2. Among the three treatment groups, patients who received radioactive iodine treatment had worse Impaired health-related quality of life in Graves’ disease: a prospective study, Quality of life in patients with benign thyroid disorders: a review, Quality of life aspects and costs in treatment of Graves’ hyperthyroidism with antithyroid drugs, surgery, or radioiodine: results from a prospective, randomized study, Graves’ disease: a long-term quality-of-life follow up of patients randomized to treatment with antithyroid drugs, radioiodine, or surgery, Impaired quality of life after radioiodine therapy compared with antithyroid drugs or surgical treatment for Graves’ hyperthyroidism: a long-term follow-up with the Thyroid-Related Patient-Reported Outcome Questionnaire and 36-Item Short Form Health Status Survey, Thyroid-associated ophthalmopathy: quality of life follow-up of patients randomized to treatment with antithyroid drugs or radioiodine, https://doi.org/10.1089/ct.2019;31.144-147, http://doi.org/10.1089/ct.2019;31.144-147. Among the three treatment groups, patients who received RAI had worse thyroid-specific QoL scores than patients treated with ATD or surgery, as measured by ThyPRO (score of 27 in RAI group, compared to 21 in the ATD group and 22 in the surgery group). Patients were assessed at a mean (±SD) of 8±0.9 years after the diagnosis of Graves’ disease. JAMA Internal Medicine. Quality of life is worse at 6-10 years after radioactive iodine therapy of Graves’ disease compared with treatment with antithyroid drugs or surgery. Author information: (1)Department of Endocrinology, Singapore General Hospital, Singapore Radioactive Iodine treatment for Graves’ disease – what you should know. this time went for radioactive iodine treatment. 32 years after therapy with RAI. In August I was diagnosed with Graves Disease- I had all the scans done along with radioactive iodine uptake which pointed to Graves disease.Right before Radioactive Iodine treatment was started They found a nodule and had it biopsied. Only those in whom thyroid ophthalmopathy developed had worse QoL, which was more frequent in the RAI-treated group than in the ATD-treated group (46% and 27.6%, respectively). I-131 is the destructive form used to destroy thyroid tissue in the treatment of thyroid cancer and with an overactive thyroid. However, at follow-up only 51% of the 147 patients had normal serum TSH levels, with 44% with low TSH levels and 4% with high TSH levels. We immediately moved forward to discussing treatment options, and the doctor was quite pushy in his recommendation of radioactive iodine. Previous studies have reported that general-health quality of life among patients treated with three treatment methods as similar, but they were limited by a smaller number of participants or a shorter duration of follow up. Tay WL(1), Lee LMY(1), Tong AKT(2), Chng CL(1). Graves’ disease is typically treated with anti-thyroid medication, radioactive iodine therapy, or surgery. Following treatment with radioactive iodine, the thyroid gland becomes smaller, the uptake of iodine by the gland is reduced, and the level of organic iodine in the plasma becomes normal. Is such a drastic treatment justifiable for Graves’ disease? These patients may have had a more prolonged or complicated disease course, which could have contributed to worse QoL measures. There are three main conventional treatment pathways for Graves disease: anti-thyroid drugs (ATDs), surgical removal of the thyroid (Thyroidectomy), and the destruction of the thyroid via radioactive iodine treatment … All rights reserved, USA and worldwide. Median ages were significantly different for the treatment groups: 43 years (range, 33–55) for the ATD group, 54 years (range, 45–63) for the RAI group, and 35 years (range, 29–46) for the surgery group. If the address matches an existing account you will receive an email with instructions to reset your password. Hyperthyroidism may be treated with antithyroid meds (Methimazole, Propylthiouracil), radioactive iodine or surgery. Treatment of Graves’ Disease by the “Atomic Cocktail”by Malcolm R. Powell, M.D., F.A.C.P, F.A.C.N.PThe so-called “atomic cocktail” became available after World War II for the treatment of thyroid disease. I had radioactive iodine therapy for my Graves Disease two weeks ago. HYPERTHYROIDISM As there was also no information available on thyroid hormone status at follow-up of these subjects, the potential effects of concurrent biochemical hypothyroidism or hyperthyroidism on QoL could not be assessed. DOI: 10.1001/jamaminternmed The RAI group also had worse scores for goiter symptoms, hyperthyroid symptoms, tiredness, anxiety, depression, emotional susceptibility, impaired social life, impaired daily life, and impaired sex life than the ATD and surgery groups. July 1, 2019. Background: Autoimmunity against the thyrotropin receptor (TSH-R) is a key pathogenic element in Graves' disease (GD) and the autoimmune aberration may be modified by antithyroid treatment. Background: Relapse of Graves’ disease (GD) after a prolonged period