Remission with T3 Toxicosis

From Elaine Moore's websie, she writes "However, in GD the thyroid gland produces more T3 relative to T4 than usual. This results in a condition known as T3 toxicosis. Despite it's ominous sound, T3 toxicosis is a good indicator of a favorable response to ant-thyroid drug therapy."

Is this true? And if so why?

[GravesLady]

You realize that, once Graves' always Graves'.  There is no cure for Graves' Dsisease, only the symptoms of the hyper side of Graves'.  Antibodies are not treatable nor curable.

Antithyroid medication is most effective for mild hyperthyroidism, in people younger than 50 years of age, and for slight enlargement of the thyroid gland, small goiter. Patients with Graves' disease who have significant enlargement of the thyroid gland or severe thyrotoxicosis with high T4 levels and increased ratios of T3 to T4 may be less likely to go into remission. In the setting of moderate to severe Graves' disease, antithyroid drugs may be used as temporary treatment to control the production and secretion of excess amounts of thyroid hormone while plans are made to proceed with more definitive treatment. Although the disease may seem to go away entirely,  drug therapy might be needede to keep the thyroid operating properly.

ATDs act as a chemical block to the production of thyroid hormone, and by calibrating the dose the drugs can interfere with "some" thyroid homrone production. The key is to interfere with just enough so that you do not become hypothyroid due to the drug. However once back to normal/remission, there still is a functioning thyroid,  antibodies can still attack the thyroid thereby putting a person back to the beginning of illness. Remission does not mean "cured." Only 20% to 30% of  individuals treated medically will experience long-term remission. Second remissions are much less with about 10% of patients who will experience remission a second time. Some have experienced a 10 year or longer remission before things fell apart again. For Some even when hormone levels are under control and  back to the normal range will experience symptoms to where its not toleratable. Thus, either surgery or radioactive iodine is needed to achieve long-term cure for most pediatric patients with Graves’ disease.                  

The definition of "remission" is being able to go off  antithyroid drugs for a period of a year or more without needing medication to stabilize thyroid hormone levels. Going off the drugs for a couple of months is not necessarily a remission.  A lot of Gravers who experience  going off the medications think they are "in remission."  However it can take time for the effects of the medication to wear off, depending upon which ones were taken.   The real test of remission is being able to be off medication for a considerable length of time.

Remissions by definition, is temporary.