[ChrisRose1]

#1070334

I was diagnosed at the age of 23 and had RAI. I would go with Dr.’s recommendations. I have had children and one is at a great college now (re: your question about having children).

[QZsue]

#1019244

My 20-year old daughter was diagnosed with GD in December 2008 following a bout with mono. She was put on Metoprolol and Methamazole and monitored by her endo since then. Most of her symptoms have abated and she is feeling better, but she has gained a lot of weight–close to 30 pounds. She is short with a very athletic, muscular build. The weight gain is mostly in her abdomen and she is very upset about it. She goes to college full-time, works two jobs and still manages to exercise and play golf and softball.

On Friday the endo told us the meds are not working. Her T3 is high, despite being on the highest dose of Methamazole. The doctor gave her the choice of RAI or surgery. My daughter wants to have the RAI done. She thinks this will solve all of her problems and she can get her life (and weight) back to normal. I’m concerned she is making the decision too quickly. She is only 20. How will this affect having children? Will she be able to get her weight back down while on the Synthroid? Does anyone think think this is happening too quickly?

My family has a history of hypothyroidism and this is our first experience with the hyper, so I want more information.

[bradybunch6x1]

#1070335

Hello Worried Mom,
I think that your thought on the happening to quickly is right on, it sometimes takes awhile to level out thyroid hormones. Follow your gut. Also as far as having children, with having ablation, alot of the things I have read actually say to wait to have RAI until child-bearing years are over. I myself did not know that, and am one of the ones that had complications during pregnancy because of Graves, although very few do have the type of problems I have it can make it harder to deal with. Also I myself would check into the cautions on cancer related issues as far as RAI is concerned. If there is any kind of history of this type of thing in your family, you may want this info.
Valarie

[Ski]

#1070336

Elevated rates of cancer have not been linked to RAI . RAI has been used as a treatment for GD and thyroid cancer for about 60 years. Your concerns are the precise reason the studies have been so careful to track prior patients. Thyroid cancer patients receive doses up to 10 and even 20 times what we get, and even that is considered a therapeutic dose.

The effects of Graves’ Disease on pregnancy have more to do with the antibodies in your bloodstream than the treatment used. As long as she does not get pregnant within six months after RAI, all the eggs that had any potential of being affected by the RAI (those maturing when the dose is given) are out of the body. It’s likely that only one or two are mature enough to be in any way affected by the RAI, so waiting for six months removes all doubt. Unfortunately though, ATDs and surgery have a better likelihood of reducing antibody levels than RAI, so that is something to consider when also looking at future pregnancy. Higher antibody levels correlate to the likelihood of complications with pregnancy. Though rare, those complications can be very frightening. Antibody tests at the time of pregnancy are a good idea, just so you are aware of any possibility of problems. (This is true no matter what treatment you use. Antibody levels are somewhat capricious.)

Still, RAI is not the only way to remove the thyroid. If the ATDs are not working for her, something must be done, and the only other choices are RAI and surgery. Surgery can be very effective, and many people are thrilled with the results. In the hands of an experienced surgeon, it can actually be the quickest possible way back to health. RAI takes a while to act on the thyroid and completely destroy it, while of course surgery is instant.

Regulating on replacement hormone can be a little tricky at first, but as long as she is vigilant about watching her symptoms and getting her levels tested, she should be able to settle into a good dose for her and then just have blood tests done annually. It can be easier than managing ATDs, since the antibodies do not act on the replacement hormone to change things unpredictably.

Bottom line is that she needs to get her thyroid hormone levels into normal ranges and stabilize them.

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