[Ski]

#1074292

I think that whatever you like best should be your treatment choice, truly. Each of us has our own considerations, and if a look at the three treatments makes one stand out big and bold for you, then that’s the right thing for you. The extra advantage of ATDs is that it keeps your options open, which the other two do not. At the very least, it would make sense to use ATDs to lower your levels in order to give your body some immediate rest and then you can continue to research.

The truth is that this decision can be somewhat emotional. Many people I’ve spoken to have had an immediate reaction against one or another of the possible treatments, and that’s been against all three possible treatments for different people, for a bazillion different reasons. So you believe that ATDs seem the obvious choice, and that’s probably how you should start, unless your doctor advises against it for some reason. EVEN SO, if your doctor advises against it, consider that, but it is not necessarily a given that you should do exactly what your doctor advises ~ it is essential to understand the basis for the advice (does the doctor say it may be bad for you, or does he think it’s bad for anyone, for instance), and you may want to get advice from several doctors. The truth is that not all the doctors agree on this, and information is power for the patient. The more information you have, the better decision you will make for yourself.

[YoungManWithGraves]

#1019821

I am a 24 year old male and have just recently been diagnosed with graves disease. After listening to the 3 treatment methods i am wondering why i would choose RAI or surgery without at least trying the thyroid meds first. Its my understanding that the hyper roid could go into remission and I could feel fine and not have to take a pill everyday. So why would i not at least try this method first? Also i got my first leg lesion(sp?) today. I named it Disgusting. I was also wondering if GD has caused anyone else to break out(acne), as My face had been fine until about 6 months ago when I started having graves symptoms(unknowingly at the time).

[DianneW]

#1074293

An endocrinologist at one of the NGDF Conferences said she recommended antithyroid drug treatment to most of her patients to begin with for the very reason that it gives patients a chance to make any further treatment choices while thyroid levels are normal and they are in a better place both mentally and emotionally to be making important decisions. Then if the treatment goes well and remission is achieved, that’s ideal.

Some endocrinologists believe that RAI is the treatment with the fewest serious risks, and that since only about 20-30% of patients will have a permanent remission after ATD therapy and of those, many become hypothyroid eventually anyway, they recommend RAI to most of their patients at the outset, sometimes without even mentioning other options.

I agree with Ski that it should be the patient’s choice, not the doctor’s. There are many factors that go in to this decision besides the doctor’s assessment of the outcome for his entire patient group. Each patient has a unique lifestyle, preferences, and even prejudices that enter into decisions and should be respected. Since each treatment choice has both advantages and disadvantages, deciding which of the disadvantages is most distasteful has to be a personal decision. I also presume that patients who feel they chose among all the options will ultimately be more content with their role in the process. I know I’d be very upset if I hadn’t been given a choice, but I know it happens even with doctors who have the patient’s best interest at heart.

Certainly as Ski said, ATD treatment allows you time to gather information, and more is better. Another advantage is that researchers are working on treatments that may eventually treat the cause of the autoimmunity and not need to destroy the thyroid in the treatment process. Only those who still have a thyroid will benefit when that day comes.

Good luck with your treatment if that’s what you decide to do!

[kaicee118]

#1074294

Just a little comment regarding your last sentence – yes, Graves does cause my face to break out. It causes all kinds of strange things to happen…

[James]

#1074295

Youngmanwithgraves,

I felt the same way you did, that is, questioning why I would want to ablate my thyroid without trying ATD’s first. This makes perfect sense to me.

If it is your inclination to go this route, than go for it! It IS a medically acceptable treatment option. Some people have allergic responses to the drug and cannot tolerate it. It is those people who may not have a choice. Unless there is some medically compelling reason that you cannot take ATD’s, it is a very valid option.

If it is your intention to aim for remission, I always encourage individuals to carefully look at their lifestyle and environmental factors, particularly during the period of time leading up to diagnosis. You can discuss possible triggers with your Dr. in more details. Although some environmental triggers may not be proven, I am of the opinion that this DID play a role in triggering or at least exacerbating the disease in my particular situation.

In most cases this isn’t going to be a quick fix, it can take a long time to achieve and sustained a remission and requires some discipline and determination, but in my view it is well worth it, particularly if you respond well to ATD’s (which is more likely than unlikely). The most important thing for your right now is to get your thyroid levels in check.

Wishing you the best! Keep us posted on your progress.

James

[npatterson]

#1074296

In some cases, a person is not a candidate for ATD’s because their Graves’ is just too advanced. You are right, however, in that it is a very logical choice.

[mamabear]

#1074297

Hello and welcome !!!

I wanted to let you know that when I was diagnosed back in 2002 I was told "you must take RAI in order to get rid of this disease and then in 6months you will be able to try to get pregnant". I was mortified that I only had one treatment option. Till i figured out that I did have more options and then I told that dr. ummmm well lets just say I said goodbye to him ” title=”Wink” />

I found a dr. who treated me with PTU(same as Tapazole but since I was 27 and trying to have another child I chose the PTU which was safer at the time). I was within normal limits wihtin a few months and was able to get pregnant (with help from a dr.) and was taken off the PTU.

I was able to have the baby which was my 2nd child at the time(1st one was when i was 21), when 2nd child was 10months old I wound up pregnant again (with help again) and was able to not have to worry about thyroid, it was fine then entire time.

3rd child was about 4 1/2 months old when I went into Thyroid Storm. This was caught early becasue I have a wonderful general dr. But I was studdering and lets just say things were bad. Bottom line was I was able to get back on PTU and back to normal level within a few months. Theeeeeeeeen I was taken off PTU and was without medicine for 7months doing fine with no symptoms and TSH was fine and wound up pregnant on my own(no fertility meds at all).

AFter baby #4 was born I was still fine with my thyroid levels until I started feeling "off" back in 2007, i was able to get back on PTU for a short period and off of the drug and have been off the drug since May 2007 and am officially in remission for 20 1/2 months.

So yes you shoudl be able to have all the facts but please if you continue to have problems with your thyroid and your levels that you might want to consider other options besides the drugs. I know that if I didn’t remain in remission for long periods of time that I would have chosen something else but since it is going ok for now that is what it best for me. If it starts to not be good for me and I start having thyroid issues again that wont stop then I will consider my options again.

research what you need and know what your body says.

Also when you go on the medicine it can take a long time to get to a good level and even after you are at a good level it can take a while to get to feeling better. OR it might not take long , every single person is so different. Also note that this is a disease that IS hereditary and your future wife will need to know that because you can pass this along to your kids. It is very rare for a man but you can still give those genes to your kids. Not saying you shouldn’t have children at all , i am saying that their future might have this in it and you as a future parent should make sure that you and your dr’s are aware of it so you can do something about it if it ever does happen.

I found out that my family had it after a few years of pushing the issue with my family. they never spoke up about things and I hated that.

hope all works out well either way.

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