# Grave's treatment options



## davea (Feb 4, 2011)

Hi all.
I had a RAI done this week and an Endo appt. later today. I caught a peek at the scan (picture) and saw that the right side was fairly bright. When I questioned the tech he said it was fairly homogeneous and probably Grave's, no nodules.

I want to be educated when this doctor (who I don't really like) tells me I have Grave's. What meds would he likely put me on and which are not recommended based on your experiences?

Should I immediately consider the RAI and get rid of this thing? I really have no bothersome symptoms to speak of at this point.


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## runnergirl (Feb 6, 2011)

I just had an RAI yesterday. I am young, no kids yet, and very active. I wanted no chance of this coming back, although I know that Graves is always there. I considered meds but others said that could be a longer road to take. I will always wonder, but hopefully my experience will be good. So far I have felt fine. My symptoms before were bad at times. This all started just around the new year. I am lucky we caught this so soon. I am currently on a beta blocker which helps a lot. I go back at 4 weeks and then 7 1/2 weeks. Good Luck...research and be comfortable with your choice.


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## Andros (Aug 26, 2009)

davea said:


> Hi all.
> I had a RAI done this week and an Endo appt. later today. I caught a peek at the scan (picture) and saw that the right side was fairly bright. When I questioned the tech he said it was fairly homogeneous and probably Grave's, no nodules.
> 
> I want to be educated when this doctor (who I don't really like) tells me I have Grave's. What meds would he likely put me on and which are not recommended based on your experiences?
> ...


Hi there! RAIU is what I think you meant to type in the first sentence. Bright could mean hot which in most cases would probably be good. I hope that when you get the report, you can share it with us. No sense trying to second guess something we know little about.

I "am" very very glad you have had RAIU.

Now...............what to do? What to do? Learn your options and really really give it some thought. This is highly individual and only you can make the right decision for you.

Not to mention that the RAIU report may or may not cause you to lean a certain way in the decision-making process.


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## davea (Feb 4, 2011)

Ooops, yes I meant RAIU. BTW, I forgot to mention my uptake was 52%.
High according to the tech. Oh well, at least its treatable. I post after my appointment this afternoon. Thanks all.


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## Andros (Aug 26, 2009)

davea said:


> Ooops, yes I meant RAIU. BTW, I forgot to mention my uptake was 52%.
> High according to the tech. Oh well, at least its treatable. I post after my appointment this afternoon. Thanks all.


Yep; that is high. Will be looking forward to further info.

I just posted this elsewhere; you may be interested.

http://www.physorg.com/news/2011-02-thyroid-safe-effective-graves-disease.html


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## davea (Feb 4, 2011)

Ok, doctors says Grave's disease. He's treating it with 20mg of Tapazole (generic) daily. More labs in 6 weeks, he said he was only testing TSH and T4. He said no T3 test because that is only 1% and T4 is about 99%.??

My only symptom(s) remain a higher heart rate (2-3 beats per minute) and some palpitations.

So, uh, what now? Take meds for 1-2 years, see if it goes into remission and the take it out?

The doctor indicated that it is easier to treat hypo without the Thyroid than it is hyper. Thoughts?


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## lavender (Jul 13, 2010)

I think your doctor is being quite careless with your disease and suggest you find a new doctor. You said you do not like him, and I doubt that will improve. 
It is very important to monitor Free T3 when you are hyper because it is your active hormone and is what actually causes you to have symptoms such as your heart issues. Free T3 can be quite high, even with a normal TSH and T4. When my Graves was at its worst, My Free T4 was about double normal, and Free T3 was 5x normal. My doctors would have missed that and risked my life by neglecting to test T3.

I was on methimazole for 4 months and my symptoms did not improve even though my thyroid levels did. I opted for surgery, and think it was the best thing I could do. The challenge with being hypo is getting to the right dose/type of replacement med. Once there, it's easy to maintain. Having a good relationship with a doc is essential to managing thyroid replacement.

Hyper is a lot more unpredictable, but some people do well on meds. I suggest giving them a try to see how you feel. You may eventually decide on a permanent solution, but you don't have to decide today.


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## davea (Feb 4, 2011)

Thanks lavender
I have retesting in 6weeks, so I'll see where I'm at then. I will contact the doctor and have him test the T3 also. Thanks for your advice and I will be in touch.


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## Andros (Aug 26, 2009)

davea said:


> Ok, doctors says Grave's disease. He's treating it with 20mg of Tapazole (generic) daily. More labs in 6 weeks, he said he was only testing TSH and T4. He said no T3 test because that is only 1% and T4 is about 99%.??
> 
> My only symptom(s) remain a higher heart rate (2-3 beats per minute) and some palpitations.
> 
> ...


Scratching my head here. Free T3 is the active hormone and out of all the tests one would think that would be the most important one. You got me on that one.

Did you read the link I provided? That might help you decide.


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## davea (Feb 4, 2011)

I have decided to contact the endo and have orders put in for the T3 also.

andros,
The article is interesting. If I were to forgo screwing around with Tapazole for 1-2 years, just to see what happens, then is RAI as effective as surgery in completely disabling the Thyroid?

I saw the RAIU scan when the tech thought I wasn't looking. The entire right side was lit up to the edges, the outline was visible. The left side was at least 60% lit up.

