[Bobbi]

#1074968

There are many good, medical reasons why any one patient should do one treatment over another. Our doctors are the people qualified to make that judgment call, and they give us their best advice. If you are not confidant that your doctor’s advice is the best, then you need to find another, equally qualified MD/endo and get a second opinion. There are lots of folks here online who would be more than willing to tell you what to do — but none of them are qualified to do that and none of them have your specific set of medical circumstances so what they did is irrelevant to what you should do. Please, discuss things carefully with your own doctors instead.

As for the way you worded your subject, RAI does indeed remove the thyroid, just as surgery removes the thyroid. Both have the same percentage incidence of the treatment not working — i.e., leaving us still hyperthyroid. Both typically require us to then take replacement hormone, which can take some time to adjust to the proper dose. There are pros and cons to both options. RAI does not involve some of the risks that surgery does (even in the hands of a well-qualified surgeon). But RAI takes longer for the effects to settle in. And, sometimes, RAI aggravates an existing eye disease temporarily. So patients with significant eye disease are sometimes routed towards surgery rather than RAI. (It is thought that RAI stimulates an immune system response — and any immune system response raises the numbers of antibodies, and therefore increases the symptoms of any autoimmune disease.)

I do wish you good luck with your decision-making and treatment. And, if there are specific questions about treatments, the moderators here are more than willing to give you that information. (Just not advice.) ” title=”Smile” />

[shannon8774]

#1019912

hello ! first im so grateful to have found this site i have been diagnosed with graves it runs in my family . my sister had the rai treatment and she keeps telling me to get my thyroid removed she was very sick from the rai… my doctor wants to do the rai .. i am just wondering if someone can give me some tips i dont know what to do but the doc says i could go into thyroid strom any help will be appreciated …

[Mickey65]

#1074969

I did the RAI on dec 12 – barely a week ago, and I’m not sick yet from it. I’m actually starting to feel better a bit already!

I think it depends on the person and how they react to it, maybe?

[Bobbi]

#1074970

You are about due, Mickey, for a bit of excess hyperthyroid symptoms. Roughly a week after RAI, thyroid cells that are damaged by the RAI start releasing their stored supply of thyroid hormone into the body. These cells are not making new hormone, but anything stored is let loose. As a result, we can experience a spike in hyper symptoms that lasts a few days. I mention this phenomenon because some folks have panicked when it occured.

I hope you continue to feel better each day,

[Mickey65]

#1074971

I’m just curious as to what to expect with that, when it happens – the spike in hyper? :” title=”Question” />

[Bobbi]

#1074972

What we experience are more pronounced hyper symptoms like rapid heart rate, tremors, "nervousness," irritability, inability to sleep well, hot flashes, etc. Nothing new — just the old ugly symptoms rearing their head more vigorously. About 20% of the thyroid’s hormone production is T3 which is the form of thyroid hormone that is directly, and immediately, used in the cells (as opposed to T4 which must be converted to T3 in order to be used in cell metabolic processes). So the T3 particularly goes right to cells revving them up. Fortunately, T3 has a very short life span: it’s half life is three-quarters of one day. So the T3 that is released after RAI is used up fairly quickly.

I think the problem for some folks is that after RAI they expect continuous improvement, and this dumping period feels like a set-back. Also, some people online call this "thyroid storm" which is a fearsome concept, but this period isn’t the same: in storm the thyroid cells are continuously producing new hormone in extreme amounts in addition to using up their stored supplies. After RAI, the cells are not making new hormone — simply releasing hormone already made and stored in thyroid cells. So after RAI the period of excess hyperness is typically of limited duration.

Some endos prescribe medications to be taken during this period of time. For example, my endo told me to double my dose of the beta blocker when this occurred. I did that, but only for a couple of days. It depends on your endo, and your level of hyperness to begin with whether or not that is the case. Also, some folks cannot safely take the medications most often prescribed.

[elf]

#1074973

Mickey – I had RAI almost to the date – on Dec. the 13th, but three years ago, in 2005. While I read that people had various experiences and various speed of turning hypo afterwards (some as soon as 2 weeks), I can only relate my experience.

I, too, was apprehensive and listening to my body days and weeks after. Nothing really was happening to me for months. I wasn’t taking any ATDs, my thyroid levels were eurothyroid through May, so no Synthroid neither. On March 1st, and for a week after, I had a bit of hand tremors, and my eyes were especially sandy – I knew then it was that last ditch effort of the dying thyroid. In May, finally, my tests showed hypo, so I was given 0.1 mg of Synthroid (based on my weight). I’m taking it ever since. I never experienced any "hypo crash" like I’ve heard. My eyes settled by the end of that year (2006). For 2 years, I have had no signs or problems health-wise.

[elf]

#1074974

shannon8774 wrote:hello ! first im so grateful to have found this site i have been diagnosed with graves it runs in my family . my sister had the rai treatment and she keeps telling me to get my thyroid removed she was very sick from the rai… my doctor wants to do the rai .. i am just wondering if someone can give me some tips i dont know what to do but the doc says i could go into thyroid strom any help will be appreciated …

I could write a lot why thyroid surgery would creep me out, but I know already that if a person feels uncomfartable about a certain treatment, it won’t make much difference. Your sister has much more influence on you, than an online stranger. I had no problems with and after RAI, your sister had. By all means, go with what YOU feel comfortable with, what you will regret the least afterwards.

[Jake_George]

#1074975

When considering tyhroidectory, another consideration is that the doctor uses a nerve probe for the vocal cords. One risk of surgery is damage to the nerve that feeds and supports the vocal cords.

They put a probe on the nerve and when they get close to it during the surgery it emits a beep letting them know that they are close to the vocal cord nerve. When the doctors use this probe the chances of vocal cord damage drop to almost nil.

Make sure you select a doctor that uses the probe in the thyroidectomy surgery.

[Mickey65]

#1074976

"Some endos prescribe medications to be taken during this period of time. For example, my endo told me to double my dose of the beta blocker when this occurred. I did that, but only for a couple of days. It depends on your endo, and your level of hyperness to begin with whether or not that is the case. Also, some folks cannot safely take the medications most often prescribed."

My endo has me on 10mg of Propoponal (sp?) – – take two, three times a day and also Predisone (steroids) 10 mg – twice a day.

The predisone is great for helping my neck not feel so "tight" and "full".

Tomorrow will be a week since the RAI and I knew better to not expect instant results from it. I’m just going to ride it out until I feel better, completely – or almost!

[Author]

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