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Suggest treatment for Grave's disease

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Posted on Tue, 22 Jul 2014
Question: hi ,
I have grave & hyper . my specialist wants me to undergo a 2nd radioactive iodine procedure - the 1st one dec 11 2013 .. didnt work .. as a child , teenager i had 3 seperate operations for thyroid cysts , so have scar tissue in my neck ... would surgery would be a better option as medication doesnt seem to stabalise this condition ..
thanks XXXXXXX
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Answered by Dr. Binu Parameswaran Pillai (1 hour later)
Brief Answer:
Hello

Detailed Answer:
Hello Ms.XXXXX,
Good day.

Noted your history and lab reports.

The first choice in Garve's disease is radio active iodine treatment ( if it doesnt rspond to nemerczole). Surgery is the next option ( in candidates who are not candidates for radio idoine and if there is suspicion of cncer).

Surgical scar tissue in neck can make a re operation little bit difficult. I hope your initial radio idone ( or technicinum scan) diagnostic scan didnt show any cold nodules.

If the initial diagnostic scan showed a diffuse uptake, then radio iodine treatment is certainly better. Usually one dose would suffice. Either your gland size was big or the dose used was less in the first sitting. Since it is almost 7 months since the first treatment, this is the time for second treatment. You should discontinue neomercazle atleast 7 days before the radio iodine treatment and avoid taking iodine containing food or creams etc atleast 10-15 days before treatment. The more you starve the body of iodine, the better the response with treatment.
That way the treatment will be more effective. I hope you have no active grave's eye disease. It is important to avoid smoking ( passive and active). Selenium 200 mcg daily also may help.

Regards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Binu Parameswaran Pillai

Endocrinologist

Practicing since :2003

Answered : 1435 Questions

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Suggest treatment for Grave's disease

Brief Answer: Hello Detailed Answer: Hello Ms.XXXXX, Good day. Noted your history and lab reports. The first choice in Garve's disease is radio active iodine treatment ( if it doesnt rspond to nemerczole). Surgery is the next option ( in candidates who are not candidates for radio idoine and if there is suspicion of cncer). Surgical scar tissue in neck can make a re operation little bit difficult. I hope your initial radio idone ( or technicinum scan) diagnostic scan didnt show any cold nodules. If the initial diagnostic scan showed a diffuse uptake, then radio iodine treatment is certainly better. Usually one dose would suffice. Either your gland size was big or the dose used was less in the first sitting. Since it is almost 7 months since the first treatment, this is the time for second treatment. You should discontinue neomercazle atleast 7 days before the radio iodine treatment and avoid taking iodine containing food or creams etc atleast 10-15 days before treatment. The more you starve the body of iodine, the better the response with treatment. That way the treatment will be more effective. I hope you have no active grave's eye disease. It is important to avoid smoking ( passive and active). Selenium 200 mcg daily also may help. Regards Binu