[Kimberly]

#1062109

Hello – the fact that an individual has one autoimmune condition does make them statistically slightly more likely than the rest of the population to contract another autoimmune condition.

However, I’ve never seen any research done on this issue relative to which treatment option is selected for Graves’. In terms of the antibodies that are responsible for Graves’, one study indicated that these antibodies can remain elevated for up to 5 years in patients who undergo RAI treatment. In fact, I have heard speculation that this may be responsible for the possible link between RAI and Thyroid Eye Disease, although this is a controversial issue. This was actually discussed at our most recent conference.

The most widely cited study that highlighted the correlation between RAI and TED was Bartalena, et. al. from 1998. They found that about 15% of patients experienced a worsening of eye symptoms following RAI. Of these patients whose symptoms got worse, about 2/3 eventually saw enough spontaneous improvement that they did not need medical treatment. The remaining 1/3 had symptoms that were serious enough to require further medical intervention. Patients who had RAI, but were treated with a course of steroids did not show a worsening of the eye disease.

Other more recent studies have yielded mixed results. Some have shown an increased risk of eye involvement following RAI. Another study concluded that there was no additional risk of worsening eye disease following RAI as long as the patient was NOT allowed to remain in a hypOthyroid state for too long.

The individual who presented on this issue at our conference said that she would recommend a course of steroid therapy for any patient who had active eye disease and was classified as “high risk”. (High risk being defined as smokers, patients with existing eye involvement, and patients with high T3 and high antibody levels at the time of diagnosis).

However, there is still a lot of controversy around this issue. One doctor at the conference indicated that he would not recommend RAI for any patient who had active eye disease. (This gentleman was from Europe, where they are much more conservative about using RAI as a treatment option).

Plenty of patients have RAI and never experience eye issues. Some patients choose Anti-Thyroid Drugs or Surgery and *still* wind up with eye issues. However, this is certainly a consideration that patients will want to weigh when considering treatment options.

[fj122876]

#1017999

Just one more question about surgery or rai. Is there a higher chance of getting another autoimmune disease after these procedures? If you have the autoimmune DNA does have to go somewhere or does it just stay dormant in your system? Is there a higher risk with surgery or is there a higher risk with rai? Or is there really nothing to worry about. Also, do you increase your risk for TED with either one of these procedures? I know its alot of questions but decision making time is closer than ever and I’m worried about alot of things. Thanks for the help.
Jessica

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