Because of the carcinogenicity of its beta radiation in the thyroid in small doses, I-131 is rarely used primarily or solely for diagnosis (although in the past this was more common due to this isotope's relative ease of production and low expense). Instead the more purely gamma-emitting radioiodine iodine-123 is used in diagnostic testing (nuclear medicine scan of the thyroid). The longer half-lived iodine-125 is also occasionally used when a longer half-life radioiodine is needed for diagnosis, and in brachytherapy treatment (isotope confined in small seed-like metal capsules), where the low-energy gamma radiation without a beta component makes iodine-125 useful. The other radioisotopes of iodine are never used in brachytherapy.
The use of I as a medical isotope has been blamed for a routine shipment of biosolids being rejected from crossing the Canada—U.S. border. Such material can enter the sewers directly from the medical facilities, or by being excreted by patients after a treatment