[brondack]

#1059590

Results from blood work and uptake / scan: TSH = 0.02, FreeT4 = 2.25, Total T3 = 227, 4 hour uptake = 45.4%, 24 hour uptake = 61.7%.

So, pretty clearly hyperthyroid. My endo presented the standard (I guess) 3 options – drugs, RAI, and surgery.

I have opted to go with the drugs (Methimazole – 30mg) for now, but I understand that is NOT a long-term solution. Is that correct?

I will ultimately do the RAI pill but my question is: how long after the pill (and the different drugs) does everything stabilize – on average. I read that it varies, but I am trying to get an idea on the range of time, as I need some unrelated surgery and obviously I my be stable in order to have it.

Thanx in advance for any and all assistance.

[Kimberly]

#1176001

Hello and welcome!

Hopefully, you will get some more specific responses from others who have chosen RAI as their treatment option. In general, RAI can take anywhere from 6-18 weeks to do its work, and then there is a period of adjustment where you and your doc work to find the “sweet spot” of replacement hormone dosing that will work for you.

As for long-term use of anti-thyroid drugs, doctors tend to have different opinions. Personally, I’ve been on methimazole for 5+ years, and do not plan to pursue a permanent option unless it becomes a medical necessity due to side effects. You can read more in this thread:

(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, or you will have to log back in to the forum. As an alternative, you can right-click the link and open it in a new tab or new window).

http://gdatf.org/forum/topic/42509/

Take care – and please keep us posted!

[brondack]

#1176002

Thanx, Kimberly.

As the unrelated surgery is something I need (but NOT for a life-threatening ailment), it sounds like I should do the Methimazole route until everything is stabilized as that should happen with 6-8 weeks(?), have the surgery and then make another decision about the long-term solution.

Appreciate the response.

[smtucker]

#1176003

I am one month into this Graves Disease so don’t have much experience to share. I too am doing the Methimazole treatments, but have been told I am not a candidate for radiation since my eyes are showing signs of TED.

My goal will be to avoid surgery if at all possible….

Anyhow, just a small welcome. Sounds like our paths are going in similar directions.

[cmac]

#1176004

brondack. The ATD’s may well be all you need, it’s too early to say. Don’t assume you will eventually need to choose between RAI and surgery, it may not come to that. I have just had my first Endo visit and reviewed my recent labs. TSH 5.3, it was negligible 4 months ago. T3 2.99, and T4 .82, both now in range, I don’t know the earlier levels, but they were bad. In August I started on 15 mg methimazole, went to 10, then 5, now down to 2.5. The Endo is actually worried I may go Hypo. I will see her again in 4 months and have labs in the meantime to check up. Of course, everyone is different, but give the ATD a chance to work. Good Luck!

[Kimberly]

#1176005

@brondack – Every patient is different, so you can’t predict exactly when levels will be stabilized. Personally I went from hypER to borderline hypO in a matter of weeks after starting methimazole, but there are other posters here who took much longer to see their levels come down.

As you noted, doctors prefer to NOT do any type of surgery if levels are in the hypER range, due to the risk of thyroid storm. There is an alternative (potassium iodide drops and beta blockers) that can temporarily get levels down if surgery is needed right away or if a patient can’t tolerate anti-thyroid drugs, but the preference is generally to stabilize levels via ATDs.

Take care!

[brondack]

#1176006

smtucker – thanx for the welcome – I’m about a month into it too. Good luck to you.

cmac – The only reason I am expecting to have to make the RAI / surgery decision is that my endo gave me the clear impression that he did not consider ATD’s a long term solution. I guess I really need to talk to him (he and his office are REALLY hard to get to talk to).

Kimberly – Thank you again – I know that stablization is not a exactly predictable thing. I should have said that it seems that it should be a shorter time than doing the RAI now and then starting the stabilization process with the thyroid replacement drugs. Again, my endo(actually his nurse) presented all three choices when she gave me all my test results.

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