[Aravindh]

#1073308

Dear Ski,
I have a few questions regarding the RAI Process. The url that I mentioned states that the males who are administered RAI should avoid parenting for several months. I took one of the pamplets and there is a section called Are future Pregnencies possible ??? I am not technically competent to interpret this paragraph. It would be very much helpful if you could help me with this. Thank you
[b:2p313nkn][i:2p313nkn]"For safetys sake males are advises to avoid parenting a child for several months.Females are advised to postpone pregnancy for six to seven months after radio iodine treatment. Women are advised to wait a little longer to help stabilize their thyroid status before conception. This is because a theoritical risk to a developing fetus existsm even though the amount of radioactivity retained may be small and there is no medical proof of an actual risk from radio iodine treatment,Such a precaution would essentially eliminate the direct fetal exposure to radioactivity and markedly reduce the possibility of conception with the sperm that might theoretically have been damaged by exposure to radio iodine. You may need to contact your physician for guidance about the methods of contraception.

Regulations regarding the use of radio iodine theraphy are made by US Nuclear regulatory commission NRC.Physicians and hospitals that administer tghis theraphy much have a license to administer radioiodine and must adhere to stringent regulations regarding its use. If you have any questions before or after receiving your treatment, please do not hesitiate to contact your physician or your hospital radiation safety officier for clarification[/i:2p313nkn][/b:2p313nkn]"

[Ski]

#1073309

There are several points to answer here ~ first, thank you for the info regarding males and fertility, because that’s come up several times and I don’t remember ever seeing a satisfactory answer. This seems to indicate no danger of future infertility in men, and, being very much overcautious, recommendations are that you wait a little while before attempting to father a child following RAI.

For women, we have more details. RAI is taken up into your thyroid, but a small percentage (the difference between your uptake percentage and 100%) is eliminated through the body’s liquid waste channels ~ mostly urine, a little bit in sweat and saliva. As the excreted RAI is processed through the bladder, it passes by the ovaries. The only eggs that can potentially be affected are those that are reaching maturity. We are encouraged to drink lots of water and urinate often, which minimizes even that limited exposure. In addition, the excess RAI is completely excreted after 48 hours. The recommendation is to wait for at least six cycles to pass. That is, again, an abundance of caution. There are usually only one or two eggs reaching maturity at any time. Waiting six months makes us absolutely certain that there has been no exposure to the egg ~ and also gives some time to regulate thyroid hormone levels. A pregnancy could be disastrous while we are trying to stabilize thyroid hormone levels, because the hormones involved in pregnancy could distort things, AND we could be potentially damaging the fetus with abnormal thyroid hormone levels. All that being said, women HAVE become pregnant earlier than six months after RAI, and delivered beautiful, healthy children.

[Aravindh]

#1073310

Dear Ski,
Thanks. Today I happened to see one action movie at house. When I saw saw action scenes suddenly my hear palipitations increased and suddenly I felt a little restless. Is that expected ? Suddenly I felt dizzy also. Now I am tending to get a little bit better. WOuld the action scenes trigger the release suddenly or is it psychological ? Please do help. Thanks

[Ski]

#1073311

To the extent that those scenes caused an adrenaline rush, yes, they could cause a rush of hyperthyroid symptoms. Adrenaline boosts the immune system, which could boost antibody action for you.

[DianneW]

#1073312

Just to clarify issues with radioactive exposure to both sperm and eggs following RAI:

The ova that are closest to maturity are most susceptible to radiation damage, but ALL ova do receive a very tiny amount of change to DNA from RAI just as they do from ANY radiation source. The same applies to the sperm. So the question is not whether the DNA of the ova and sperm receive damage from RAI, but how much, and what it means; and this is what we have to keep in perspective.

All of us receive radiation every day from many sources, and medical sources are an extra source that we try to keep to a minimum and use only when the benefits clearly outweigh the risks, since usually medical radiation adds to the cumulative exposure very quickly at high rates. Comparing the amount of radiation in RAI that goes to the ova and sperm to that of other medical technologies, you’d find it’s higher than most. A 5 milicurie dose of RAI is approximately equal to a couple of barium enemas in that regard. However, the theoretical risk of birth defects is extremely low, and in practice, no increased birth defects have been seen.

