Radioactive iodine - does it make a difference to treatment?

[Simplyred57]

Hi I’m just getting all my information together to go back to my doctor after posting my results - thank you to everyone who has given me advice. I had radioactive iodine treatment 20 years ago, my previous Dr told me I will still be producing some thyroid hormones is that correct? Or should people who have had this treatment be medicated differently.

[Nanaedake]

It depends on why you had the radioactive iodine treatment and how large a dose you had and how much thryoid has been removed or destroyed as to how much thyroid hormone you will still be producing. Blood tests can reveal whether your replacement thyroid hormones are adequate.

Unless you've had thyroid cancer then treatment should focus on restoring adequate thyroid hormone so that you become symptom free. This includes checking vitamin and mineral levels that may be depleted due to inadequate replacement or gut dysfunction due to disruption of hormonal levels.

If your GP has not checked vitamin levels then ask for vitamin B12, folate, ferritin, vitamin D and calcium at a minimum. NHS doesn't usually do mineral levels although you may be lucky and get magnesium thrown in.

If you post your latest thyroid test results, people will be able to advise you on whether your current dose of thyroid hormone is adequate or if you are not taking thyroid hormone, they will advise you whether you need to and then you can discuss with GP.

[Simplyred57 in reply to Nanaedake]

Thank you I had graves - I posted my results and I’m currently getting all my information to go back to my dr as he wants reduce my dose and I’m fighting his decision, just wasn’t sure if after RAI you are basically starting from zero if that makes sense.

[Nanaedake in reply to Simplyred57]

You are not necessarily starting from zero, RAI might not destroy all of the thyroid tissue.

I would take a copy of your results and point out that your FT3 and FT4 are comfortably within range so you are not overmedicated. If anything you could be undermedicated as your body might have got used to higher levels of thyroid hormone due to Graves disease.

If you have symptoms there must be another explanation. It could be some other factor. Has your Doctor run tests on liver, kidney, insulin function, bone health and so on?

One more thing to find out is whether your diagnosis of Graves disease was correct. Graves disease is diagnosed by TRAB and TSI antibodies results. You could ask for results for your historical blood tests to include antibodies results. If these antibodies were not checked in the past then you could ask for these tests as the antibodies don't vanish with Graves disease, even after RAI. I think there is more known about thyroid disease now and it's worth confirming the diagnosis. Read up as much as you can before your appointment.

[bantam12]

I had RAI and have no thyroid left, Im well on Levo so don't need any different treatment.

[diogenes Remembering]

It is very important whether or not you have any working thyroid left. If you have some left, the remnant will work extra hard to try to keep your FT3 levels as close to "healthy" as possible - it may or may not succeed in this completely. However if you have no thyroid left at all the situation is fundamentally different and the body has to do all the work in making enough FT3 from the T4 you are given in therapy. This means the relations between TSH, FT4 and FT3 are different according to if you have any working thyroid or not.