In general, Graves disease should be treated. Serious complications of prolonged, untreated, or improperly treated Graves' disease include weakened heart muscle leading to heart failure; osteoporosis, or possible severe emotional disorders.
The choice of which treatment is dependent on the physician, but the information above has some discussion involving each therapy.
Thanks,
Kevin, M.D.
The most important question I wanted your opinion on in my origianl post was whether the Graves Disease really needs to be treated, or not. i feel fine hyperthyroid. Why can't I just leave it at that.
I agree with the referral to an endocrinologist.
Here are the recommendations from UptoDate, which is a peer-reviewed medical text.
"The choice of therapy should involve active discussion between physician and patient; it is also determined by the severity of the patient's hyperthyroidism:
- Patients with many symptoms of hyperthyroidism should usually be started on a thionamide (most often methimazole), and euthyroidism should be attained before a decision is made regarding prolonged thionamide therapy versus radioiodine or surgery.
- Thionamide therapy is preferred for children and adolescents. If, however, the thionamide is poorly tolerated or compliance may be an issue, then therapy with radioiodine or surgery may be necessary.
- Surgery is indicated for an obstructive goiter.
- Women desiring to become pregnant in the near future should be encouraged to choose radioiodine or surgery six months in advance of a planned pregnancy to avoid the need for a thionamide during the pregnancy.
- Several concerns of the patient also may influence the decision. As an example, the recommendation to avoid close contact with young children for several days after radioiodine administration may make this treatment temporarily unattractive if alternative child care is unavailable. Patient fears regarding radiation exposure or agranulocytosis also are important in selected cases.
We usually recommend, and most patients in the United States choose, radioiodine therapy. Although a thionamide provides control of hyperthyroidism as long as the drug is taken, the persistent remission rate when the drug is discontinued one to two years later averages only about 30 percent. There are, however, patients in whom it may be reasonable to delay radioiodine (or surgery). Included in this group are women with mild hyperthyroidism, and patients with small goiters or with goiters that shrink during thionamide therapy. If radioiodine is chosen, the patient must be comfortable with the decision to ablate the thyroid and be aware that prolonged thionamide therapy lasting even decades is an acceptable alternative as long the drug is tolerated and the hyperthyroidism is controlled. Physicians and patients must also be aware that radioiodine therapy may be associated with an increased risk of the development or worsening of Graves' ophthalmopathy." (1)
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Bibliography:
Ross. Treatment of Graves' hyperthyroidism. UptoDate, 2003.