[cathycnm]

#1069752

Molly – What an interesting question. I am not sure but it seems as if the voice hoarsness that can accompany hyperthyroid would resolve with treatment.

Welcome to the board. ” title=”Razz” />

[Ilovemy2sweetpeas]

#1069753

We aren’t struggling with any voice hoarseness here.

*Edited to add – sorry – just realized you meant this for someone else.*

[cathycnm]

#1069754

Molly – I was multi-tasking when I posted that crazy responce to you – It was for someone else.

I don’t have a lot of answers on Graves in kids but some of the other moderators are great and hopefully will chime in.

Antibodies are produced regularly – and those that are against "self" are actually generally suppressed by our own immune system. Usually, that is. Autoimmune disease is our immune system not stopping those antibodies that are directed against our own tissue. Antibodies are actually produced by cells of the immune system. They are not stored, per se, but there are immune cells that develop memory so that they can produce more antibodies faster the next time the foriegn material (antigen) is encountered. Again, our problem is that we recognise our own tissue as foriegn because the cells that control the immune system from doing this are not working normally.

There are some good discussions on both RAI and surgery in our archives. I think both are effective treatment options. Both act slightly differently to eliminate the thyroid. One of the facilitators may know of a pros/cons list. I am not sure.

Your endos should be very aware of this, but, as you say, sometimes informed consumers are not what they are use to. There are some good books listed on our website that really helped me with a lot of this when I was making decisions. I read 3 or 4 books before I felt I really understood well enough – and I am a nurse practitioner. So – keep asking, keep reading and welcome to the board.

[Ilovemy2sweetpeas]

#1019163

HI everyone – I have a few questions that maybe someone can help me with.

I am hyper due to Graves’ – and have been for about 3 1/2 years now. I was diagnosed while pregnant with my second daughter, and was immediately put on PTU. (I was on PTU until about 2 months ago, when I finally saw a new Endo, and she switched me to Methimazole.) While I was pregnant and nursing, I was on doses of PTU as high as 600 mg/day – and only during the last month of pregnancy did I get below 200 mg/day (last month I was on 50 mg/day, I think). My labs have constantly swung back and forth, and my dosages have changed dramatically month to month. I do NOT have signs of TED. When I was in the late stages of pregnancy, I tried to convince my Endo at the time, and my IM (Internal Med) docs that I would prefer surgery, and wanted it done WHILE I was admitted having the baby (repeat c-section). They told me I was crazy and that "everyone does RAI because it’s EASY."

So, fast forward a few years. I finally have another Endo (the last one – the referral was stopped after I delivered the baby), and she said that surgery is a viable option. Where oh where would I find a "list" of the pros and cons of both RAI and surgery?

I’m also curious about what the difference is — long term health-wise — as to the effects of both. Will either one affect my long-term health, significantly? And if so, in what way? Where are the antibodies produced? Is there any way to suppress their production? Would surgery actually be a "good" option – since it doesn’t allow for "storage" of the antibodies anymore? (Either my Endo’s don’t know enough themselves, or don’t understand that I know *enough* about medicine to get what they tell me when I ask these questions because neither has been able to answer me so far.) Help?

Because I have the family history of GD as well as many other auto-immune diseases, my Endo is going to run some AI testing at my next visit — any idea what she’d be looking for?

Also, my daughters have had their TSH checked every year (at their physicals), and the youngest one had hers checked at each well-baby visit as well, since I was nursing and on PTU. (Believe it or not, I was HYPO for about 10 years before all this, and was on synthroid while PG with/nursing DD1.) Anyway, my second DD has always had "low-normal" TSH (0.78 this time, and 0.48 a year ago), but I have recently discovered a lump in her neck/throat. Her pediatrician is sending us for an U/S of her neck/throat tomorrow, then will probably refer us on to a Pediatric Endo. What should I expect from the Pediatric Endo? What type of tests (beyond the U/S and TSH) and what kinds of treatment should I expect for her? (She JUST turned 3.)

Thank you so much for any help/information/assistance you can offer…
Molly

[Ski]

#1069755

The end result of both RAI and surgery is basically the same ~ they are just alternate ways to remove the thyroid, so the effect is that you end up with no natural thyroid left in your body, and you must replace its hormone with replacement hormone you take once a day, as well as managing the "feedback system" with TSH manually.

Fortunately, there are only a few things that necessitate changes in our thyroid hormone replacement dose, and typically once we find a good dose for us (one that leaves us not only within the normal range but at our optimum POINT within the normal range), we only need to test annually (or when symptoms arise) to maintain that level.

If there were any one treatment choice with results that were above and beyond the rest, we would only advocate that particular treatment choice. All three treatments available to Graves’ patients are comparable in terms of effectiveness, and so we leave that choice up to you. They all carry a certain level of risk, so your task is to look at each treatment carefully, then decide which risks you are willing to take on. For example, someone who makes a living with their voice may not want to take on the risk of surgical complications, even though they are rare. For that person, the one risk of losing or permanently changing the voice, no matter how small, would be unacceptable.

You may want to see both a surgeon and a radiologist to evaluate the two treatments for yourself. They know best the intricate details and the statistics on various complications and issues. Keep in mind that most doctors believe their discipline is THE BEST, so your surgeon will probably tell you that surgery is the best option, and your radiologist will probably tell you that RAI is the best option. It’s YOUR choice.

Now, as for your daughter’s new issues ~ that’s something you’ll need to take one step at a time, and I’m sure you’ll know a good deal more after her ultrasound. You don’t have enough information yet to say conclusively what’s going on with her, and that’s the first step. The ultrasound is typically pretty conclusive for what may be going on inside her thyroid, if indeed anything unusual is going on in her thyroid. Once you know what you’re dealing with, it’ll be easier to know what to do. You’re seeing the immediate benefit of knowing what you’re talking about, knowing your own disease and its potential for showing up in your children. The pediatric endo should be able to clarify your options after the test results are in, so please update us on both of you!

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