of radioactive iodine (RAI)-induced hypothyroidism is very unusual. Overall, patients with treated Graves’ disease had worse scores on thyroid-related QoL measures, as assessed by ThyPRO, than the general population. However, patients treated with ATD or surgery had scores of tiredness and emotional susceptibility that were similar to those of the general population. treatment was started They found a nodule and had it biopsied. Graves disease, the most common form of hyperthyroidism, occurs most often in women, is treated with radioactive iodine, given as a pill. Radioactive iodine treatment (RAI) is usually the choice after an unsuccessful course of anti-thyroid medication. Quality of life was assessed using two different questionnaires at an average of 8 years after the diagnosis of Graves’ disease. The purpose of this retrospective study was to clarify the possible risk factors of early hypothyroidism after RAI therapy in Graves’ disease. Further studies to ascertain this observation would be needed, given the potentially important impact of choosing treatment options for patients with Graves’ disease in routine clinical practice. Impaired quality of life after radioiodine therapy compared with antithyroid drugs or surgical treatment for Graves’ hyperthyroidism: a long-term follow-up with the Thyroid-Related Patient- Reported Outcome Questionnaire and 36-Item Short Form Health Status Survey. Usual treatment options include antithyroid drugs (ATDs), radioiodine (RAI), or surgery. Patients treated with RAI had worse scores on all SF-36 scales than the ATD group, especially in the areas of general health, role limitations, and social function. Patients were divided into three groups: (i) 347 patients treated with antithyroid drugs only, (ii) 395 patients treated with radioactive iodine therapy (with or without previous treatment with antithyroid drugs), but not surgery, and (iii) 233 patients treated with surgery to remove thyroid gland (with or without previous treatment with antithyroid drugs or radioactive iodine therapy). Radioactive Iodine treatment for Graves’ disease – what you should know. This study reports a new observation that there may be a negative impact of RAI treatment on long-term QoL measures in patients with Graves’ disease. Sleep apart from adults by at least six feet (a separate bedroom is recommended) and avoid sexual activity. I received the news that I have Graves' disease (besides a long time diabetic diagnosis) at my appointment last week. You usually need to take levothyroxine for life after radioactive iodine treatment (RAI) if you have Graves’ disease but not for as long if the cause of the thyroid over-activity is a toxic multinodular goitre or … Thyroid carcinoma after radioactive iodine therapy for Graves' disease. After her original diagnosis of Graves’ disease, Williams decided on a single dose of radioactive iodine taken orally to destroy the misbehaving thyroid cells. Radioiodine is the preferred therapy in the United States whereas in Europe and most of Asia, it is reserved as second line for patients who relapse after initial thionamide treatment [].The recent guidelines of the UK National Institute for Health and Care Excellence (NICE) recommends that radioiodine should now be first line treatment for Graves’ disease in the UK (Table 2) []. After radioactive iodine treatment. Hyperthyroidism: a condition where the thyroid gland is overactive and produces too much thyroid hormone. Kitahara CM, Berrington de Gonzalez A, Bouville A, et al. Quality of Life Is Worse at 6-10 Years after Radioactive Iodine Treatment of Graves’ Disease as Compared with Antithyroid Drugs or Surgery Sun Y. Lee Section of Endocrinology, Diabetes, and Nutrition; Department of Medicine, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts, U.S.A. The authors concluded that, for every 1,000 patients treated with RAI at the age of 50, an estimated lifetime excess of 18 to 31 solid cancer deaths would occur (including 4 to 6 breast cancers), most occurring more than 20 years after treatment with radioactive iodine. Thyroid 29:322–331. Association of radioactive iodine treatment with cancer mortality in patients with hyperthyroidism. A total of 1186 patients with Graves’ disease diagnosed between 2003 and 2005 in southern Sweden were included in the study. Previous studies have reported similar general-health QoL with the three treatment methods, but were limited to shorter-term follow up (3,4). Additionally, another randomized study of 308 patients showed no difference in general QoL measures, as assessed by SF-36, after ATD or RAI treatment at 4-year follow-up (6). Radioactive Iodine treatment for Graves’ disease – what you should know. Most people with Graves' disease become euthyroid after 4–8 weeks of treatment with carbimazole. Overall, patients with treated Graves’ disease had worse thyroid-related quality of life scores than the general population. You usually need to take levothyroxine for life after radioactive iodine treatment (RAI) if you have Graves’ disease but not for as long if the cause of