Yonsei Med J.  2015 Jul;56(4):1021-1027. 10.3349/ymj.2015.56.4.1021.

Effect of a Low Iodine Diet vs. Restricted Iodine Diet on Postsurgical Preparation for Radioiodine Ablation Therapy in Thyroid Carcinoma Patients

• Lim CY
• Kim JY
• Yoon MJ
• Chang HS
• Park CS
• Chung WY

• KMID: 2366344
• DOI: http://doi.org/10.3349/ymj.2015.56.4.1021

Abstract

PURPOSE
The radioiodine ablation therapy is required for patients who underwent a total thyroidectomy. Through a comparative review of a low iodine diet (LID) and a restricted iodine diet (RID), the study aims to suggest guidelines that are suitable for the conditions of Korea.
MATERIALS AND METHODS
The study was conducted with 101 patients. With 24-hour urine samples from the patients after a 2-week restricted diet and after a 4-week restricted diet, the amount of iodine in the urine was estimated. The consumed radioiodine amounts for 2 hours and 24 hours were calculated.
RESULTS
This study was conducted with 47 LID patients and 54 RID patients. The amounts of iodine in urine, the 2-week case and 4-week case for each group showed no significant differences. The amounts of iodine in urine between the two groups were both included in the range of the criteria for radioiodine ablation therapy. Also, 2 hours and 24 hours radioiodine consumption measured after 4-week restrictive diet did not show statistical differences between two groups.
CONCLUSION
A 2-week RID can be considered as a type of radioiodine ablation therapy after patients undergo a total thyroidectomy.

Keyword

Thyroid carcinoma; iodine diet; radioiodine ablation therapy

MeSH Terms

Ablation Techniques
Adult
Carcinoma/metabolism/*radiotherapy/surgery
*Diet
Female
Humans
Iodides/urine
Iodine/administration & dosage/urine
Iodine Radioisotopes/metabolism/*therapeutic use
Male
Middle Aged
Republic of Korea
Thyroid Neoplasms/metabolism/*radiotherapy/surgery
Thyroidectomy
Treatment Outcome
Iodides
Iodine
Iodine Radioisotopes

Reference

1. Cancer incidence from 2003 to 2005 and cancer survival rate from 1993 to 2005 of Korea. Division of Cancer Registration & Surveillance, Ministry For Welfare and Family Affairs;2008.

2. Mazzaferri EL, Kloos RT. Clinical review 128: current approaches to primary therapy for papillary and follicular thyroid cancer. J Clin Endocrinol Metab. 2001; 86:1447–1463.

3. Samaan NA, Schultz PN, Hickey RC, Goepfert H, Haynie TP, Johnston DA, et al. The results of various modalities of treatment of well differentiated thyroid carcinomas: a retrospective review of 1599 patients. J Clin Endocrinol Metab. 1992; 75:714–720.

4. Wartofsky L. rhTSH-Stimulated Thyroglobulin Study Group. Management of low-risk well-differentiated thyroid cancer based only on thyroglobulin measurement after recombinant human thyrotropin. Thyroid. 2002; 12:583–590.

5. Pluijmen MJ, Eustatia-Rutten C, Goslings BM, Stokkel MP, Arias AM, Diamant M, et al. Effects of low-iodide diet on postsurgical radioiodide ablation therapy in patients with differentiated thyroid carcinoma. Clin Endocrinol (Oxf). 2003; 58:428–435.

6. Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, et al. Management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2006; 16:109–142.

7. Kim JY, Kim KR. Dietary iodine intake and urinary iodine excretion in patients with thyroid diseases. Yonsei Med J. 2000; 41:22–28.

8. Roh JH, Kim BI, Ha JS, Chang SJ, Shin HY, Choi JH, et al. Comparison of Urine Iodine/Creatinine ratio between Patients following Stringent and Less Stringent Low Iodine Diet for Radioiodine Remnant Ablation of Thyroid Cancer. Nucl Med Mol Imaging. 2006; 40:322–326.

