[QZZznne]

#1060004

This is my second round of being Hyperthyroid. First was back in October of 2011. Went on Methamazole until August of 2012 when I had good levels. Just went back this month for a check to find I am right back where I started. My doctor wants me to have my thyroid removed and is having the surgeon call me to schedule a consultation. I went along with her but my question is why is she so quick to suggest this be my plan? Is that the norm?

[Kimberly]

#1179544

Hello – It certainly doesn’t hurt to go to the consult, but in the meantime, I would ask your doc why he/she is recommending that you go this route. Although the medical guidance recommends a “definitive” solution (RAI, surgery) for patients who relapse, it *does* leave the door open for patients to remain on low doses of ATDs longer term, if that is the patient’s preference.

We have one old facilitator here (James) who is currently in a 9+ year period of remission, but needed 3 rounds of ATDs. Ultimately, you and your doc will need to decide which approach is best for you.

If you do opt for another round of ATDs, make sure that your doctor is aware of the recommendation to test antibody levels (TRAb) prior to withdrawing the meds. Patients who go off the meds while antibodies are still raging are at higher risk for a relapse.

Take care!

[bigad]

#1179545

A large percentage of Docs seem to recommend RAI- is that an option for you? I’m scheduled for mine next week.

[QZZznne]

#1179546

My doctor (the practice) believes in the “definitive” solution. She actually told me the first day I went to her that I should start doing my homework on it because she rarely sees remission last. She told me when it happened last August, “enjoy it while it lasts”. So I think she believes that it is the best solution for me and I should trust her but when you remove it, your just taking medication everyday anyway.

I am going to go talk to the surgeon and see if perhaps he sheds some light on it all. I have two friends who had a thyroidectemy by the same doctor and he is very well respected in his field.

Didn’t have a lot of the syptoms this time like I had last time except for agitation. Last time I could barely walk by the time I got to the endo. No high blood pressure, nothing.

Since restarting the meds, I feel more achy than before actually. I remember right before I was taken off them, when my levels were good, I felt the very same way.

It is difficult to know what is right………….sigh.

[QZZznne]

#1179547

[QZZznne]

#1179549

bigad wrote:

A large percentage of Docs seem to recommend RAI- is that an option for you? I’m scheduled for mine next week.

Good Luck you to you:) I hope that you feel better.

[Naisly]

#1179548

QZZznne

Did your doctor test for antibodies? They would be TRAb and or TSI. A lot of doctors miss this and it usually takes a patient who advocates their health to ask for this test.

If she hasn’t tested this, then I would look for an new endo as well. Because if she is not up to date, then how is she going to continue to treat you when you go Hypo?

[QZZznne]

#1179550

Naisly wrote:

QZZznne

Did your doctor test for antibodies? They would be TRAb and or TSI. A lot of doctors miss this and it usually takes a patient who advocates their health to ask for this test.

If she hasn’t tested this, then I would look for an new endo as well. Because if she is not up to date, then how is she going to continue to treat you when you go Hypo?

My doctor has never even mentioned TSI’s to me. WHY?

[Naisly]

#1179551

Euthyroid means normal thyroid function and does not mean Graves disease is in remission (The thyroid gland is the victim, not the cause).

For Graves to be in remission, you must not have any (or very very little) TSI (thyroid stimulating immunoglobulin) which causes the production of the thyroid hormone. TSI is the direct cause of hyperthyroidism in Graves’ disease and TED. TSI will continue to be elevated if there are still environmental triggers.

There are 2 things that stimulate your thyroid:
TSH
TSI

TSI ‘pretends’ to be TSH and your thyroid makes more and more thyroid hormones all the while your TSH thinks you have too much so less and less TSH is made – Hence, Hyperthyroidism.

The goal is, is to get those nasty buggers to leave. You can do this with the ATD therapy. Where as RAI will only make them angry (sorta speak) and they will search for something else to attack ie: eyes. Same thing with surgery, but not as bad as RAI. With TT there is ‘some’ thyroid tissue left. Obviously because of nerves, vocal cords, and parathyroids. Some believe that removing the thyroid will in fact remove the antibodies. I wish this was true. Fact is, TSI can be found in the brain, skin, bones, eyes.

[QZZznne]

#1179552

Naisly wrote:

Euthyroid means normal thyroid function and does not mean Graves disease is in remission (The thyroid gland is the victim, not the cause).

For Graves to be in remission, you must not have any (or very very little) TSI (thyroid stimulating immunoglobulin) which causes the production of the thyroid hormone. TSI is the direct cause of hyperthyroidism in Graves’ disease and TED. TSI will continue to be elevated if there are still environmental triggers.

There are 2 things that stimulate your thyroid:
TSH
TSI

TSI ‘pretends’ to be TSH and your thyroid makes more and more thyroid hormones all the while your TSH thinks you have too much so less and less TSH is made – Hence, Hyperthyroidism.

The goal is, is to get those nasty buggers to leave. You can do this with the ATD therapy. Where as RAI will only make them angry (sorta speak) and they will search for something else to attack ie: eyes. Same thing with surgery, but not as bad as RAI. With TT there is ‘some’ thyroid tissue left. Obviously because of nerves, vocal cords, and parathyroids. Some believe that removing the thyroid will in fact remove the antibodies. I wish this was true. Fact is, TSI can be found in the brain, skin, bones, eyes

Thank you for that explanation. I am going to print this out and bring it along with me for discussion with my doc.

[Author]

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