# Prescribed methimazole...what is the point?



## kimberly13 (Nov 20, 2013)

The results of my uptake scan were that I have zero nodules, the iodine was quickly absorbed through all of my thyroid. I can't post labs because I was told I could get that information on MyChart, the website for UF/Shands medical information. I have my own account, but my labs are not there.

I have been prescribed 30mg of methimazole. The endo told me to take it once a day, but the pharmacy gave me 10mg tablets. It seems strange to take three tablets all at one time. In 4 weeks I go for more labs, and 5 weeks the endo will see me again. Anyway, 30mg seems like a high dosage to start with after hearing about the horrible side effects. And I am also wondering what is the point of this treatment? The endo told me that only 50% of those who take it will go into remission, and the remission is usually not permanent. So why use this treatment at all? The information I have on RAI seems that would be a better way to go. Very few side effects, and in my case it very well may be a one time treatment, as I have no goiter. The hyperthyroidism is also not effected my eyes at this point.

Can someone please explain to me why meds are prescribed when the information I am getting is that they are not very effective. Also, can anyone tell me their experiences with methimazole? How effective was it for you? What side effects did or do you have? The thing is, I don't feel that badly right now. The only symptom of hyperthyroidism that is really frightening me is the weight loss. Treatment seems worse than the disease.

I wanted to add something else. I was also recently prescribed Klonopin .5mg twice daily and Zoloft 25mg for anxiety. I have not taken any of these meds yet because all of my life I have steered clear of medications unless I HAD to take them, such as antibiotics. I am taking 60mg of Propanolol for my pulse, but adding all of these other medications is too much for me. I try to explain this to my doctors, but they won't listen. I will say the endocrinoligist was very understanding about not suddenly wanting to take multiple meds all at once.


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## Octavia (Aug 1, 2011)

No first-hand experience here with anti-thyroid meds, but I did have RAI for thyroid cancer. I completely agree with your thinking. And I'd be willing to bet that once you get your hyperthyroid under control, your anxiety is no longer an issue. My guess is that the hyper is causing the anxiety. But hey, I've been wrong before!

Did you ask your doctor about skipping the anti-thyroid meds and going straight to RAI?


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## kimberly13 (Nov 20, 2013)

I didn't ask her. At the time of the appointment, I wasn't told which option to take, although the doctor did tell me since this is my first time getting treated, it might be best to start with meds. I don't have much of a medical history, which is in my favor. I have not had any health problems until the hyperhyroidism. She explained both RAI and antithyroid drugs to me, and at the time I thought the meds might be the best option. However, after taking time to think about it and read over the literature she gave me, RAI seems a lot more succesful and less of a risk for side effects. The only negative to RAI I could see is becoming hypo, but it seems in the end that is going to happen anyway, so why not get it over with?

I'm sure my anxiety is partly because of the hyperthyroidism, but I've had it for many, many years, so I don't think it's all of it.

Thank you for the response. How did you do with RAI treatment for your cancer? Any bad side effects?


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## joplin1975 (Jul 21, 2011)

No personal experience either with anti-thyroid meds, but a family friends was dx'ed with Grave's the same time I was dx'ed with thyroid cancer. We share an endo and said endo told her that most insurance companies want you to try the meds first. Must be cheaper? I'm not sure, but I do remember her telling me that.


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## Andros (Aug 26, 2009)

kimberly13 said:


> The results of my uptake scan were that I have zero nodules, the iodine was quickly absorbed through all of my thyroid. I can't post labs because I was told I could get that information on MyChart, the website for UF/Shands medical information. I have my own account, but my labs are not there.
> 
> I have been prescribed 30mg of methimazole. The endo told me to take it once a day, but the pharmacy gave me 10mg tablets. It seems strange to take three tablets all at one time. In 4 weeks I go for more labs, and 5 weeks the endo will see me again. Anyway, 30mg seems like a high dosage to start with after hearing about the horrible side effects. And I am also wondering what is the point of this treatment? The endo told me that only 50% of those who take it will go into remission, and the remission is usually not permanent. So why use this treatment at all? The information I have on RAI seems that would be a better way to go. Very few side effects, and in my case it very well may be a one time treatment, as I have no goiter. The hyperthyroidism is also not effected my eyes at this point.
> 
> ...


I found taking Tapazole to be a waste of precious time. If I could do it over, I would go straight on to RAI. You can start on a low dose of prednisone prior to help protect your eyes and you should take your anti-thyroid until you doc tells you to stop prior to RAI so you don't have a thyrotoxic dump.


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## Andros (Aug 26, 2009)

kimberly13 said:


> I didn't ask her. At the time of the appointment, I wasn't told which option to take, although the doctor did tell me since this is my first time getting treated, it might be best to start with meds. I don't have much of a medical history, which is in my favor. I have not had any health problems until the hyperhyroidism. She explained both RAI and antithyroid drugs to me, and at the time I thought the meds might be the best option. However, after taking time to think about it and read over the literature she gave me, RAI seems a lot more succesful and less of a risk for side effects. The only negative to RAI I could see is becoming hypo, but it seems in the end that is going to happen anyway, so why not get it over with?
> 
> I'm sure my anxiety is partly because of the hyperthyroidism, but I've had it for many, many years, so I don't think it's all of it.
> 
> Thank you for the response. How did you do with RAI treatment for your cancer? Any bad side effects?


Let us know what you decide. Trust your instincts.