9. Tomoda C, Uruno T, Takamura Y, Ito Y, Miya A, Kobayashi K, et al. Reevaluation of stringent low iodine diet in outpatient preparation for radioiodine examination and therapy. Endocr J. 2005; 52:237–240.

10. Guljord L. Low-iodine cookbook. 7th ed. New York: ThyCa: Thyroid Cancer Survivord' Association, Inc;2010. 18–21. accessed on 2010 July 1. Available at: http://www.thyca.org.

11. Jaffe M. Uber den Niderschlag welchen Pikrinsaure in normalen Harn erzengt und uber neue Reaktion des Kreatinine. Z Physiol Chem. 1886; 10:391–400.

12. Edge S, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A. AJCC Cancer Staging Manual. 7th ed. New York: Springer;2010.

13. DeGroot LJ, Kaplan EL, McCormick M, Straus FH. Natural history, treatment, and course of papillary thyroid carcinoma. J Clin Endocrinol Metab. 1990; 71:414–424.

14. Keston AS, Ball RP, Frantz VK, Palmer WW. Storage of radioactive iodine in a metastasis from thyroid carcinoma. Science. 1942; 95:362–363.

15. Blahd WH. Treatment of malignant thyroid disease. Semin Nucl Med. 1979; 9:95–99.

16. Haugen BR, Pacini F, Reiners C, Schlumberger M, Ladenson PW, Sherman SI, et al. A comparison of recombinant human thyrotropin and thyroid hormone withdrawal for the detection of thyroid remnant or cancer. J Clin Endocrinol Metab. 1999; 84:3877–3885.

17. De La Vieja A, Dohan O, Levy O, Carrasco N. Molecular analysis of the sodium/iodide symporter: impact on thyroid and extrathyroid pathophysiology. Physiol Rev. 2000; 80:1083–1105.

18. Park JT 2nd, Hennessey JV. Two-week low iodine diet is necessary for adequate outpatient preparation for radioiodine rhTSH scanning in patients taking levothyroxine. Thyroid. 2004; 14:57–63.

19. Hollowell JG, Staehling NW, Hannon WH, Flanders DW, Gunter EW, Maberly GF, et al. Iodine nutrition in the United States. Trends and public health implications: iodine excretion data from National Health and Nutrition Examination Surveys I and III (1971-1974 and 1988-1994). J Clin Endocrinol Metab. 1998; 83:3401–3408.

20. Interdepartmental Committee on Nutrition for National Defense. Manual for Nutrition Surveys. 2nd ed. Washington DC: US Government Printing Office;1963. p. 249.

21. Maxon HR, Thomas SR, Boehringer A, Drilling J, Sperling MI, Sparks JC, et al. Low iodine diet in I-131 ablation of thyroid remnants. Clin Nucl Med. 1983; 8:123–126.

22. Lakshmanan M, Schaffer A, Robbins J, Reynolds J, Norton J. A simplified low iodine diet in I-131 scanning and therapy of thyroid cancer. Clin Nucl Med. 1988; 13:866–868.

23. Katamine S, Mamiya Y, Sekimoto K, Hoshino N, Totsuka K, Naruse U, et al. Iodine content of various meals currently consumed by urban Japanese. J Nutr Sci Vitaminol (Tokyo). 1986; 32:487–495.

24. Follis RH Jr, Vanprapa K, Damrongsakdi D. Studies on iodine nutrition in Thailand. J Nutr. 1962; 76:159–173.

25. Passero C, Arce L, Reinert S, Hennessey JV. 2002 131-I ablation success after iodine depletion in thyroid cancer patients (Abstract). In : 74th Annual Meeting of the American Thyroid Association; October 10-13; Los Angeles.

26. Bleiler RE, Schedl HP. Creatinine excretion: variability and relationships to diet and body size. J Lab Clin Med. 1962; 59:945–955.

27. Rowe JW, Andres R, Tobin JD, Norris AH, Shock NW. The effect of age on creatinine clearance in men: a cross-sectional and longitudinal study. J Gerontol. 1976; 31:155–163.