In the United States, the most frequently recommended course of action is radioactive iodine ablation (RAI). However, in other parts of the world, this and surgery are considered last resorts. Why? That I still don't know. But it is this, along with the fact that destroying my thyroid really didn't seem right to me, that lead me to first seek out medication to treat my hyperthyroidism.
There are two types of medication offered in the United States: Propylthiouracil (PTU) and Methimazole (Tapazole). Because my husband and I were trying to conceive when I found out I had Grave's Disease, my doctor prescribed PTU. I was on it five weeks, after which time I found out that I had the rare side effect of liver damage. After that, I decided to go ahead with the RAI treatment.
Here's what I can offer based on my experience:
- Consider the risks. However, don't be put off by the fact that the PTU caused me liver damage. In 15 years of prescribing the drug, I was the first of my doctor's patients to receive this rare side effect. Also, the drug was working, so if I hadn't received the side effect, I would have continued the treatment.
- Consider the goal. The goal of the medications is to put the disease into remission. The success rates of this form of treatment is low (20%), but it's not impossible.
- Consider life circumstances. I decided not to try Tapazole after trying PTU because I still want to have a family someday. PTU is the only drug that can be prescribed during pregnancy. The RAI treatment has not been known to cause birth defects or infertility, so it was a good option for me.
- Consider life changes. While any of the three treatment options may fix the symptoms of Graves' Disease, there is a correlation between the disease and stress. In my mind, this means that in addition to treating the symptoms of the disease, I need to change myself--how I cope with stress--if I want to live a long and happy life.