# RAI vs Surgery



## AndiB (Sep 7, 2010)

I was recently diagnose w/GD in April. Racing heart, tremors, hairloss, etc...I am currently on Propranolol and was taking methimazole. Methimazole didn't agree with me at ALL. Itchy hands and feet, and within a month of taking it, it has effected my liver. So...had to discontinue it.

Now...I am deciding is it RAI or surgery?? I feel like a crazy woman just trying to decide which treatment is best for me?? I am super senitive to meds, so it gears me towards having surgery. I am terrified of RAI, because of all the negativity, experiences from others. I am also worried of 2nd cancer. I am told even though I am having a low dosage of RAI (No cancer or goiters, just secreting a lot) it is still a low risk to obtain 2nd cancer down the road. But I am also worried about risk with surgery. Can't win with a decision. I just want to feel better.

Does anyone know when you are on Propranolol does it help prevent from getting heart failure?? I understand it is just a band-aid to control systems, but I can still obtain heart failure if I don't actually fix the problem. :sad0049:


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## Andros (Aug 26, 2009)

AndiB said:


> I was recently diagnose w/GD in April. Racing heart, tremors, hairloss, etc...I am currently on Propranolol and was taking methimazole. Methimazole didn't agree with me at ALL. Itchy hands and feet, and within a month of taking it, it has effected my liver. So...had to discontinue it.
> 
> Now...I am deciding is it RAI or surgery?? I feel like a crazy woman just trying to decide which treatment is best for me?? I am super senitive to meds, so it gears me towards having surgery. I am terrified of RAI, because of all the negativity, experiences from others. I am also worried of 2nd cancer. I am told even though I am having a low dosage of RAI (No cancer or goiters, just secreting a lot) it is still a low risk to obtain 2nd cancer down the road. But I am also worried about risk with surgery. Can't win with a decision. I just want to feel better.
> 
> Does anyone know when you are on Propranolol does it help prevent from getting heart failure?? I understand it is just a band-aid to control systems, but I can still obtain heart failure if I don't actually fix the problem. :sad0049:


Hi there! I don't blame you for being anxious. We all have been at one time or another.

Some things we just have to do on a wing and a prayer as they say. Try to make the decision that you think is best for you.

And I will give my opinion. I believe that surgery is the better choice for many reasons mainly to check for cancer but also because sometimes one RAI does not do the trick. I for instance, had to have RAI 3 times.

This was many years ago and I knew nothing. If I knew what I know now, I would definitely have the surgery.


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## AndiB (Sep 7, 2010)

Thanks for your reply...Are your worried having RAI 3x's? I was told I do not have cancer. Can they tell with a scan? I have no lumps/goiters. It is just secreting too much. Mine doesn't even feel swollen, per my intern and endocrine dr's. My scan showed consistent with GD. I am worried with sugery too, what if they nick a parathyroid gland? There is risk with both treatments.


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## Andros (Aug 26, 2009)

AndiB said:


> Thanks for your reply...Are your worried having RAI 3x's? I was told I do not have cancer. Can they tell with a scan? I have no lumps/goiters. It is just secreting too much. Mine doesn't even feel swollen, per my intern and endocrine dr's. My scan showed consistent with GD. I am worried with sugery too, what if they nick a parathyroid gland? There is risk with both treatments.


Yes; there is risk w/both treatments and there is also a risk attached to staying on antithyroid meds indefinitely. And an even greater risk by not doing anything.

It's a conundrum to be sure.

I cannot tell you how many people have been told they don't have thyroid cancer. They then had total thyroidectomy only to discover that cancer was present at pathology.

Radioactive uptake scan is probably the best. I can't vouch for any other. Sonograms do have limitations I have read.


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## Lovlkn (Dec 20, 2009)

I had a TT 5.5 years ago and wish I had done it sooner in my Graves DX.

It renders you hypo almost immediately and then you can concentrate on proper replacement.

YOU have to be very aware during the replacement phase and ask questions of the doc to be sure they properly medicate you.

FT-4 and FT-3 is the only way to dose replacement and if your doc is not willing to dose you using those 2 lab tests they you will have to find another.


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## AndiB (Sep 7, 2010)

Andros,

I had the RAIU and they said I didnt have thyroid cancer. I pray it remains at that. 
I've talked to dr's today and the dosage I need is so low that they told me I should not worry about getting 2nd cancer. The radiation is about the same strength as laying in the sun for the day. Im told??? There concerns with surgery is...most likely the surgeon will take more out than what should be taken out. To make sure it is not overactive anymore. RAI the dosage is more controlled. I was told I will still have thyroid functioning.


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## lavender (Jul 13, 2010)

I just had a TT for Graves a month ago, and I would do it again in a heartbeat. I could feel the difference in my body the moment I woke up from surgery. All Hypo symptoms were immediately gone!!! 
I just feel tons better and I so glad I did not go for RAI and have to wait months to see if it worked. My body reacts crazily to all sorts of meds, and I did not want to take the risk with RAI. I was also worried about eye disease which can be worsened or triggered by RAI. 
Thyroid replacement has been a breeze for me. Docs have told me I am hypo now, but honestly, I can not tell because I just feel so much better. Just a wee bit tired at times, but nothing like before. Hyper had me totally knocked out.
Pathology report said that they took out 1 parathyroid. I have had low calcium issues since surgery which docs tell me is a result of my parathyroids being "stunned," and they think it is temporary. I am taking tons of calcium and prescription vitamin D (Calcitrol). The first week after surgery was pretty difficult due to the calcium issue, but once I got it elevated enough, it has been fairly easy to manage, and I am taking less this week because I just don't feel like I need it as much. I would rather take a bottle of calcium every week than continue to feel as bad as I did before. To me, it was worth the trade off.
I will also say that even though no doctor ever mentioned cancer to me, it was really nice to get the pathology report to confirm it.


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