The following question was answered by an expert in the appropriate field:Q about radioactive iodine therapy

I was diagnosed with Graves’ disease and was prescribed 629 MBq of radioactive iodine to address my disease. After the 131I intake, I went into self-imposed isolation for 10 days to protect my wife and my almost two-year-old daughter. 

After the 10 days, I was told by the hospital nuclear medicine staff that I could go on with my life as normal. 

On the 11
th, 12th, and 13th days, I spent considerable time with my family and believe that I spent about 3.5 hours watching television by or cuddling my daughter. I estimate that the average distance of her little head to my thyroid was about 15 cm. We also went to lunch and shopped as a family during these three days. 

On the 14
th day I decided to buy a radiation detector to check whether I was still radioactive. I was very, very frightened to see that I was still radioactive, and am very concerned about the exposure to my daughter on the 11th, 12th, and 13th days. On the 14th, day, I went into isolation again in separate quarters in my house.

  1. Could you please give me advice input on how dangerous was my exposure to my daughter?
  2. Is there any possibility of estimating how much I may have exposed her to?
  3. Are there noninvasive and nonnuclear ways to know how bad was the exposure?

I am very, very concerned and hope that you will answer my questions.

Before you read the below response by the expert, let me give you our take on this. We have over 30 years of experience with radiation monitoring and decontamination.

First, the simple answer is no, the time you spent snuggling with your daughter did not do here any harm. 14 days after your radioactive iodine therapy, the amount of GAMMA radiation that your body is emitting is not harmful to anyone as long as their exposure is limited to a few hours a day. You will be emitting gamma radiation for many more weeks.

The real danger here is from the unanswered question, did your daughter or anyone else in the family go into your isolation room? Even 14 days after your radioactive iodine therapy, your isolation area is very dangerous to others, unless you properly decontaminate it. During the first 2 weeks of your isolation you have been leaving radioactive contamination everywhere. It comes out in your urine, your stool, saliva, sweat, body oil, even your breath.

Take that gieger counter and look around your room. You will find your bed HOT, you will find your sink, your toilet, the WALLS near the toilet, your TV remote, your phone, etc. all hot. Contact with any of these surfaces is dangerous for others, especially children.

The good news, it will go away… in about 90 days. That’s right, hot area will take up to 10 half-lives to decay down to background, that’s 88 days. This is why you need Bind-It. With the Bind-It Patient Care Pack, you can limit the contamination by washing your hands often with Bind-It Hand and Body soap. Once your isolation time is up, Bind-It ready to use spray will safely and effective remove the I131 contamination for all surfaces.

The gamma radiation exposure, in only a part of the danger to others from Radioactive iodine therapy, and quite frankly, it’s the beta radiation exposure caused by uptake of radioactive contamination that should be of concern. You can read more about the effects of I131 in other articles on this website.

Now here is the expert response.

You have not harmed your daughter. You followed the instructions given to you and were isolated even more days than many facilities require. 

Radiation detectors are very sensitive and can even detect the cosmic radiation that we are exposed to every day that we live on earth. Being able to detect it is not unusual, even two weeks later since the material that was incorporated into your thyroid will now be decaying by half approximately every eight days. 

Hospitals classify the dose given to you for Graves’ disease as a low dose. Studies were performed to determine when it is safe for a person treated with radioactive iodine to be around other people. The conservative assumptions that are used to determine when controls can be suspended are based on the Nuclear Regulatory Commission (NRC) regulations to not expose a family member to more than 5 mSv from a nuclear medicine treatment. That is also the total radiation dose that the fetus of a pregnant woman is legally allowed to receive if the mother continues to work in radiation areas while pregnant. 

The policy at my facility is for a person who receives less than 1221 MBq to be isolated for the first four days and to avoid holding children for long periods of time for the first week after treatment. Usually more than half the amount of radioactivity leaves the body the first day. Some of the radioiodine concentrates in the thyroid and the remainder is removed in the urine. Your isolation time was greater than my hospital’s directions (seven days compared to your 10 days). 

It is not possible to estimate the exposure to your daughter and there are no noninvasive nor nonnuclear ways to determine her exposure. To perform an estimate, I would not want to guess how much was in your thyroid since there are so many variables that I don’t know, such as, how much uptake you had, how rapidly it left your body, the initial radiation exposure reading and subsequent readings. I feel confident that she was exposed to much less than 5 mSv, especially since distance was kept for 10 days and then you isolated yourself again after you became concerned. And, as I said earlier, 5 mSv is considered a safe dose for a baby in the womb. It is certainly safe for a two year old. 

I can understand your fears and concerns. However, given our many years of experience treating patients with radioiodine, I believe that no harm was done to your daughter. 

Marcia Hartman, MS