[LadyGrey]

#1058843

Hello,
I am new to posting. I was treated for Graves with 131I in 1985 and my December bloodwork came back “abnormal” for the first time since 1985. I don’t have the specifics because I was too shocked. I was told I could have come out of remission. Back in ’85 there was no talk of remission, and I first heard about remission of Graves last Monday. I will try to help anyone I can and look forward to helping others. Be well!

[Kimberly]

#1170362

Hello and welcome! It’s helpful to get hard copies of your labs so you can see for yourself where your levels are falling. Hopefully, you aren’t dealing with a recurrence, but it’s still a good idea to be an active participant in your own health care.

For patients who were treated many years ago, some docs used to try to give just the right dose of RAI that would kill off *part* of the thyroid but not all of it. The theory was that if you destroyed just the right amount of thyroid tissue, that the patient would end up euthyroid (normal) and wouldn’t have to take *any* meds. However, it’s since been discovered that some of these patients ended up experiencing a recurrence. So the thinking now is to give a “fully ablative” dose on the first treatment, meaning a high enough dose to completely destroy all thyroid function. Thyroid surgery has actually gone through the same shift over the years, with the preference moving away from partial thyroidectomy and more towards total thyroidectomy.

Do you have a follow up appointment with your doctor to review your labs and discuss next steps?

[LadyGrey]

#1170363

Dear Kimberly,
I have a follow up appt with my Internist in 6 weeks, however I am trying to find an Endo with thyroid experience who is covered by my health care plan. To date the only Endo in my area(central NJ) with thyroid experience is not in my network – seeing the dr would all be out of pocket. I am leaning toward paying out of pocket to get a real read on my tests. However, would you please provide me with the exact type of thyroid bloodwork I need to have in order to see where this is really going. I am sure you respond to the same type of question many times a day, however I could not find the answer on your site. Thank you for your kindness,

[Kimberly]

#1170364

Hello – This document from the American Thyroid Association and American Association of Clinical Endocrinologists has the latest info on diagnosis and management of hyperthyroidism.

You can check out pages 6-7 (pages 598-599 of the original article) for comprehensive info on testing practices.

Since your doctors suspect a relapse of Graves’, but aren’t sure, my guess is that they would go through the same testing procedures as they would for a brand new diagnosis.

Tests would generally include TSH, Free T4, T3, and antibody testing such as TSI or TRAb. A Radioactive uptake & scan is useful if the TSH/T3/T4 tests show that you are definitely hyperthyroid, but the antibody tests are not conclusive.

(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. As an alternative, you can right-click the link and open it in a new tab or new window).

http://thyroidguidelines.net/sites/thyroidguidelines.net/files/file/THY_2010_0417.pdf

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