Deciding what treatment option to do is a difficult one. There can be very valid reasons why any one individual should choose one treatment over another. The ATDs can be very effective chemical blocks against the production of thyroid hormone, and some folks stay on them for long periods of time. Whether or not that is a wise choice, however, depends upon whether or not they are actually working to “control” thyroid hormone levels. If your antibody levels fluctuate a lot, or spike with regularity, and if you are finding yourself frequently hyperthyroid, the ATDs may not be the best choice for you.
As for doing something “irreversible” like RAI or surgery, try to keep in mind that the disease itself is permanent. There can, for a minority of us, be periods of remission, followed by a return of the disease. But remissions are, by definition, temporary. “Being” hyperthyroid has long-term, adverse health consequences. It has been demonstrated by studies that even being slightly hyperthyroid has long-term, adverse health consequences. So, if the ATDs are controlling things well, fine, but if they are not controlling you well, it may well be time for you to talk seriously with your doctor about another treatment option, even if you do view it as irreversible.
Bobbi — NGDF Online Facilitator