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Diagnosed With Graves Disease. Prescribed PTU And Inderal. And Second Doctor Advised Radioiodine. Suggest?

Posted on Wed, 24 Jul 2013

Question: Hi I have been diagnosed with Graves disease. The endocrinologist who asked me to take the technetium uptake test had prescribed PTU 100 mg 3 times a day and inderal 40 mg twice a day.
We read about PTU and took a second opinion from another endocrinologist who has asked me to take 10 millicuries of Radioiodine.

I would like your advice on whether the tablet option is better or the radioiodine option is better

Answered by Dr. Guru (1 hour later)

Hi,

Thank you for consulting HealthcareMagic!

Actually, selection of antithyroid drugs or radioiodine in the treatment of Grave's disease depends on many factors, including age, size of goitre, social and economic factors and complications of treatment.

Radioiodine is being increasingly used these days.

Usually we follow the following guidelines in the treatment of Grave's disease:

Younger patients with small goitres and mild case - 18-month course antithyroid drugs.
Older patients with small goitres - radioiodine (preferably when euthyroid, which means thyroid function tests are normal).
Large goitres - antithyroid drugs until euthyroid, then Radioiodine.

Hope it helps!

Please let me know if you have any further queries!

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Guru (1 hour later)

Thanks for the reply Doctor. Please let me know if it is okay to use PTU.

Answered by Dr. Guru (27 minutes later)

Hi,

Thank you for follow up query.

PTU has it's own side effects like agranulocytosis, aplastic anaemia, liver injury etc and it is usually reserved for use in patients who are unable to tolerate other treatments like using methimazole, radioactive iodine etc.

Same time, radio-iodine also has it's side effects. But, if you were my patient, I prefer radioactive iodine.

However, it is prudent to discuss about this with your treating doctor who had analyzed your condition better than me and did physical consultation.

Hope it helps!

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Guru (21 minutes later)

Thanks again Doctor for your reply. One last question, what would be the normal dosage of radioactive iodine for hyperthyroid / graves.

Answered by Dr. Guru (31 minutes later)

Hi,

The normal levels for Grave's disease usually range from 5-15 mCi (millicuries) per dose, but doses are selected on various other criteria. It varies from patient to patient. Today’s research indicates that a move toward individualizing the dosing of prescription agents is warranted and it can happen only after physical consultation. Your doctor will know about these.

Take Care!

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Above answer was peer-reviewed by : Dr. Vasanth