Why a Low-Iodine Diet?
Thyroid cells in your body absorb iodine, which is contained in many foods. Your doctor may ask you to avoid certain foods and medicines that contain iodine for a few weeks before your ablation procedure, Tg testing or whole-body scan (WBS). Doing so will deplete your body of its natural storage of iodine, allowing any remaining thyroid cells to better absorb the radioactive iodine given to you before these procedures. Be sure to let your doctor know if you've had CAT scans, angiograms, pyelograms, stent placements or any other x-ray procedures in the month before your test since some x-ray exams use iodine-containing chemicals that could interfere with your scan.1
Being on a low iodine diet can be challenging. However, there are several cookbooks available to help you select and prepare healthy, low iodine meals before your testing if your doctor thinks this is important for your care. Visit the following links for low-iodine meal-planning suggestions:
- Light of Life Foundation: Low Iodine Cookbook
- National Institutes of Health: Preparing to Receive Radioactive Iodine: The Low-Iodine Diet
- Thyroid Cancer Survivor’s Association: Low-Iodine Diet & Cookbook
- Your Health Press: The Low Iodine Diet Cookbook
Foods to avoid that contain iodine2
- Iodized salt and sea salt
- All dairy products (milk, sour cream, cheese, cream, yogurt, butter, ice cream)
- Egg yolks
- Seafood (fish, shellfish, seaweed, kelp)
- Foods that contain carrageen, agar-agar, align, or alginate (all of these are made from seaweed)
- Cured and corned foods (ham, bacon, sausage, corned beef, tuna, etc.)
- Marinated chicken or turkey
- Dried fruit
- Canned vegetables
- Bread products that contain iodate dough conditioners
- Soy products (soy sauce, soy milk, tofu)
- Foods that contain FD&C Red Dye #3
Foods you can eat2
- Kosher salt
- Egg whites
- Fresh non-cured meat from the butcher
- Fresh fruits and vegetables, washed well (limit bananas, spinach, and broccoli)
- Frozen vegetables with no added salt
- Canned peaches, pears and pineapples
- Matza/ Matzah/ Matzo (Homemade bread made from non-iodized salt and oil (not soy) instead of butter or milk)
- Natural unsalted peanut butter
- Clear sodas
- Coffee or tea made with distilled water (with non-dairy creamer only)
- Popcorn popped in vegetable oil or air popped, with non-iodized salt
- Sorbet (without FD&C red dye #3)
Please note: A low-iodine diet does not restrict sodium or salt. It only restricts iodized salt or sea salt. Any salt that is labeled non-iodized may be used freely.
Other tips: You may want to shop and freeze or store your ingredients before starting your diet to avoid being tempted by iodine-containing foods at the store.
Important Safety Information and Indications
Important Safety Information and Indications
IMPORTANT SAFETY INFORMATION
Patients should not use Thyrogen with radioiodine if they have a contraindication to the use of radioiodine. Please consult with your doctor for a list of contraindications for radioiodine.
Thyrogen can cause serious side effects, including:
- There have been reports of events that led to death in patients who have not had surgery to have their thyroid gland removed, and in patients with thyroid cancer cells that have spread to other parts of the body.
- Patients over 65 years old with large amounts of leftover thyroid tissue after surgery, or with a history of heart disease, should discuss with their physicians the risks and benefits of Thyrogen.
- Thyrogen can be administered in the hospital for patients at risk for complications from Thyrogen administration.
- Since Thyrogen was first approved for use, there have been reports of central nervous system problems such as stroke in young women who have a higher chance of having a stroke, and weakness on one side of the body. The relationship between THYROGEN administration and stroke is unknown. Patients should remain hydrated prior to treatment with Thyrogen.
Sudden Rapid Tumor Enlargement:
- Leftover thyroid tissue after surgery and cancer cells that have spread to other parts of the body can quickly grow and become painful after Thyrogen administration. Patients with cancer cells near their windpipe, in their central nervous system, or in their lungs may need treatment with a glucocorticoid (a medication to help prevent an increase in the size of the cancer cells before using Thyrogen.)
Risks Associated with Radioiodine Treatment:
- If THYROGEN is administered with radioiodine (RAI), the serious side effects for RAI apply to this combination regimen. Please consult with your doctor for a list of contraindications for radioiodine.
In clinical studies, the most common side effects reported were nausea and headache.
USE IN SPECIFIC PATIENT POPULATIONS
Pregnant patients: Notify your healthcare provider immediately in the event of a pregnancy. If THYROGEN is administered with radioiodine, the combination regimen should not be used in pregnant women. Thyrogen should be given to a pregnant woman only if the doctor thinks there is a clear need for it.
Breastfeeding patients: If THYROGEN is administered with radioiodine, the combination regimen should not be used in breastfeeding women. It is not known whether Thyrogen can appear in human milk. Breastfeeding women should discuss the benefits and risks of Thyrogen with their physician.
Children: Safety and effectiveness in young patients (under the age of 18) have not been established.
Elderly: Studies do not show a difference in the safety and effectiveness of Thyrogen between adult patients less than 65 years and those over 65 years of age.
Patients with kidney disease: Thyrogen exits the body much slower in dialysis patients and can lead to longer high TSH levels.
INDICATIONS AND USAGE
Thyrogen (thyrotropin alfa) is used to help identify thyroid disease by testing the blood for a hormone called thyroglobulin in the follow up of patients with a certain type of thyroid cancer known as well differentiated thyroid cancer. It is used with or without a radiology test using a form of iodine.
Limitations of Use:
- The effect of Thyrogen on long term thyroid cancer outcomes has not been determined.
- When Thyrogen is used to help detect thyroid cancer, there is still a chance all or parts of the cancer could be missed.
Thyrogen is also used to help patients prepare for treatment with a form of iodine, called radioiodine, to remove leftover thyroid tissue in patients who have had surgery to take out the entire thyroid gland for patients with well differentiated thyroid cancer who do not have signs of thyroid cancer which has spread to other parts of the body.
Limitations of Use:
- In a study of people being prepared for treatment with a form of iodine after thyroid surgery, results were similar between those who received Thyrogen and those who stopped taking their thyroid hormone for up to 5 years after treatment. Researchers do not know if results would be similar over a longer period of time.
Click here for full Prescribing Information.