RAI Pill

[LadyBlair64]

Good Day!  Does everyone that has an underactive thyroid take the pill to "kill" the thyroid production, then go on a full replacement therapy dose of thyroid meds? I have Hashimoto's and still have some of my thyroid "working" and some of my friends who had this for many years have for one reason or another (they don't remember much) taken the pill to kill the thyroid & now are on a nice dose of Synthroid and their levels stay pretty good.
If I still have use of part of my thyroid, how can my levels stabilize for 6 mos to a year after you find the correct dose?  I FINALLY have begun to feel better, & now live in fear that my thyroid will get worse & it'll take too long for me to realize it again & then I'll have to start from scratch.

Any help with these questions are very much appreciated & thank you for your time. I've noticed very nice things on this website & encourage my friends and family to check it out.

[tinkerbell 2006]

You go by your Free T3 and Free T4 not the TSH

If you have Hashimoto's Disease you need your TSH as close to zero as possible, it does not mean you are hyper.

Your FT3 needs to be at the top of the range and your FT4 well up in thw range as well but slightly lower than the FT3

[LadyBlair64]

Thanks. That's another of my "concerns" - my TSH levels are at .71, BUT my T4 levels & T3 are still at the lower end of the range (5.8 with range of 6.1-12.5) so thankfully my Dr. increased Synthroid to 112mcg. for me & I actually am beginning to feel better  -  ONLY NOW!  My "concern", however, is how low can your TSH go if your T3 & T4 is only slowly rising?  As we ALL know by now with our research, the TSH levels alone are NOT a reliable sourse to follow, & the T3/T4 hold the energy levels (from what I understand), so, again, do I need to be very concerned?  Everyone tells me about the TSH at 1.0, but for me, the T4 was too low with that & I did NOT feel good at all.  Actually felt SO DEPRESSED I didn't want to get out of bed.  This morning, however, I was up & had a load of clothes in the washer by 8:15am!!  

Thanks again for all of your help.

[Mark Lupo, M.D.]

Patients with Hashimotos and subsequent hypothyroid (under-active) do not need the RAI (I-131) treatment.  I-131 is to treat an overactive thyroid not to "kill off" the rest of the hashi gland.  It's rare that this would be needed.

Hashi is a progressive problem and sometimes the dose of synthroid will need to increase over time - so testing at least every 6 months may be necessary to avoid under/over treatment.

[LadyBlair64]

That's the strange part.  I have absolutely NO hyper symptoms, so, maybe I'm the square peg.  If anything, I'm just now feeling back to somewhat normal.  No heart palpitations, still a low blood pressure - probably helps that I'm quite fit - excellent cholesterol levels etc.  I have thought of asking the docs about cytomel, but must wait until next checkup/bloodwork.  Thanks for your concern and help -

[lhowell]

If your TSH is at .71 and your doctor increased your dosage, you could start to experience symptoms of hyperthyroidism (how much did your dr increase your dosage by?)

If you are worried about your T3/T4 levels (and feeling bad despite a great TSH level), you might want to talk to your doctor about trying some Cytomel in addition to your Synthroid or switch your meds to Armour.

I hope GravesLady sees your post (or you can post this in the Thyroid Support room where she hangs out and helps everyone); she will be able to provide more insight than I can.

[lhowell]

Usually, only people with an OVERactive thyroid (Graves Disease) have RAI.  If you have Hashimotos and hypothyroidism, you should just take Synthroid (or other levothyroxine) to bring your TSH level down to around 1.0.  If you were to have RAI (and thus kill your thyroid), you'd have to take a higher dose of medicine.

[lhowell]

Oh also...your doctor should monitor your TSH level so that if you need a higher dose, it's caught before you have symptoms.  Usually, it happens gradually so try not to worry.

Best wishes!