the thyroid over-activity is a toxic multinodular goitre or a solitary toxic thyroid Quality of life is worse at 6-10 years after radioactive iodine therapy of Graves’ disease compared with treatment with antithyroid drugs or surgery. Radioactive iodine (RAI) therapy is an important treatment option for Graves’ disease (GD), the main side effect of RAI treatment is hypothyroidism, and the factors resulting in hypothyroidism are still controversial. Graves’ disease is usually treated with antithyroid drugs, radioactive iodine therapy, or surgery. A publication of the American Thyroid Association, Summaries for the Public from recent articles in Clinical Thyroidology, Table of Contents | PDF File for Saving and Printing. Some Graves’ patients have achieved remission after years of therapy using anti-thyroid drugs combined with levothyroxine (modified block and replace therapy). Radioactive Iodine Testing Depending on the dose, radioactive iodine can kill a portion, or all, of your thyroid. Quality of life was assessed using two different questionnaires at an average of 8 years after the diagnosis of Graves’ disease. These findings should be further substantiated in future studies, given the potential long-term implications of selecting treatment choices for patients with Graves’ disease. However, in the initial weeks of RAI treatment for Graves’ disease, blood thyroid levels actually rise, instead of declining. Thyroid-Related Patient-Reported Outcome questionnaire (ThyPRO): Change In Thyroid Nodule Volume Calculator, Find an Endocrinology – Thyroid Specialist, https://www.thyroid.org/radioactive-iodine/, Personalized Approach to Thyroid Disorders, Clinical Thyroidology for the Public (CTFP). Robyn’s experience with RAI, Graves and a life forever impacted. Flush Twice: Life After Radioactive Iodine Treatment I didn't know what to expect when I received the treatment last Friday. However, findings of a worse long-term QoL in those treated with RAI, as compared with those treated with ATD or surgery, is in contrast to previous studies. Quality of Life Is Worse at 6-10 Years after Radioactive Iodine Treatment of Graves’ Disease as Compared with Antithyroid Drugs or Surgery Sun Y. Lee 9 … What is radioactive iodine treatment? i have graves disease. 32 years after therapy with RAI. It is a very effective treatment for thyroid cancer but what about Graves’ disease. I've had a lot of success with eating a keto diet - I lost 30 lbs in 5 months last year and the doctor decreased my synthroid dosage. Radioactive Iodine (RAI), I 131 is one of the treatments for Graves’ disease and thyroid cancer. A similar pattern was found in general QoL measures as assessed with the SF-36 questionnaire. It is a very effective treatment for thyroid cancer but what about Graves’ disease. Copyright 2019 American Thyroid Association, Inc. © 2021 Mary Ann Liebert, Inc., publishers. Enter your email address below and we will send you your username, If the address matches an existing account you will receive an email with instructions to retrieve your username. . Graves' disease: a long-term quality-of-life follow up of patients randomized to treatment with antithyroid drugs, radioiodine, or surgery. We report a case of GD with the longest time-to-relapse so far published, i.e. Age, sex, and presence of comorbidities (presence of diabetes type 1 or 2, vitamin B12 deficiency, rheumatic disease, celiac disease, Addison's disease, vitiligo, psoriasis, sarcoidosis, and other chronic disease) were assessed to adjust for potential confounders. Regardless of treatment method, patients with Graves’ disease had worse QoL measures at 6 to 10 years after diagnosis than the general population. Thyroid-Related Patient-Reported Outcome questionnaire (ThyPRO): a validated questionnaire in determining quality of life in patients with thyroid disorders, A publication of the American Thyroid Association. Graves’ disease is a toxic form of hyperthyroidism that may require immediate treatment. Quality of Life Is Worse at 6-10 Years after Radioactive Iodine Treatment of Graves’ Disease as Compared with Antithyroid Drugs or Surgery Sun Y. Lee Sun Y. Lee Section of Endocrinology, Diabetes, and Nutrition; Department of Medicine, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts, U.S.A. Radioiodine represents a cost-effective treatment option for Graves’ disease. Abraham-Nordling M, Torring O, Hamberger B, et al. The point of most Graves treatment plans is to make you hypothyroid because it will solve the problem for the rest of your life. Case Presentation: A 69-year-old woman was referred in 2016 for evaluation of hyperthyroidism. i have graves disease. Radioactive iodine is very effective, is safe and rarely causes side-effects. It's the rare Graves bird that goes into remission without going hypo. Graves’ disease is a common cause of hyperthyroidism and may be associated with a negative impact on patients’ quality of life (QoL) (1,2). It is best to discuss all your doubts with your doctor before taking any decision. 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