8. Does the choice of treatment affect my chances of getting TED? Specifically, does RAI increase the odds of worsening or new development of TED?
There is little doubt that YES RAI increases the chance you will get TED or worsen TED.
BUT— very important– this risk for certain patients may be so small that it is by far the best treatment! One must consider any treatment in context.
For example– there is no doubt that getting in your car each day increase your risk of dying in a car accident… but we still drive.
RAI may be a great choice for many patients. We showed in a JAMA article that surgical thyroidectomy decreases the risk of developing TED significantly. ?However, that surgery carries risks also
I introduce my patients to all forms of medical and surgical therapy and have them meet professionals in our team who do those treatments. This way a patient can decide which risks they want to take. All treatments have risks– and doing nothing also carries risk — it is making sure everyone understands the risk and is comfortable.
In general if someone has moderate eye disease and no risk factors for surgery- I tend to lean toward surgery if medical therapy has failed.
DrDouglas
Kimberly