[amy3820]

#1059532

Hi! I am new to all of this and would love some advice. I have just been diagnosed with sub-clinical hyperthyroidism. My doctor really thinks I should have the RAI because of my history of heart problems (Mitral Valve Prolapse with Regurgitation and Paroxysmal Atrial Fibrillation). He wants to skip Anti-thyroid drugs because it is sub-clinical and has been for 2 years. My levels normalize and then within a few months are off again.
Can I get some opinions on my options? I am typing my labs below.

November 9, 2012
TSH receptor antibody 3.64 IU/L Normal range 0-175
Free T3 3.5 pg/mL Normal range 2.3-4.2
Free T4 .9 ng/dL Normal range 0.5-1.4
TSH 0.06 IU/mL Normal range 0.34-5.6

Ocotober 18, 2012
TSH 0.015 Normal range 0.34-5.6

April 2011

Uptake and Scan – uptake of 50% at 24 hours. Diffuse enlargement, homogenous increased uptake.

[Bobbi]

#1175455

The heart issues are serious ones to consider. When we are hyperthyroid, our heart is stressed. And we can be thrown into arrythmia because the system that controls heart beats can go suddenly out of whack. Going into and out of hyper isn’t good for us either because our bodies don’t necessarily heal properly in between bouts. My point of view, stated here on the board from time to time, is that it is possible to live very well without a thyroid. I do. Several of my friends do. So, trying to save the thyroid, at the expense of an organ that is vital makes little sense to me.

If you are unwilling to accept your doctor’s advice at this point in time, you might consult with a cardiologist, or another endo to get a second opinion.

[Kimberly]

#1175456

Hello – If you check out the “Treatment Options” thread in the announcements section of this forum, the second link includes a section on subclinical hyperthyroidism. (It’s on page 617-618 of the original journal article or page 25-26 if you download the doc as a PDF).

The guidance notes that heart issues *are* a reason to treat subclinical hyperthyroidism, rather than the usual “watch and wait” approach — and it mentions RAI, anti-thyroid drugs, and surgery as potential treatment options.

Agree with Bobbi that a second opinion might be helpful if it would give you a little more peace of mind as you make this decision.

Take care!

[amy3820]

#1175457

Thanks Bobbi and Kimberly. My doc told me to think about and research before I decided. I figured that the best way to do so would be a place that other people have had the treatments. I am leaning toward the RAI, but my husband is still skeptical about it. I teach, so I wouldn’t be able to have it done until Christmas or summer break. I can’t really go to another endo (live in Alaska ). I am going back to my cardiologist to make sure he agrees with the endo.
Bobbi did you have the RAI? My main concern is not the RAI, it is getting the correct meds after. My husband is in the Army and we move a lot. Some of the places we go do not have the best medical care and some of the docs will not listen. Is it a constant battle to find the correct dosage, or is it fairly constant after the first couple of years?

[Bobbi]

#1175458

Hi, Amy: Yes, I did RAI back in 1996. It took a number of months to get my replacement hormone levels correct. And, over the past 16 years my dose of replacement hormone has been tweaked a handful of times. I consider it an easy fix when things go slightly out of whack. It is most definitely not a constant battle — for me at least — to find the right dose. But it does take time, at first, to get it properly calibrated.

[mvk]

#1175459

Hi Amy 3820,

I had RAI in April, 2012. I have had several months of trying to regulate my replacement Levothyroxine therapy. This week I had blood draws and my FT4 is 1.9 (norm 0.8-1. and my TSH is .71 (norm .40-4.50). These are the best results I have had. I am up to .175 Levo/day. It has been 7 months post RAI. I feel a whole lot better and have had ups and downs in these past months. I am a lot older than you (62) and decided that RAI was the best option for me. It is interesting to me that before, during and after this whole ordeal I have always been cold. I never had the hot issues even during menopause. The last couple of weeks I can’t say I’m warm, but I’m certainly not as cold as I typically run temperature wise. No more muscle or joint pain, a lot less anxiety, not so tired and I have actually lost a couple of pounds. It is a huge decision to make and I wish you the best in making yours and hopefully feeling better soon.

mvk

[Author]

Posts