11 days after RAI

[Smilerdeb]

I had RAI (8mlc) done 11 days ago and because of fibrillation was put on Inderal.
I was on Carbimazole up tuntil a week before RAI when I developed severe mouth ulcers on the tongue and inside the mouth. It was decided to then put me on PTU 5 days after RAI and this has also caused the same reaction.
I took the PTU for 2.5 days and stopped 2 days ago to find the mouth ulcers healing.
Would you agree that this may be a reaction to Anti-thyroid meds?
I had no nodules, goiters...only Graves and Hyperthyroidism causing supraventricular fibrillation prior to RAI for 12 months.

Also my Labs were done a week after RAI....
FT4 ......15.6 (10.0-19.0)
TSH......0.51 (0.50-4.00)
FT3 ....4.2    (3.5-6.5)

Prior to RAI I had 'T3 toxycosis' and my FT's were at the TOP end of the scale.
I am super drug sensitive and prior to the 2 1/2 days I went back on PTU after RAI , I wasnt on ATDS for 3 weeks.
Normally I am extremely HYPER after 7-8 days with no ATDS.
I have also reduced my Inderal (40mg) from 1 1/2 (60mg) a day to 1/2 (20mg) a day and feel terrific.
Though there is one BIG what if at the back of my mind.
What if I go Hyper again?
Any advise would be great.
Regards

[Mark Lupo, M.D.]

The reaction was likely due to anti thyroid meds.  With this history, definitive treatment of the hyperthyroidism from Graves was necessary.  The chance of going hyper again is only about 10% but the chance of going hypo and needing replacement medication is quite high -- so close follow up is important.

[Smilerdeb]

P.S
I forgot to mention that I have had NO fibrillation since RAI.
I have had the fast heart rate and increased the Inderal but the last episode was approximately 6 days ago.
Thankyou

[Smilerdeb]

Thankyou for that.
I am going through a 'phase' the last few days of feeling BOTH symptoms..Hyper (I think Hyper spikes) and Hypo so my Doc and Endo have given me lab forms to get my bloods checked when I start to feel 'crappy' as they put it.
My Doc has scheduled me to see him every 2nd week and do labs whenever I feel the need for them.
At the moment...feeling good so will watch and take note everyday.
I also have the thyroxin in the fridge ready to take when it is needed.
My Doc said it looks like the RAI worked but also stated I would go HYPO quicker than most. You have confirmed what he has said.
My biggest fear was going Hyper with no anti-thyroid meds.
Been there, done that :(
I have been closely monitored but I just needed the reassurance that I wouldnt go HYPER again.
I do realise the dangers of both HYPO and HYPER as have been through the HYPER dangers and hope that I can avoid a crash to HYPO  and come down slowly.
Thankyou very much for your reply.
It was a warm welcome :)

[hypogirl80]

RAI should not affect you until at least 4 to 6 weeks after. So, all your symptoms now should have nothing to do with RAI.  Anyway, since you did RAI, you may become Hypo after a few weeks. Some people had RAI will have a short period of temporary Hyper in the first few weeks, but that will change after your RAI starts working.  At this point, you need to take repeated blood tests (I suggest once a month) to see how RAI affect your body,   especailly, watch for any of the hypo sign and get the supplements ready if you need it.  (chances for you to be hyper again is very small) Good Luck ..

[Smilerdeb]

Thanks for that Hypogirl.
Labs were done yesterday which show the TSH is rising and the Free T's dropping and have had Eutroxzig ready in the fridge a week before I had RAI as Endo and Doctor thinks I will go Hypo fast.
I go for Labs every 2 weeks because of being super drug sensitive and was going from hyper to hypo every 2 weeks on the lowest dose of CBZ.
Many Thanks

[hypogirl80]

Glad to see you in good hands. But one thing doctors don't pay too much attention is weight gain. usually people take RAI gain weight 10-15 pounds in the first 6 months. So if weight is one of your problems, control your eating the first few months. since once you gained the weight, it is very hard to get rid of it. So better to watch it at the beginning.  And watch your eye too. (go read Dr. Lupo's other post about RAI) Good luck.

[Smilerdeb]

Yeah I gained 16 kgs through drug sensitivity and as of yet havent gained any  after RAI but do expect some.
Also the eyes have been checked on numerous ocassions and no sign of TED.
Thanks