[beach45]

#1058993

I will be having RAI first week of May 2012 as per a previous recent post here.

My endocrinologist does not think there will be a need for a beta blocker after RAI since I have been on Methimazole 20 months (5-10 mg) and that my heart rate now is still in the mid 80s (on 5 mg daily) even with hyperthyroid numbers that came back recently in my blood work.

I was just wondering for those who had RAI, did you need a beta blocker or anxiety medication due to some temporarily hyperactivity as the thyroid was dying off after RAI?

I did read a past post from Bobbi which explained what happens post RAI which was very informative.

I guess I am just looking for reassurance as I realize that it is different for every individual.

My doctor’s nurse did say though if my numbers are consistently over 100 bpm pre or post RAI (I will be off of the Methimazole one week prior to RAI) to give them a call regarding a beta blocker. I had a pulse of 120-130 bpm back in 2010 when this started prior to going on Methimazole and I just do not want to ever experience that again if at all possible!

Thank you!…beach45

[Bobbi]

#1171420

I was on a beta blocker throughout after my diagnosis. Actually, I was put on a beta blocker even before my diagnosis of hyperthyroidism. My endo instructed me to double the dose “if needed” approximately one week after RAI when stored supplies of thyroid hormone get dumped into the blood by damaged thyroid cells. I felt the need for that double dose for, I think, two or three days, after which symptoms subsided rather quickly.

I think it helps to know that there is a rather finite limit to the extra hyperness. While T4 has a half life of 8.1 days, it must be converted to T3 in order for the cells to use it. T3, the more potent form of thyroid hormone, has a half life of approx. three-quarters of ONE day, so we get quite revved when there is too much of it, but it goes away rather quickly if no more is hitting the blood. The damaged cells are not making “new” hormone once RAI has damaged them sufficiently, so the extra jitters time is limited.

[beach45]

#1171421

Bobbi, Thank you for the very detailed explanation as I needed that. Now I completely understand. I have such little time with my endocrinologist to go into details as he double books to see me as a patient as I come from 1-1/2 hours away and I was kind of shocked that he decided on RAI instead of increasing my Methimazole one more time yet it was 20 months; so he felt the up and down with the MMI was too much and that post RAI I would eventually even out once I got on the right amount of thyroid hormone.

He was not concerned about me post RAI as far as heart rate goes (!). Your explanation is so good and that explains probably why he was not so concerned being that my heart rate has been pretty much under control for 16 of the 20 months on MMI except for the sleep loss and the shakes I’m starting to experience. Well at least the nurse said call if the heart rate gets out of control to get a beta blocker.

Thank you again for sharing your story and the information!… beach45

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