remission and treatment

[Guest guest]

This is a quote from the New England Journal of Medicine

Approximately 30 to 40 percent of patients who are treated with an

antithyroid drug remain euthyroid 10 years after the discontinuation of

antithyroid drug therapy, which means that the Graves' disease has

remitted. Whether the remission is entirely spontaneous or is due to

amelioration of hyperthyroidism or to an immunomodulatory action of

these drugs is unclear.4 If hyperthyroidism recurs after treatment with

an antithyroid drug, there is little chance that a second course of

treatment will result in permanent remission.

Do I understand this correctly to mean that it is reasonable for me,

a first time patient, to at least try an antithyroid regime first and

refuse RAI?

I want to quote this to my doc.

jae

[Guest guest]

On Thu, 7 Aug 2003 20:40:38 -0500 Jae writes:

>

>

> This is a quote from the New England Journal of Medicine

>

> Approximately 30 to 40 percent of patients who are treated with an

> antithyroid drug remain euthyroid 10 years after the discontinuation

> of

> antithyroid drug therapy, which means that the Graves' disease has

> remitted. Whether the remission is entirely spontaneous or is due to

>

> amelioration of hyperthyroidism or to an immunomodulatory action of

> these drugs is unclear.4 If hyperthyroidism recurs after treatment

> with

> an antithyroid drug, there is little chance that a second course of

> treatment will result in permanent remission.

>

> Do I understand this correctly to mean that it is reasonable for

> me,

> a first time patient, to at least try an antithyroid regime first

> and

> refuse RAI?

>

> I want to quote this to my doc.

It's reasonable to refuse RAI even if your dr. doesn't take it seriously.

BTW, my theory about the hyperthyoidism recurring after a round of ATD is

that I wouldn't begin to take it seriously UNLESS I knew that the

patients in the study went through a round of ATD properly administered

and withdrawn. Nickels to doughnuts pitifully few did.

You brought up a few things in describing the results of the scan that I

couldn't pay proper attention to at the moment but probably wouldn't know

enough about to comment on anyway. My gut reaction, though, is that until

you get it all clarified you don't want to even TALK RAI. And, if your

doctor feels it's dangerous for you to go untreated, then you want to go

on ATDs while you explore your options, and you want to go on ATDs on the

assumption that this is the most benign treatment and has a good chance

of working.

Of course, there is the remote possibility that the results of your scan

will limit your options but you still don't need to be rushed into

permanent treatment without being fully informed. And that'll take time.

Good luck with the dr.

Take care, Fay (and If I need to on ATDs again, I will do so with the

greatest of optimism ;-)

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[Guest guest]

Hi Jae-

It's very important that you get the reference and a copy of the entire

article and bring it with you on your next doctor's appt. Otherwise, he/she

might dismiss the quote. If you have a hard copy from a reputable medical

journal (like NEJM), the endo cannot ignore it.

Your local university library or hospital library will have the journal.

And you might try calling your local library in advance to see if they have

it if that's closer for you.

Good luck!

Take care,

dx & RAI 1987 (at age 24)

> This is a quote from the New England Journal of Medicine

>

> Approximately 30 to 40 percent of patients who are treated with an

> antithyroid drug remain euthyroid 10 years after the discontinuation of

> antithyroid drug therapy, which means that the Graves' disease has

> remitted. Whether the remission is entirely spontaneous or is due to

> amelioration of hyperthyroidism or to an immunomodulatory action of

> these drugs is unclear.4 If hyperthyroidism recurs after treatment with

> an antithyroid drug, there is little chance that a second course of

> treatment will result in permanent remission.

>

> Do I understand this correctly to mean that it is reasonable for me,

> a first time patient, to at least try an antithyroid regime first and

> refuse RAI?

>

> I want to quote this to my doc.

[Guest guest]

Hi Jae-

It's very important that you get the reference and a copy of the entire

article and bring it with you on your next doctor's appt. Otherwise, he/she

might dismiss the quote. If you have a hard copy from a reputable medical

journal (like NEJM), the endo cannot ignore it.

Your local university library or hospital library will have the journal.

And you might try calling your local library in advance to see if they have

it if that's closer for you.

Good luck!

Take care,

dx & RAI 1987 (at age 24)

> This is a quote from the New England Journal of Medicine

>

> Approximately 30 to 40 percent of patients who are treated with an

> antithyroid drug remain euthyroid 10 years after the discontinuation of

> antithyroid drug therapy, which means that the Graves' disease has

> remitted. Whether the remission is entirely spontaneous or is due to

> amelioration of hyperthyroidism or to an immunomodulatory action of

> these drugs is unclear.4 If hyperthyroidism recurs after treatment with

> an antithyroid drug, there is little chance that a second course of

> treatment will result in permanent remission.

>

> Do I understand this correctly to mean that it is reasonable for me,

> a first time patient, to at least try an antithyroid regime first and

> refuse RAI?

>

> I want to quote this to my doc.