[kimh66]

#1059707

Hello all,
I was diagnosed with Graves last month and am deciding on treatment. My diagnosis started because I felt a lump in my throat and point it out to my dr. during a physical. I referred to an Endo. who initially assumed it was hyperthyroidism, but I was told after a scan last month I had Graves.

My husband was with me at that dr. appt. and I think we were both in shock so I didn’t really ask any questions — didn’t know WHAT to ask at the time. My dr. basically said, my levels were too high for treatment, so he put me on Tapazole and a beta blocker this past month. I’m going in this afternoon to discuss treatment.

However, during my last visit he indicated that we would proceed with RAI as that was the cheapest and he just seemed so matter of fact. He said I couldn’t treat with Tapazole because it could cause liver damage. From what I’m reading, liver damage is very rare?

Here is my issue, I feel fine, and I have felt fine for the last several months. Yes, I’ve had a lot of the symptoms, but all very mild and nothing I couldn’t live with. I guess the scariest sympton is the rapid heartbeat. As such, I don’t really want to destroy a part of my body if I can try medication as a treatment first. I’ll discuss further with my dr., I guess I’m just a little uneasy because I’ve never had to have this type of conversation with a dr. I’m also thinking about a 2nd opinion before I do anything.

[Kimberly]

#1176933

Hello and welcome! Liver issues can occur with anti-thyroid drugs, but it’s fairly rare, and Tapazole has a much better safety track record than the other anti-thyroid drug, PTU. The one case where starting Tapazole is not recommended is if liver function tests are already severely off-kilter. I’m guessing this isn’t the case for you, or your doc wouldn’t have recommended starting the Tapazole in the first place.

The “Treatment Options” thread in the announcements section of the forum is a great place to start researching the treatment options. ALL of the options (including RAI) do come with risks, so it’s important to do your research and make an educated decision.

This is an interesting piece that just came out on treatment practices for Graves’ over the last 20 years. RAI is still the most common treatment option in North America, but the use of anti-thyroid drugs like Tapazole has been increasing:

(Note on links: if you click directly on the following link, you will need to use your browser’s “back” button to return to the boards after viewing, or you will have to log back in to the forum. As an alternative, you can right-click the link and open it in a new tab or new window).

http://www.thyroid.org/wp-content/uploads/publications/clinthy/volume25/issue2/clinthy_v252_35_36.pdf

Hopefully, this will give you some good info to get started with. Please feel free to jump in if you have other questions!

[vanillasky]

#1176934

Hi Kim and welcome to our group!

.
I was diagnosed October, 2012. I just stopped Tapazole this month. My levels are normal now and they came up quite quickly and I’m in normal range. Doctor is watching levels. I have to go to the blood lab each month for TSH, FT4, FT3. And did he tell you what your antibody count is? Mine is TSI 800

So you might want to see another endo, it’s up to you. Liver damage I was told can happen, but they don’t seem really concerned about it.

Karen

[kimh66]

#1176935

I decided to stay on Tapazole and think more about future treatment. My doctor was fine with that and I’m supposed to go back in 12 weeks for labs/results. He’s only been giving me one number, and I know that was at 3.6, but after a month on Tapazole my level has decreased to 1.8.

Hopefully, I’ll be better able to track my labs etc. as I just signed up to be able to view my labs online. Love technology.

[Kimberly]

#1176936

@kimh66 – I use a mobile app that provides lab results online, and I’m really happy with it. It will give you MUCH more insight to see exactly what is being tested and what the “normal” range is for each test.

As you go through this process, make sure that your doc is looking at Free T4 and T3, and not just TSH. TSH can remain suppressed in Graves’ patients and is NOT a good benchmark for making dosing decisions with Tapazole.

Also, the latest medical guidance (which you can read in the “Treatment Options” thread) recommends follow up testing every 4-8 weeks after starting on anti-thyroid drugs. It’s common for patients to need a reduction in dose after the first few weeks to prevent hypOthyroidism. With your next appointment so far out, I would definitely be on the lookout for symptoms of hypo and make sure you get a set of labs done more quickly if that happens. Symptoms can include fatigue, joint pain, weight gain, constipation, dry skin, cold intolerance, and slow pulse.

Take care!

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