ObernesserfamilyNovember 1, 2017 at 11:25 amPost count: 1
My husband has been dx with graves, taking the tapazole as prescribed. Thyroid function tests are back to norm except immunoglob. That is still elevated, our doc says now we need to try either surgery or radioavtive iodine. Been reading up on it but would love some personal expiriences. He is pretty healthy otherwise, no medical issues. Thoughts? Thanks!KimberlyOnline FacilitatorNovember 2, 2017 at 3:23 pmPost count: 4262
Hello and welcome – I’ve never heard of a doctor pushing surgery or RAI simply because antibody levels didn’t go down! Some docs will recommend RAI or surgery after 12-18 months on Tapazole, but we are seeing a lot more support in the medical community for longer term use.
Issues where doctors might be more likely to recommend RAI/surgery would be if your husband is having serious side effects with the Tapazole, or if the Tapazole isn’t effectively controlling his thyroid levels.
Hopefully, others will chime in – but we have community members here who have shared past experiences with both RAI and surgery, so you can use the “Search Posts” feature to look up old posts by keyword.
If your husband wants to pursue surgery/RAI, great – but he needs to understand the risks and benefits, and also the fact that he won’t get a “do-over” if he changes his mind later!
If he’s currently being treated by a primary care provider, an appointment with an endocrinologist might be helpful. (Or consider a second opinion). You can find doctors near you using the “Looking for a Doctor?” thread in the announcements section of the forum.Liz1967November 4, 2017 at 4:33 pmPost count: 305
If he has any eye symptoms, surgery would be beneficial as it tends to shorten the course of the eye disease. Men seem to get more severe eye disease. I had a total thyroidectomy after 6 months on methimazole and in my case, it was absolutely the right decision. There is no advantage to long trials of medical treatment, so it is reasonable to opt for definitive treatment early on. Work with your docs to choose the best option.
Here is just one study supporting early TT. https://www.ncbi.nlm.nih.gov/pubmed/28681142forumusertestNovember 8, 2017 at 3:28 pmPost count: 3
test responseforumusertestNovember 8, 2017 at 3:59 pmPost count: 3
Test 2emmteeNovember 15, 2017 at 11:55 pmPost count: 148
I also question the need to rush to a definitive therapy (thyroidectomy or RAI). When I was diagnosed, I had bit of a goiter, which my endo told me was an predictor that I was unlikely to go into remission on methimazole. She still offered it as one of my treatment options, though. I initially started taking it because I was interested in having a thyroidectomy, but I needed to become euthyroid (thyroid levels in the normal range) before the surgery. I had an unusual case, and it actually took about a year for me to become euthyroid. By that time, I was comfortable with the medication and wasn’t really in a hurry to have surgery. After 4 years on methimazole, we found a large nodule that made a thyroidectomy necessary.
I was satisfied with both my Graves’ treatments. After that first year, I did pretty well on methimazole. I also had a very successful surgery – no complications and a pretty quick (2 weeks) recovery in spite of the fact that the surgery was more challenging than most. Having a really good surgeon is key. I would say that I wish I had had my surgery sooner, except that my surgeon wasn’t around back then. (She was only recruited by the hospital a few months before my surgery).
I’ve actually started to have a few minor eye issues after my TT. Chances of eye issues are said to be worse with RAI, so I’m really glad I didn’t opt for RAI.
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