[DianneW]

#1073780

RAI does not cause a person to become sterile. People are able to have children following RAI, and children born to RAI patients have no increased risk of birth defects. This has been well-studied. All forms of radiation, whether for diagnostic or treatment purposes, or from exposure to the sun, cause changes to DNA, and RAI is no exception. The amount of radiation received to the gonads in RAI treatment is roughly equivalent to a couple of barium enemas. Since all radiation causes small changes to DNA, the risks to the gene pool on the whole vs benefits of treatment to the patient have to be weighed, just as with all medical radiation, and it’s a personal decision for each patient to make.

If you’re concerned about costs, you will probably be able to manage antithyroid drugs most easily, as you can apply for reduced-costs on the meds if you don’t have insurance. Some people aren’t able to tolerate them, in which case another choice would have to be made. If your wife can tolerate antithyroid drugs, most people take them from 1-2 years and then stop to see if normal thyroid levels can be maintained once the drugs are stopped. (The doctor usually has a good idea even before whether this will happen, depending on whether the levels have come down, whether the thyroid has remained enlarged, and what the antibody status is by that time.) Approximately 50-60% of patients initially have a remission, but only about 15-20% have a permanent remission (meaning, the hyperthyroidism never returns during their lifetime). If the hyperthyroidism returns, you have the choice of going back on the drugs or choosing a permanent treatment (RAI or surgery).

RAI is fairly expensive. I can’t give you an exact cost at all, but it will be well over $1000 I’m quite sure. Perhaps others can tell you what they paid. It can take 1-3 months to control the hyperthyroidism (if successful; sometimes a second dose is needed) and after that can take 6 months to a year to adjust thyroid replacement hormone, unless it goes extra smoothly or extra badly, in which case it can be less or more than that. I’m trying to give you the short version.

As you guessed, surgery is probably the most expensive treatment, as it involves hospitalization. It may not be an option for the uninsured.

Starting out with the meds isn’t a bad choice while you learn all you can about the treatment choices, and if you want to plan for RAI or surgery you might start thinking of purchasing surgery with the idea of making it through that year of a pre-existing condition, if you can still obtain it. I wasn’t able to obtain life insurance once I had a GD diagnosis, which is ridiculous considering that GD doesn’t reduce longevity.

I hope I’ve answered your questions.

[schmals]

#1019737

Hello. So, my significant other has just been diagnosed with hyperthyroidism (most likely graves’), and we are confused about it all. We understand that there are three main treatment paths: daily medication, RAI treatment, and surgery. I’ve seen a lot of talk about it going into remission, and if it doesn’t, that another course of action should be taken? I’d just like to hear some information from everyone about how treatment usually ends up going. Does one usually end up taking the daily med at first, and if so, do they have to take it life-long or can they stop if it goes into remission? How does one know that it has gone into remission? What if it doesn’t go into remission? In that case should RAI or surgery be the next course of path? Unfortunately, cost is another big concern for us. We are scraping to make it by and she isn’t currently covered under any health insurance. So, obviously surgery isn’t really a great option for us because of the expense. How much do the meds usually cost? Is RAI treatment very expensive and what are the repercussions of that. We’re just confused about this all. We’ve done research, but find conflicting data. I’ve seen information stating that if the RAI treatment is pursued, then the person becomes sterile. I’ve also seen information stating that there is no risk of such a thing. Please let us know any information that you can. We appreciate any answers you can provide!

[schmals]

#1073781

Thank you very much for the insight. It really does help a lot.

[christa815]

#1073782

My endocrinologist suggested ATD for at least the first year. If that proved not to do much, then RAI was my next choice. I had the RAI in May 2006. I continued to stay hyperthyroid until October 2006, when I became severly hypo. I was then put on Levothyroxine (generic for Synthroid). Unfortunately, I am one who is still having to change doses every couple of months trying to get it right.

My first endo told me that the RAI did affect fertility, but when I went to a new endo for a 2nd opinion on treatment options, he confirmed that it did NOT affect fertility, and I am proof of that! I got pregnant with my 3rd child 7 months after RAI and he was a happy, healthy baby. I am now pregnant with my 4th child, so go figure!!!

Good luck to your significant other and your family!!

[elf]

#1073783

Some people try to keep their thyroid and "heal" it, so they prefer medications, regardless of what their doctors say. They hope to achieve remission in 18 months or so.

For some people, the sooner they take the thyroid out (with RAI or TT), the less chances of developing thyroid eye disease (bug eyes).

RAI is definitely a cheaper option than the surgery. With RAI, you take a pill and walk out of the room. No expensive Dr’s or surgeon’s time.

I don’t know how much would RAI or TT cost, but if you need surgeries for your eyes (to push them back or to adjust lids), each surgery is around $10,000 – 20,000.

Since she already has Graves, the private health insurance would already be high. I feel for you.

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