One of the reasons birth defects haven’t been seen in babies born to parents who had RAI is that most mutations in DNA are recessive, so it would take a defective gene from each parent on the same gene to cause a birth defect. The odds of this occurring are extremely low. If RAI patients began to marry only each other and their children mixed only in this same gene pool, birth defects might show up more often, as they do in birds living in the area damaged by the Chernobyl nuclear accident.

The bottom line is that every patient who has RAI and then has children is probably introducing some tiny extra DNA changes into the gene pool, above and beyond those that would occur in the normal course of living, and theoretically it’s even possible for a birth defect to be caused by RAI, but it would be statistically impossible to know that was the cause, since the chances are so small. But this is a case where each patient must decide whether the therapeutic benefits of RAI are worth risks that are mostly theoretical.

Until recent years RAI wasn’t given to patients who still wanted children because doctors know all radiation causes changes to DNA, but now that many years of treatments of patients of childbearing age have shown no increased birth defects, many doctors will recommend it. Others still don’t. I think it should be the patient’s choice, but I think each patient has the right to know exactly what the facts are.

[DianneW]

#1073313

Aravindh,

Is your doctor now recommending RAI without giving you a chance to have a remission on methimazole? If so, I just want you to know that you don’t have to follow that recommendation. The choice is yours.

[mamabear]

#1073314

I agree, I think trying to get into remission would be tried first before doing RAI.
As long as you are healthy enough to do that.
I understand that Graves’ can get so out of hand that there is no choice but to do RAI and than deal with the Hypo stage after that. If your health is not in danger I think trying Tapazole or even PTU would be good try first.
Great that you are doing all of your homework though!!!!

[Aravindh]

#1073315

Thanks for all your comments. I have been logging into this site daily but was unable to post for a couple of days. I even thought that the site was shut down. But alas the site came up with a new appeal. The UI looks very good and I also read a couple of posts stating that we moved to a brand new server. All that is great to hear. I have been doing well over the past few days. My Endo called me up and said that I could slowly stop the Inderal. But my GP asked me to come again next Tuesday and wanted to see me before stopping the dose. Endo also asked me to lower the dose of tapazole from 20 mg to 15 mg per day.. So I have lowered the dose for the past 2 days. Thats the news from my side. My body seems to be slowly improving (in baby steps as Ski told).. I still do have a little bit of dizziness, tiredness, heat flashes etc.. I feel tired in the evenings and fall asleep on trains but I find it difficult to sleep in the nights…Hope the situation improves in days to come. It has been exactly 7 weeks of medication and I am starting to have a little bit of confidence most of time time.I feel depressed only at times when I feel dizzy (in the mornings immediately after I wake up). I also have a frequent urinating sensation.Hope everything to go away…
Thats all for now. Will keep posting. Thanks for all the advise.
Regards
Aravindh Natarajan

[Aravindh]

#1073316

Dear MaamabearSki,

As mentioned in my previous post I had gone to the General Physician on Last Tursday (April 7th) and I had my blood tests..The results were out today and the T4 Level is 0.81 and the TSH is 0.101. These were the readings as of April 7th. Starting to feel better and better. Doctor has actually asked me to reduce the Tapazole to just 10mg per day. That is 5 mg in the morning and 5 mg in the night.. Really happy about this.. I am starting to feel well and for the first time yesterday night I felt very much normal after a long time.. Even now except for this dizzy spells I feel normal.. I presume these dizzy spells might be because of the anxiety and the general level of my curiosity.. I am actually trying to control the same. These are my updates for now.. Would keep posting more and more updates. Thanks for all your advises and posts.
Best Regards Aravindh

[Aravindh]

#1073317

Hi All,
Is Elevated Blood Pressure Level an associated symptom of this Hyperthyroidism ? My T4 is at 0.81 and my TSH is at 0.101.. Even then why does my Blood Pressure seem to be a little high ? I have never been a high BP except for the fact that I used to have spells of High BP when I was under stress because I am a software professional… But I have never been on BP Medications. A lot of times my BP used to be normal before.. I expected this to come down naturally when the T4 and TSH levels went normal. It still doesnt seem to.. Any advises at this stage ? My Doc has advised me to do light exercises starting from now.. would that help ? I feel these Hypertensive drugs make me dizzy ? Could you pls comment on the same.

