[Bobbi]

#1063880

As a general rule, if you get adequate treatment soon enough, you can expect your health to improve. You will probably always have to take some form of medication to maintain your health, but you should not expect to have "problems" unless you were hyper so very long, that damage from the hyperthyroidism was permanent. Hyperthyroidism is really wicked on the body, and some people continue to have heart problems (for instance) after appropriate treatment eliminates the hyperthyroidism; some people lose so much bone while hyperthyroid, that they develop osteoporosis. But for the majority of us, we regain our health.

I think it’s important to make a distinction when you talk about "Graves" causing something or other. The major problem that the Graves-associated antibodies cause is thyroid malfunction. If you have wonky thyroid levels, you will be tired. None of your body systems will be working properly. When you first get your thyroid levels under control, you’ll probably still feel tired. But after your body has had a chance to heal AT normal levels of thyroid hormone for a few months, you should start to feel "normal" — but "normal" also includes the possibility that you’ll feel tired at times. And, when you are healing, if you don’t exercise wisely to regain muscle strength, you might feel tired symptoms longer than necessary.

It is impossible to avoid stress. People who advise you to avoid stress are likely to be unaware of that fact. The reason behind the advice is that it is thought that stress contributes to the immune system revving up into overdrive. When that happens, we have a higher level of antibodies than normal, and for those of us with autoimmune diseases, that means our symptoms of the disease will increase. The problem is that stress occurs all the time, in various ways. You cannot avoid, for example, the stress associated with losing a love one; or the stress associated with planning a wedding, preparing the Christmas dinner, expecting a baby, anticipating a job review….etc. IF you have behaviors which increase your own stress levels, then changing your behavior to lower those levels can help. For example: I realized that a lot of what I did to prepare for holiday dinners was unnecessarily stressful. I did not have to "do" things in one particular way to please anybody else becuase I was doing them to please myself. So, I figured out how to structure holiday prep more sanely (at least for me). It helped to lower the stress. It did not eliminate it totally, however. That would be impossible.

[sheila1972]

#1063881

Thank you Bobbi, That answer alot of questions. There are three treatments correct? How do you decide which is best for you?

[Kimberly]

#1063882

Sheila – You are correct…there are three different treatment options. All three options can potentially restore us to health…but each one has its own pros and cons, so this is a decision that you will want to make in conjunction with your doctor. I would recommend doing searches on this site for "RAI", "Anti-Thyroid Drugs", "ATDs", "Surgery", and "Thyroidectomy". Then you can read some first-hand experiences from patients who have chosen the various options. Keep in mind that no two patients will have the same experience with any given treatment — but this will at least give you a starting point in making a decision.

Best of luck!

[sheila1972]

#1018306

The more I read about Graves disease, the more I do not understand. After starting treatment my health will improve or will I always have problems? Is being tired all the time caused by graves? I read that stress needs to be avoided, why?

[Bobbi]

#1063883

Hi, Sheila:

You asked how I decided which treatment option was best for me. Like everyone else (or just about) I was put on an antithyroid drug at first. There are many good reasons for starting out on an ATD, so that is often the doctor’s first choice. ATDs interfere with the production of thyroid hormone, and the thyroid stores thyroid hormone it’s already made, so taking the drug for a while lowers the total amount of thyroid hormone not only in the blood, but also stored in the thyroid. It makes it somewhat safer, from what I understand, to then go ahead and remove the thyroid either via RAI or surgery.

I was on PTU, and felt horrid the whole time. Many people on the ATDs report feeling much better. It didn’t work that way for me, and I decided that there was no way I was spending years taking a drug that made me feel doped up. So after a few months I decided, after researching, to do RAI and remove my thyroid. I felt so awful hyperthyroid, and so much worse on the PTU, that I decided I needed to get rid of the body part that was making me ill in the first place. Part of why I chose RAI over surgery is that I am somewhat irrationally phobic about surgeries in general. It turned out that I was right: I was having an adverse reaction to the ATD. Removing my thyroid put me back on the path to good health.

Anyway, my recommendation to you is (1) do research and list the FACTUAL pros and cons of the treatment options. Include in that the pros and cons of using the ATDs (methimazole or PTU) vs. using replacement hormone as well. In other words research side effect issues. The reality is that we will be on a medication of one type or other forever. Only 20-30% of people experience a true remission (defined as being able to go off the meds for a year or more and have normal thyroid function), and most of those people become hyperthyroid again at some point later in their lives. So understanding the pros and cons of the medication you plan to use is important.

THEN, (2), list your fears/emotions about the treatment options and take a good hard look at them. By identifying the emotional response you have to one treatment or another, you will be able to be a wee bit more objective. No, I didn’t do surgery, but my doctor wasn’t advising it, either. But had my doctor been strongly urging me towards surgery to treat my hyperthyroidism, by understanding that I am somewhat irrational where it is concerned, I could make a better decision for myself.

You will find yourself doing a lot of second-guessing, and perhaps wavering between one option or another. The one thing that may help you though, is to understand that ALL of our treatment options are safer for us, in general, than staying hyperthyroid. Your doctor will give you the benefit of his/her experience and medical knowledge about whether or not you should avoid one treatment over another. Listen carefully to any advice like that. There are really good medical reasons why any one of us should avoid one treatment and consider others, and this varies from one person to the next. But staying hyperthyroid will destroy your health — so, barring your doctor telling you that one treatment probably is not a good idea, any treatment decision you make will be be better than where you are now.

Good luck,

[snelsen]

#1063884

Hi Sheila,
Ask Kimberly suggested, I would use the treatment options in the search engine. You will see several posts from people who have recently experience surgery, several from people who have chosen RAI.
However, in response to Bobbi’s comment about second guessing a choice, I am sure that is a natural feeling to have.
But not for me. I was SO relieved when I made a decision, which was surgery, I really felt good about it. My personal feelings,were simply that I did not WANT RAI. and I sure did not want to continue with ADT’s, and all the uncertainty that I felt would exist, if I chose the ADT route.
So it still amounts to what feels the most right for you, and not necessary to justify anything to anyone. I felt a great peace of mind with choosing surgery. I think you will hear from people on this board about their different choices, and what it was "like" after RAI or surgery, but I don’ t think you will ever hear someone telling you what to do.
So basically, I am reflecting what Bobbi and Kimberly have already said!’
Shirley

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