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Forum Name: Endocrinology Topics

Question: Odd question...thyroid and x-rays?


 4PtSake - Fri Mar 03, 2006 4:55 am

Hello,
I'm a 44 year old female with degenerative issues in my lumbar spine and neck, and OA in both hips, have been told in the past I have fibromyalgia, and have had IBS for 30 years. I've been told that I had an immune deficiency when I was small (was frequently sick) and they gave me gammaglobulin (sp?) shots for it. As far as I know there is no family history of thyroid problems. I am currently taking lexapro for depression but otherwise only suppliments...multi vit., calcium, fish oil, glucosamine and condroitin, and Tylenol/Advil for pain.

Basically, from the array of symptoms I've been aquiring over the last year and everything I've been reading, I fit the bill pretty well for thyroid or possibly pituitary problems. Cold intolerence and cold hands and feet, exhausted constantly, tight throat and trouble swallowing, achy joints and muscles (mostly below the waist and upper back), weight loss, constipation, very moody, among a few other things.

This is going to sound like an odd question but...can having a large number of x-rays in a short period of time cause thyroid/pituitary problems...or aggrivate them if they already exist?

Between Jan '06 and Nov '06 I had 16 total x-rays of my hips, lower back, and neck as well as a full set of dental x-rays in Oct '06. I've read recently that radiation therapy (which I realize is much stronger than normal x-rays) can cause thyroid problems and (due to a family members experience) I know that large numbers of x-rays can cause cancer. My guess is that it's just coincidence but am curious for future reference. With all my joint issues I'm sure I have lots more x-rays in my future and, though I don't know for sure yet that I do have thyroid problems, if the connection is not totally unreasonable I can be sure to monitor the number of x-rays I get a little more closely...though I should have been doing that already and plan to from now on.

Thank you for offering this service and your time and energy and for any info you might have on the subject. Take care.
 Theresa Jones, RN - Sat Mar 04, 2006 8:16 am

User avatar Hi 4PtSake,
Radiation exposure from x-rays and radiation treatment are in much different levels. X-rays have a very low level of radiation exposure. Of course, records should be kept of these diagnostic studies and not done unless medically necessary. The potential benefit of identifying a disorder outweighs the small risk. There has not been an actual number as what is considered safe or dangerous (to my knowledge). Here is a weblink provided by the FDA. Click here! As for your suspected thyroid problems I would suggest an evaluation by an Endocrinologist to identify if an underlying disorder is present.
Sincerely,
Theresa Jones, RN
 4PtSake - Sun Mar 05, 2006 3:23 am

Thank you, Theresa, for the reply. I actually have an appointment for a stress test on Monday to make sure some of the other symptoms aren't heart related and my doctor is trying me on Aciphex to see if some of it might be digestive then we'll go from there. The meds have helped some but I do plan on discussing it all a little more in depth when I go in later in the month for a follow up. Thank you for the FDA info. as well.
I really appreciate all of the medical folks, including yourself, taking time out of your busy schedules to reply to people's questions...sometimes all we "patients" need is a little info and reassurance...Thank you!
 Dr. Shank - Sat Mar 11, 2006 7:41 pm

Dear 4PtSake:

I agree with what Theresa said.

I would add that information about safe doses of radiation to the pituitary is hard to find. The pituitary is considered to be radiation sensitive, but different pituitary cells respond differently (with the cells producing somatotropin="growth hormone" being considered the most sensitive). Conventional dosimetry, however, deals with the risk of a radiation-induced cancer, and cells that die from radiation obviously cannot develop into cancers. I was not able to find specific information about the risk to the pituitary from repeated diagnostic radiation, but it is considered to be very low. Unfortunately. during radiation treatments to the head or neck, little effort is made to protect the pituitary, since the dosimetry calculations are based upon the brain, which is fairly resistant to radiationn effects. To make matters worse, patients never seem to be warned of the possible pituitary damage or to be taken seriously when they have symptoms or even confirmed pituitary insufficiency.

As compared to the pituitary, the thyroid is much less sensitive to radiation. There is also more awareness of the risk of high cummulative occupational radiation exposure, and many who work around radiation sources routinely wear thyroid shields. Even so, I have been frustrated by what appears to be a uniform lack of follow-up or even counseling about the risks to the thyroid in patients who have had therapeutic doses of radiation to the head and neck, and none of the patients whom I have seen have reported any effort to shield the thyroid during these procedures.

Unless you have had extradinary amounts of diagnostic radiation exposure, or you also have therapeutic or significant occupational or accidental exposure, the concensus would be that your risk for radiation-induced thyroid or pituitary abnormalities is very small.

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