[Sircus]

#1018518

An endocrinologist is now suggesting RAI treatment as the next step in managing my Graves’ disease.

Thanks to the information found on this board—what an incredible resource!–I asked the endocrinologist about thyroid dumping as a complication. She became annoyed and responded abruptly that only illegal aliens and people from Third World countries have to worry about thyroid dumping. Her position is that there is so much iodine in foods found in the US that thyroid dumping after RAI is a non-issue for “anglos” (her term).

I find it difficult to believe that all members of this board who have experienced a spike in thyroid hormone levels shortly after RAI treatment are undocumented workers or immigrants from poorly developed countries. Does anyone have information about the incidence rate of side effects (more specifically thyroid dumping) after RAI treatment in the US?

Thanks.

-Sircus

[Bobbi]

#1065418

Speaking from my own experience — I was a 52 year old "anglo" when I had RAI — about one week after swallowing the pill, I was rather significantly more hyper. It lasted two or three days, and then subsided.

I don’t know what your doctor meant by the dumping phenomenon not being an issue. We have seen numerous posts here on the board over the years from panicked patients who thought they were going into thyroid storm when the dumping occurred. (It is not "storm" because the cells are dying and not making new hormone. In true "storm" the cells continue to manufacture new hormone as they dump hormone into the body.) It was definitely "an issue" for them. It was not an issue, perhaps, in terms of "danger."

I know of no documentation over incidence. My own endocrinologist, however, warned me of the phenomenon at the time of RAI, and gave me instructions for increasing my dose of beta blocker during those days in order to be more comfortable. This warning from a well-recognized, board-certified endocrinologist, suggests that it happens more frequently than not.

[ewmb]

#1065419

I had a dumping after my RAI at about 3 weeks out that lasted a little longer than Bobbi’s. The next time I had my TSH taken after RAI it was lower than it was before I swallowed the RAI. I think your endo sounds like she might not be right for you if she gets irritated with things so easily. Hope that you can get some help soon.

ewmb

[Kimberly]

#1065420

Just a couple of comments…

1. Your relationship with your endo is going to be a long-term one, so it’s definitely worth your time to find one who will treat you as a partner in your journey back to good health.

2. I haven’t seen much research specifically on the "dumping" phenomenon following RAI, but anecdotally, it appears to be fairly common. I have read of a few *very isolated* cases of thyroid storm following RAI treatment. When this happens, there are usually outside circumstances that were complicating factors (such as an underlying illness in addition to Graves’). If you do notice your symptoms of hypERthyroidism getting significantly worse following RAI, I would suggest checking with your doctor. The solution might be as simple as a temporary prescription for a beta blocker to control your symptoms…but it’s worth erring on the side of caution.

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