[Anonymous]

#1022343

I am newly diaagnosed with Graves. My doctor told me yesterday I should do something soon. I am having radioactive iodine this week. Is this the best way to treat this? What can I expect afterwards?
Thanks.

[Anonymous]

#1082551

Welcome to the NGDF Board. What is best for one person, may not be best for another. So there isn’t a “Best” treatment for everyone.

RAI consist of going to your endo’s office or the hospital and taking a pill or liquid form of radioactive iodine. You will need to not have close contact with people for a few days. You should get a list of directions from your doctor. Be sure and follow those.

The RAI treatment may work in a manner of a few weeks, what it is going to do is to stop your thyroid from working. You may begin to start having hypo symptoms. Your doctor should have given you a return visit appointment. If the symptoms begin much sooner then the visit and you are having problems then call your endo.

Diane B On-Line Facilitator

[Anonymous]

#1082552

Have been reading thru many of the messages here and found out a lot about Graves. Need to make a decision on treatment soon. Was wondering if with the graves that affects the eyes if anyone else has had just an ach in there eyes, like you had been reading way to much? I usually feel it the most when I first get up in the morning. The endo measured my eyes and said they were not bulging out at all so didn’t think I had the eye involvment. The only real symptom that I have noticed is fatigue, but not so much that I can’t function during the day. just occasional hard heart beats that only last a few seconds. Doc says I have baby skin, which isn’t all that bad, don’t need moisturizers. Have a high calcium level in the blood and am waiting for results to see if it is from the parathyroid. Does Graves cause an elevation in blood calcium? Do a lot of others have problems with thyroid and parathyroid at the same time? Free T4 2.58 upper end of range is 2 Free T3 is 7 upper range of 4.6 TSH is .01 Do others not have any significant symptoms when high reading like this, don’t really feel sick. Can you give me pros and cons of the different treatment? If you choose RAI is it wise to go on ATD or beta blockers first and then for how long befor you have RAI? I know I need to make a decision and start something right away just not sure what. Thanks for any help you can offer. Patti

[Anonymous]

#1082553

Hi, Patti:

It is important that you not dither around. Being hyperthyroid — even at minor levels — has been shown to have long-lasting bad effects on the body.

That said, there are options, typically. Many patients go on ATDs (the antithyroid drugs) while they sort out the options that the doctor gives them. If your doctor tells you that there is only one option for “you”, find out why, if only to satisfy your need to know. There can be very good medical reasons for individual patients to do one treatment over another. Any of the treatment options can work to bring patients back to health, but some patients have individual medical conditions which dictate one over another.

If your eyes are bothering you, you probably should consult with an opthamologist (the M.D. that treats eye disease). There might be any number of reasons why your eyes ache in the morning, and that is the doctor who is best able to sort things out for you.

As for the parathyroids — they are not involved with Graves. I don’t know whether Graves’ bloodwork shows elevated levels of calcium. I haven’t heard of it, but I am also not a doctor.

Pros and Cons:

ATDs: interfere immediately with the production of thyroid hormone, and can allow the patient to ride out the hyper state in hopes of a temporary remission. Con: Can adversely impact the liver, there are a few allergic reactions to the drugs, and they can sometimes suppress the levels of white blood cells, causing a serious problem vis a vis infections. In pregnant women and nursing mothers, the drugs have the potential to adversely affect the baby. That said, the adverse side effects to the mother are infrequent.

Surgery: Has been shown to have no impact in patients with the eye disease; results in the immediate removal of the thyroid — so is a “quick” end to hyperthyroidism. Cons: infections, damage to the parrathyroids, damage to the nerve that works the vocal cords — these problems sometimes depend on the surgeon’s experience and expertise. Surgery may be more dangerous for some patients with heart issues.

RAI: This is a “chemical removal” of the thyroid gland. Radioactive iodine goes directly to the thyroid (and ONLY to the thyroid) and causes damage to thyroid cells. Damaged/killed cells can no longer produce thyroid hormone. The RAI does not stay in the body long enough to produce other adverse effects associated with radiation (shown by many studies over the past 50 or so years). It does not harm the parathyroids, nor does it create a situation where infection can occur. Cons: it works gradually, over weeks and months; it has been shown in a minority of patients (about 16%) to cause a temporary worsening of the eye condition. (Note: it has never been shown to cause the eye disease, which can develop in a patient at any time, with any treatment option.)

With both RAI and surgery, the “failure” rate (patients who continue to be hyperthyroid) is approximately 10%. Successful treatments typically result in the patient becoming hypothyroid (sooner than they would due to the antibody attack which causes Graves) and needing to take replacement hormone.

I hope this helps,
Bobbi — NGDF Online Ffacilitator

[Anonymous]

#1082554

Thanks. Do you think that it would be wise to go on ATD befor having the RAI to start bringing the levels down? The Endo put me on Toprol-XL already. Looking at having the RAI this week but can push it back if I should start on ATD first for a while, How long? Saw one post on Novacaine afecting you adversely after RAI but couldn’t find the right post again, know anything about this? Patti

[Anonymous]

#1082555

Novocaine contains an “upper”, so can adversely affect someone if their thyroid levels are high. I have never heard of RAI impacting on novocaine once it had achieved normal or sub-normal levels of thyroid hormone.

I have no expertise to advise you about what treatment to do when. Individual patients can have individually specific medical considerations that tip the balance one way or another. Your doctor is your absolute best advisor along these lines.

Bobbi — NGDF Online Facilitator

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