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Storage and handling Before reconstitution (powder) Storage : Refrigerate at 2-8°C (36-46°F) Shelf life : 2-3 years when properly stored Stability : Very stable as lyophilized powder Travel : Can survive room temperature for short periods (days) After reconstitution (liquid) Storage : Refrigerate immediately at 2-8°C Shelf life : 28 days with bacteriostatic water Stability : Degrades over time, use within 28 days Travel : Keep cold (use cooler with ice packs) Light : Protect from direct light (store in box) Handling tips Always use clean technique Don't contaminate vial top Use new needle each time Don't freeze Don't shake vigorously Mark reconstitution date on vial Common mistakes with 5mg vials Using wrong water Mistake : Using sterile water instead of bacteriostatic water

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Both thyroidectomy and radioactive iodine therapy frequently induce iatrogenic hypothyroidism, leading to persistent cognitive slowing, low mood, and fatigue, while the psychological burden of cancer increases the risk of anxiety and depressive symptoms (12, 13)