If this was you, would you wait? My thinking is #1 insurance and #2 I'm going to have to have it removed eventually, right? The only think making me want to put it off is a very minimal amount of symptoms.


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## AZgirl (Nov 11, 2010)

Davea, Im fairly new too, 6months into this. I have been on same meds as you, starting with 40mgs, then to 25mgs, now to 10mgs and (crossing my fingers) talking to doc today, hoping for it to drop to 5mgs a day. So far, so good for me. Although, i am in Hypo stage at this point. This is the reason for dropping dosage. so, if i can stay on 5mgs, or less daily, im ok with that... 6months ago, i couldnt imagine saying that im ok being on meds for the rest of my life. I personally, am doing whatever i can, to avoid RAI or surgery. To me, that is a 2nd option. I wanted to be sure i tried my hardest to go the med route first, and give myself the oppertunity to see if i might be one of the lucky ones going to remission. I cant say what my outcome is going to be at this point, but, again, just making sure i do all measures before i do something like RAI or Surgery. Many people are very happy doing both of those, and many people are happy doing meds. This is def. an option you need to figure for yourself. But as far as docs go, you need to find one that will give you a true blood test to have an accurate reading. PS: FYI, a lot of people also get an allergy from the meds, too, just a heads up. But i was so determained, i started taking a benedryl (once i started a reaction to it) everyday with my meds. Then slowly cutting d own on the benedryl, kinda like forcing my body to adjust to the new medication it is taking. I spoke with 4 pharmisists who also told me doing this is ok, but only for a few weeks. Fortunatly for me, it was time to have labs done at same time again, and they cut back on my mgs too. I currently have no allergys to meds and now that im so much lower on my meds. im doing pretty good. Once again, this is my experiance, the choice that I desided, and i still not possitive about what could happen in the future. Have a great day!


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## lavender (Jul 13, 2010)

I think we are all different and the treatment that was right may not be right for you. If meds had made me feel remotely functional, I probably would have decided to stick with them for a while longer. My Graves was extremely progressed by the time I got treatment, resulting in being hospitalized for chest pain and 5 months of disability. I also had 5 years of undiagnosed/untreated health issues prior to my diagnosis. Remission seemed pretty unlikely to me. Your situation sounds a lot different, and it sounds like you have time to make a decision. If your gut is giving you a really strong signal, go with it. Otherwise, take your time.


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## Andros (Aug 26, 2009)

davea said:


> I have decided to contact the endo and have orders put in for the T3 also.
> 
> andros,
> The article is interesting. If I were to forgo screwing around with Tapazole for 1-2 years, just to see what happens, then is RAI as effective as surgery in completely disabling the Thyroid?
> ...


Okay..................please make sure it is the FREE T3 which your active hormone which is unbound and available for cellular uptake. T3 (Total 3) is bound, unbound and rT3 (reverse T3.)

Lavender gave you sage advice. Each of us is different and we each have different life circumstances. Take your time, garner all the knowledge you can and with the help of a good doctor, you will be able to decide which course is best for you!

I got tired of fooling around but like Lavender, I was in the very advanced stages of Hyperthyroid/Graves'!


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## davea (Feb 4, 2011)

Thanks to all. 
I'm going to take my current medication for six weeks and then retest to see where I'm at. If things go all screwy with me, then I will reconsider my options and move forward from there.

I will also be certain they test freeT3. It doesn't make sense to take three vials of blood and not test it.


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## Andros (Aug 26, 2009)

davea said:


> Thanks to all.
> I'm going to take my current medication for six weeks and then retest to see where I'm at. If things go all screwy with me, then I will reconsider my options and move forward from there.
> 
> I will also be certain they test freeT3. It doesn't make sense to take three vials of blood and not test it.


I think you have made a very wise decision. This won't ever leave any doubt. You do have to explore your options.

Yep; about the bloods! They don't want to do the test because it costs more than the others.


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## lavender (Jul 13, 2010)

Sounds like you are making a wise decision. If the doc refuses to test your Free T3, I would suggest going elsewhere. It is more costly, but way cheaper than ending up in the ER with heart problems because it has not been monitored!


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## Andros (Aug 26, 2009)

lavender said:


> Sounds like you are making a wise decision. If the doc refuses to test your Free T3, I would suggest going elsewhere. It is more costly, but way cheaper than ending up in the ER with heart problems because it has not been monitored!


Amen to that!


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## BRGB12X (Feb 25, 2011)

runnergirl said:


> I just had an RAI yesterday. I am young, no kids yet, and very active. I wanted no chance of this coming back, although I know that Graves is always there. I considered meds but others said that could be a longer road to take. I will always wonder, but hopefully my experience will be good. So far I have felt fine. My symptoms before were bad at times. This all started just around the new year. I am lucky we caught this so soon. I am currently on a beta blocker which helps a lot. I go back at 4 weeks and then 7 1/2 weeks. Good Luck...research and be comfortable with your choice.


I got mine 1/1/11 also. Beta blocker is not working and methywhatever is not working yet. Still scetching my brains out.


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## Andros (Aug 26, 2009)

BRGB12X said:


> I got mine 1/1/11 also. Beta blocker is not working and methywhatever is not working yet. Still scetching my brains out.


If your beta-blocker is not working, you need to tell your doctor. You may need a dose adjustment.

How much Methimazole are you on? Did you have a thyroxine dump after the RAI?

When do you see your doctor for labs?


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