/g Cr, to be associated with increased odds of unsuccessful ablation (OR: 4.74; 95% CI: 1.78-12.63). Three other retrospective studies, in the USA [11] and South Korea [12,13], found (1) no difference in ablation success rates between cohorts that were advised a 10-to 14-day LID and historic controls who were given no advice [11];…”

Section: Introductionmentioning

confidence: 99%

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A Survey of UK Centres on Low Iodine Diet Recommendations prior to Radioiodine Ablation Therapy for Differentiated Thyroid Cancer

England¹,

Moss²,

Beasley³

et al. 2019

Eur Thyroid J

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Background: Guidelines suggest that a low iodine diet (LID) is advised prior to radioiodine ablation (RIA) for thyroid cancer. We aim to describe current practice regarding LID advice in the UK, determine uptake of the 2016 UK LID Working Group diet sheet and discover whether there are differences in practice. Methods: We used an online survey distributed between November 2018 and April 2019 to centres in the UK that administer 131 I. We asked questions on whether a LID is advised, for how long, how advice is presented, whether and how compliance is measured and whether treatment is delayed if LID advice is not followed. Results: Fifty-six clinicians from 47 centres that carry out RIA for thyroid cancer responded. Forty-four centres (94%) advise a LID prior to RIA, the majority for 14 days (82%). Two-thirds of the centres use the UK LID Working Group diet sheet. Patients are told to resume normal eating when 131 I is administered at 17 centres (39%), with 18 (41%) advising waiting for 24-48 h after ad-ministration. Most centres (95%) use only a simple question or do not assess compliance. Only 2 (5%) indicate that RIA would be delayed if someone said they had not followed LID advice. Conclusions: UK practice regarding LID prior to RIA for thyroid cancer is consistent with current guidelines, but non-adherence does not usually delay RIA. The UK Low Iodine Diet Working Group diet sheet is widely recognised and used. Practice could be improved by centres working to harmonise advice on when to restart a normal diet.

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“…Among studies that examined the LID, varying degrees of detail were provided about the implemented LID protocols. However, strict prohibition of all seafood and avoidance of all dairy products were commonalities observed among existing protocols . Many studies also restricted the consumption of canned foods as well as eating out at restaurants.…”

Section: Methodsmentioning

confidence: 99%

Low iodine diet in differentiated thyroid cancer: a review

Bansal

et al. 2015

Clinical Endocrinology

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SummaryRadioactive iodine (RAI) ablation is a beneficial, adjuvant therapy for the management of differentiated thyroid cancer (DTC) after thyroidectomy. The goal of RAI is to destroy remnant thyroid and microscopic cancerous tissue. Radioactive iodine uptake is enhanced by elevating TSH levels and initiating a low iodine diet (LID) prior to ablation. An ideal LID should preferably not exceed 50 mcg/day of dietary iodine for 1-2 weeks, although the duration may be shortened to a week with a structured patient education programme. A pre-ablation spot urinary iodine concentration (UIC) of <100 mcg/l and/or a urinary iodine to creatinine ratio (UICR) of <100 mcg/gCr would support an adequate LID preparation. Hyponatraemia, most likely due to iatrogenic hypothyroidism, is a potential side effect associated with LID and occurs during and a few days after the LID. Although the overall incidence of hyponatraemia is low, patients at high risk (older age, female sex, use of thiazide diuretics) may benefit from serum sodium monitoring. The existing evidence on the impact of LID on RAI ablation has been largely inconsistent due to retrospective study designs and the lack of an objective measurement of urinary iodine levels. Future large prospective randomized control trials are needed to elucidate and confirm the crucial role of LID in achieving successful RAI ablation and greater disease-free survival in DTC.

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Low Iodine Diet for One Week Is Sufficient for Adequate Preparation of High Dose Radioactive Iodine Ablation Therapy of Differentiated Thyroid Cancer Patients in Iodine-Rich Areas

Abstract: Strict LID for one week was sufficient to achieve target UIE values for RAIT preparation, even in iodine-rich areas.

Cited by 28 publications

References 31 publications

Pattern of urine iodine excretion with low iodine diet during preparation for radioactive iodine ablation in patients with thyroid cancer

Pattern of urine iodine excretion with low iodine diet during preparation for radioactive iodine ablation in patients with thyroid cancer

A Survey of UK Centres on Low Iodine Diet Recommendations prior to Radioiodine Ablation Therapy for Differentiated Thyroid Cancer

Low iodine diet in differentiated thyroid cancer: a review

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