Thanks.. Aravindh

[Ski]

#1073318

The light exercises may help, and also I think you’re probably right that the normalizing levels will also bring your blood pressure back into range. Just keep an eye on it. I’m so glad you’re starting to feel improvement!!

[Aravindh]

#1073319

Dear Ski,
A Big Yes.. Thank you very much for all the encouragement from the beginning.. Except for the Dizziness… the alarms of an elevated BP, the nausea due to the Tapazole.. I seem to be okay… Lets see how this proceeds.. At this point I start to think.. why not the time run away fast ” title=”Very Happy” /> …

Thanks
KN Aravindh

[mamabear]

#1073320

Congrats on feeling better!!!!!!!!!!!! Keep up the good work .

When you are feeling blue…always remember that you are stronger than any old disease and you can certain kick this thing swiftly into left field!!!!! We’re here with an extra bat for ya if you break any trying to swing it out there!!!!

[DianneW]

#1073321

Dear Aravindh,

Another comment on your blood pressure problem: Remember that your body has been through an extreme insult being hyperthyroid, and that has caused your heart to function abnormally for however many months you have been hyperthyroid. The cells of your heart muscle have actually deteriorated and can’t function normally even once your levels become normal. It takes many months with normal thyroid levels to reverse this damage. This is the reason our doctors are continually telling us to be patient.

I remember having heart palpitations for the first year or two after my levels were entirely normal, and I wondered if they would ever stop. But I haven’t had one for years now, and I don’t know now when they stopped.

It’s too early to worry that the blood pressure elevation will be permanent. Your levels are only now normalizing, which is the first part of the journey back to good health. The second part is taking time to heal. Be good to yourself: try to get enough rest, eat well, exercise, have balance in all things. If work is causing too much stress, find a way to release the stress out of your body through exercise and meditation, or whatever works for you.

Do you take your Tapazole with food (to help with nausea)?

Best wishes, Dianne

[Aravindh]

#1073322

Dear DianneMaama Bear Ski,

Thank you for your kind words… I am currently taking 1.5 tablets of Tapazole 5mg in the morning and another 1.5 tablets in the night.. Most of the times I do not have the nauseating feeling. Only in the nights… I feel the nausea immediately after eating… at around 9:15 – 9:20 ish in the nights.. After that I generally take Tapazole and Inderal (0.5 tablet ~~ 20 mg) and then take some good rest and sleep… As I had mentioned in the post the T4 level have gone down to 0.81 and the TSH Level is at 0.101. Hence my Doctor has advised me to reduce the dosage of the Tapazole to 10 mg per day.. (which I am planning to reduce from tomorrow)
I would like to rewind and tell you a few things Dianne… I joined the New Port GYM about 7 months ago and at that time was a first timer to GYM.. I used to weigh about 195 pounds but was very much determined to lose weight and become healthy.. Hence I used to run for 7 miles for 4 days in the GYM.. That used to be total of 28 miles a week.. My weight nicely reduced to 175 – 176 Pounds … I was very happy and proud of it..
Then I went to India for vacation and checked my BP.. My BP was very very normal at 120/80.. I have had few small spells of high bp long before — I do accept that.. That was mostly when I was awake for a long time or when I used to work for long hours etc etc.. or have some unhealthy food with a lot of oil etc…
But after that I never had this problem..
Suddenly this Graves Disease struck me somewhere between Jan 1st and Jan 15th 2009 (or a little earlier probably) — for reason just known to God.. After that the BP has been consistently on higher side… Now the T4 levels have seemed to come to normal but I measured the BP today .. it was 140/78 at 4:45 pm EST after taking one Lotrel 10/20 in the morning and also having taken a 20 mg Inderal in the night.. I also have a faint dizziness in the mornings and in the evenings…I also have slight and occasional chest pains.. I have regained my lost weight (due to going hyper) and currently weigh around 180 – 185 pounds..
Per your post I have understood that I have to be patient and hence would surely try to be patient.. Would start going for light exercises as instructed by the Doctor..
Just wanted to confirm whether an elevated level of BP and a slight chest pain are expected behaviours even after the Thyroid levels go just below normal.. Thats why I had posted this message..
Dear Maama Bear Ski… Thanks for your words again

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