it is rare, or maybe i have never written two blogs in two days, but here is a subject that i would like to expand upon: the low iodine diet for patients before a treatment dose of I-131 is given. in my next blog, this will be a short series, i will go over isolation procedures after the treatment dose of I-131. what to expect, how to prepare for it, what to do,etc. but, again in my opinion, the diet is probably the most important part of the treatment. why, do you ask? i will explain, but first i will mention that the thyca website has some excellent information on this subject. here you will find recipes and useful information. i personally purchased an excellent book on the subject. it is called, not surprisingly, " the low iodine diet cookbook" by norene gilletz. the author explains some of the reasons why a low iodine diet is so important. ms. gilletz also has tons of recipes, and they are grouped into breakfast, lunch, dinner, desserts, snacks, and children's menus. the introduction to the book is written by Dr. Kenneth Ain. he explains the importance of reducing iodine in your diet before, during and perhaps for a short time after receiving the I-131 treatment dose. i will try to explain it in my own unique way...
thyroid cells love, love to " eat" iodine. they use it to make thyroid hormone. if you have had surgery for thyroid cancer, and your thyroid is gone to wherever they send bad thyroids to, theoretically you should not have any thyroid cells left in your body. but let us pretend that the thyroid gland is the mother ship. before the mother ship is destroyed, it sent out escape pods ( little bits of thyroid cancer cells) to other parts of the body. ( they especially like to go to the lungs and bones). so these rogue thyroid cells are now escaped thyroid cancer cells . even the best surgeon can not possibly get these tiny little guys. the trick is to get the thyroid cancer cells to feed on the radioactive iodine, not the regular iodine in the diet. you starve your body of the regular iodine, and the thyroid cancer cells are attracted to the radioactive iodine like moths to a flame. and you know how that turns out...
if a patient does not follow the low iodine diet , as instructed by their physician, it can cause severe consequences. perhaps there can be a recurrence elsewhere in the body. maybe another treatment of the I-131 would be necessary. when i read in some thyroid cancer forums that some people say, laughingly, that they have cheated on their diet, i want to scream. they have in fact cheated on themselves. the diet is a challenge, to be sure, but it is a drop in the bucket time-wise when compared to the rest of your life.
the diet usually begins two weeks before the treatment dose of I-131 and continues for a week or so after the dose when scans are usually done. the amount of time after the dose of the I-131 is given and scans completed seems to vary. this is usually just a day or two- but check with your physician to be safe. the list to avoid is long, i will admit. i will mention just a few things here. iodized salt and sea salt must be avoided, but non-iodized salt is o.k. dairy products have to be avoided. this puzzled me at first. why? milk from any mammal( that is right- no goats milk allowed, though i am not sure why anyone would want to drink it) has a high concentration of iodine. also, commercial dairies use an antiseptic containing an iodine product to clean the area that is to be milked. so no milk or other dairy products are allowed on the low iodine diet. no chocolate is allowed ( big sad face here) because of the milk content. red colored ( especially red dye #3) in medicines and foods should be avoided. this was an odd one- that is why i mentioned it. i looked up the chemical structure of red dye #3 and found that it contains iodine. mystery solved, i guess. and just a reminder, lipsticks and some other cosmetics contain red dye #3. it would be best to avoid these until after the treatment as well.
the list goes on and on, and that is why a patient needs a detailed list to refer to while on this diet. ms. gilletz recommends not eating out- because you can never be certain what exactly is in your food. and i do not mean that in a bad way, but even well meaning waitstaff and cooks may not realize the importance of sticking to the diet. another thing to omit while on the diet is multivitamins. most multivitamins contain iodine, and it would be safer to omit them for a few weeks. there is a long list of items to avoid in packaged foods. i thought it was safer to just omit them while on the diet. generally, fresh fruits, vegetables and meats are o.k. unless products containing iodine are added to them. another tip: when you see " natural flavorings" on a label, it may include salt. and it would be the iodized salt that you should avoid.
the recipes in " the low iodine cookbook" are really good. i still use some of them, especially the blueberry muffin one. it takes some planning, preparation time and lets face it, some will power to successfully complete the low iodine diet. but it is so worth it. and besides, when you are able to get off the diet, that cheeseburger will probably be the best one that you have ever had.
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