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131I is the only isotope used for treatment of thyrotoxicosis (others are used in diagnosis). Administered orally in solution as sodium 131I, it is rapidly absorbed, concentrated by the thyroid, and incor-porated into storage follicles. Its therapeutic effect depends on emission of β rays with an effective half-life of 5 days and a pen-etration range of 400–2000 μm. Within a few weeks after admin-istration, destruction of the thyroid parenchyma is evidenced by epithelial swelling and necrosis, follicular disruption, edema, and leukocyte infiltration. Advantages of radioiodine include easy administration, effectiveness, low expense, and absence of pain. Fears of radiation-induced genetic damage, leukemia, and neoplasia have not been realized after more than 50 years of clinical experi-ence with radioiodine therapy for hyperthyroidism. Radioactive iodine should not be administered to pregnant women or nursing mothers, since it crosses the placenta to destroy the fetal thyroid gland and is excreted in breast milk.
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