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## Octavia (Aug 1, 2011)

I did not have any bad side effects with the RAI, and my dose was higher than what they generally give for Graves. I got 100 millicuries, and from what I've read here on the forum, it seems like Graves patients get around 20 millicuries.


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## webster2 (May 19, 2011)

I was in a really bad place mentally and physically when methimazole and a beta blocker were prescribed to me. I took the beta blocker, because I had taken it before when I was hyper years before but kept declining the ATD. When the doctor really took the time to explain what it would do for some short term relief, until the remaining part of my thyroid would be coming out, I took it. The GP and the endo told me they didn't see the ATD as a long term solution.


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## HotGrandma (Sep 21, 2012)

Welcome........First off let me start by saying that I have no medical expertese only my personal experience and a ton of research dealing with graves.

Graves disease is caused by the body making antibodies that attack the thyroid. As you have already experienced the thyroid affects the heart that's why you were prescribed propanol. If the thyoid levels are out of whack the antibodies thrive and attack other parts of the body like the eyes. There is no treatment for the antibodies. Methamozole helps bring the thyroid levels into range so the antibodies back off.

Methamozole has a "short life" meaning it only stays in the system for 6 to 8 hours. Its best to take it every 8 hours to be effective. I cannot comment on the mg prescribed without seeing your labs with ranges. I know of several people who have successfully acheived remission on methamozole. My research and my course of action is that MMI needs to be taken for 18 months or longer and the antibodies within range to before discontinuing to acheive remission. PTU has severe side affect with regards to the liver I personally have not had problems with MMI.

RAI can trigger an attack on the eyes. You may also need several doses of RAI before it kills the thyroid.

Either way you could end up hypo which is hell to deal with. Either choice you make getting regular labs is important as to not drop severly hypo.

We are here to support you with either decision. Research Research Research


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## kimberly13 (Nov 20, 2013)

Thank you for all the responses, everyone. I am leaning towards meds at this point. A few of my friends have relatives that went through anti-thyroid treatment. One is still in remission, the other's returned and she got RAI ablation. She is now hypo and on synthroid and doing well.

The literature my endo gave me indicates that hypo is easy to manage, but from what i have seen here, that is not true. How does one find quality of life if their days are spent managing their thryoid levels? It seems a nightmare.


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## webster2 (May 19, 2011)

Hypo, IMHO, is not easy to manage!


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## Ginav (Jun 7, 2013)

It is easier than hypER! And it isn't as hard on your body and organs so it is safer!


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## Prudence (Oct 30, 2012)

Though I didn't go into remission on ATDs alone, they really did help me for abut 14 months. I was absolutely miserable without them, and they helped ease the symptoms. However, I do find it strange to take the three 10mcg all at once-methimazole/PTU has a short half life, so it's best to take 2-3 doses (or more, depending on how severe you are) throughout the day.



Ginav said:


> It is easier than hypER! And it isn't as hard on your body and organs so it is safer!


I think everyoe's different, personally. I have palps, dizziness, lethargy, brain fog,, etc. etc. whether hyper or hypo. I wouldn't wish anyone either.


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## chal4oye (Jan 4, 2014)

She explained both RAI and antithyroid drugs to me, and at the time I thought the meds might be the best option. However, after taking time to think about it and read over the literature she gave me, RAI seems a lot more succesful and less of a risk for side effects. The only negative to RAI I could see is becoming hypo, but it seems in the end that is going to happen anyway, so why not get it over with?


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## Andros (Aug 26, 2009)

Welcome to the board!

My vote is w/you. I wasted almost 2 years on anti-thyroid meds and was sicker in a different way; so so ill!

Got the RAI and on replacement thyroxine and now am good to go. Titration of the replacement med took some time but it was worth it. I feel good every single day.

When were you diagnosed and how are your eyes?


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## Airmid (Apr 24, 2013)

Ginav said:


> It is easier than hypER! And it isn't as hard on your body and organs so it is safer!


I wouldn't say that.

Certain types of hypo can be definitely easier to manage then say Hashimoto's which is another form of autoimmune disease.

While it may not be as hard on your organs, at least initially, it definitely comes with it's own set of problems that can have very serious long term ramifications. Not to mention you can feel just as bad hypo as you do hyper, it's just a different type of bad with some over-lapping symptoms.

That being said, my own personal experience talking to people (my aunt, friends, and fellow patients), clinically induced hypothyroidism is a lot easier to manage then Hashimoto's can be for some of us. My aunt, who had a TT due to cancer and then RAI has been doing well for over a quarter of century now. She did say the first six months were a bit rough as dosages got sorted out, but she's been on a stable dose for a long time. There are also others on this board who are doing well after a TT.

As another poster pointed out, it is very true also that some Graves patients need more then one dose on RAI. Some stabilize well on the anti-thyroid drugs and go into remission. Some never do and have go for either a RAI or a TT with or without RAI. It's all very personal and at the end of the day you can only do what's best for you and as others have said, research is your best friend for deciding your best option.

I hope you are doing well Kimberly and that things feel more under control for you now in the new year. hugs3


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## blueyes (Feb 15, 2013)

I'm a little late here, but I have been on methimazole since October 2012. We found a dose that works for me around July 2013, and I have been feeling great. Even if you're not sure about RAI or thyroidectomy just yet, the methimazole can give you more time to decide while still keeping your thyroid levels within range.


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