[Kimberly]

#1062278

Hello – The weight issue is *so* individual that it’s really difficult to predict what will happen. I’ve been on methimazole for 3 ½ years, and my weight has been a constant battle. I’ve known patients who have been through RAI and surgery who have also struggled with weight. But there are also other patients that *don’t* have weight problems. There are pros and cons to each treatment option, but I really don’t think any one of them has an advantage when it comes to weight issues.

One key factor after RAI or surgery will be to make sure that you aren’t allowed to go hypothyroid, as this *definitely* won’t help with the weight issues! Make sure you are getting regular labs and that you keep an eye out for symptoms of hypo, which can include fatigue, joint pain, weight gain, constipation, dry skin, cold intolerance, and slow pulse.

You mention that you are feeling great now…keep in mind that either RAI or surgery will involve a period of adjustment until you find the right “sweet spot” of replacement hormone that will keep your levels stable. Obviously, I don’t know your history with Anti-Thyroid Drugs, but some docs will support longer use of ATDs if the patient can remain stable on a low dose…and as long as any side effects don’t occur. You definitely want to research all your options and make sure that you are comfortable with your final decision.

[snelsen]

#1062279

I don’t think it makes a lot of difference. Kimberly covered this subject very well. I think there probably are many of us who have never had an issue with weight and Graves’, and you don’t hear about us because it is not an issue. I am one of them. I had a thyroidectomy. Everything seemed more definitive and quicker, and that is what I wanted. Just to be back to "being me," And when we are on the right dose of replacement, that is what happens.
I guess I think that with surgery, the progression to the "sweet spot," ie, is faster than with RAI. And more definitive.

Of course the choice is yours, and there are plenty of people on this board to represent both RAI and surgery. And the usual caveats go with both choices. Choose a surgeon who does at least 50 thyroidectomies a year, preferably at a major medical center. And the same is true for the radiologists who calculate your RAI dose.

It doesn’t sound like being on an methimazole has been a great experience for you. Is it during this time that you gained the weight? I know some of the facilitators on this site, plus others, have chosen ATD’s to manage Graves’, and they are happy with it. But I don’t know if weight gain is more of an issue with ATD’s. i would think not, unless the dose is not right for the person.

I do appreciate the fact that you are working hard to lose weight. The Atkins diet is known as a method of losing weight in a short period of time, as you have done. There is a ton of research, and numerous studies about this method. So it seems like it is a good kick start for you. No matter what your choice, a healthy diet and exercise is the right way to manage weight.
After Atkins, you have lost a lot of muscle, and are in a state of ketosis, so when you begin to eat your regular diet, it will take a bit of gradual getting into shape as you regain muscle strength. But when you add exercise, walking running, etc., I suspect that weight won’t be a problem for you after you choose your treatment, and as Kimberly says, work closely with your endo when your residual circulating thyroid hormone is gone, for then you will be hypo. It is good to catch that right away, as Kimberly says. For hypo and weight gain go together for most people, I think. Again, it was not my experience, for when I was hypo I completely lost my appetite.

I actually did not realize that weight gain was a significant issue, after people got to a euthyroid state. Unless weight was always an issue. I’d say that if you were a small person in frame and weight before you got Graves’, you can get back to that state when you begin your thyroid replacement, for the whole goal of that is to make us "like we were" before Graves’.

I hope more people respond to your post who have had more experience with weight gain. And I hope when you choose your treatment plan, and get the right thyroid replacement, it will be a total non-issue.
Shirley

[fj122876]

#1018025

So after fighting graves for almost a year, my endo does not think I will acheive a remission. (after giving me some hope before) He has discussed RAI and surgery as my options to remedy the situation.
My problem is this, like so many others I have struggled with weight gain thru this whole process. Finally (and with my endo’s blessing) I read and have been following "The Atkins Diet" along with daily yoga. I have lost 25lbs in 2 1/2 months. I’m now very close to my pre-graves weight and feel better than I have in a really long time. I’m now really concerned that if I chose one of these options the weight I have lost and the progess I’ve made will all be lost. Is this something I should worry about? I understand being healthy is more important than weight gain, but I have always been a very small person in frame and weight and the extra weight I gained was very uncomfortable and depressing. My endo does not think I should stay on the methimazole for more than 1 year so this is why I am faced with this decision now. Any thoughts.

[fj122876]

#1062280

Thanks for the responses, my weight gain actually started a little bit before I was diagnosed, so I thought I was going to be told that I was hypo, I was shocked to find out that I was hyper with graves given the weight I had gained. I have been doing yoga for so long I’ve forgotten when my thyroid is straightend out I’ll be able to return to more strenuous workouts that I was used to before getting the graves and having to slow down. I think at this point I might be hyperfocusing on the issue of weight to stop myself from worrying about these two procedures. I’m terrifiied of anethesia and the RAI worries me because I don’t want to be away from kids for a week. Thanks again for the help and support, this really has been a crazy ride.

[snelsen]

#1062281

Good processing! You will be fine. I strongly suggest that you put both RAI and "surgery" or "thyroidectomy" in the search box.
As you read the decision process of others, i think you will feel very reassured that once you make a choice, much anxiety will be relieved, and you will begin to look happily forward to healing and getting your life back. Unfortunately, everything Graves’ moves much more slowly that we like!

I had surgery, there are many recent posts on surgery. I think several of my posts are there. You might also put "anesthesia" in the search box. In my job world, as well as my personal experience with anesthesia, I can assure you that anesthesia is pretty wonderful. It is very routine to medicate pre-op and intra-op for nausea, which, for this surgery, is a non-issue in any case. It is a short surgery, usually less than an hour. If you feel apprehensive on the day of surgery, you can be medicated for that. Tell the anesthesiologist what you are concerned about, so they know. There is a wonderful drug called Versed, which is generally know as the "forgetting medicine." It helps you relax. Ask anyone who has had a colonoscopy, who did not even realize the procedure was completed! They have no memory of it at all. I think I told you in my last post that surgery seemed more fast, regarding the path of getting on a replacement thyroid dose, and back to normal.

You will find that most of us are very happy with what we chose, whatever it was. Take a look at posts from lhc11. She has had recent surgery, and describes her decision process and experience very well, and it is current.
Shirley

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