Is Long-term Antithyroid Use the Best Treatment for Graves Disease?
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- เผยแพร่เมื่อ 20 ก.ค. 2022
- www.medscape.com/viewarticle/... Welcome to this video commentary about the long-term use of antithyroid drugs in the management of Graves disease. My name is Angela Leung. I'm an adult endocrinologist at the University of California in Los Angeles and the Veterans Affairs Greater Los Angeles Healthcare System.
I'm pleased to moderate this discussion today, and we have two esteemed guests with us. The first is Dr David Cooper. He is a professor of medicine and radiology at the Johns Hopkins University School of Medicine. He's the director of the thyroid clinic there, an internationally known expert for his work in thyroid research, and an esteemed educator and clinician. He's also one of the co-authors of the American Thyroid Association 2016 hyperthyroidism and thyrotoxicosis guideline.
We also have Dr Whitney Goldner, who is a professor of medicine in the Division of Diabetes, Endocrinology, and Metabolism in the Department of Medicine at the University of Nebraska College of Medicine and the University of Nebraska Medical Center. She is the medical director of the Thyroid and Endocrine Tumor Program there, and she is active in the Endocrine Society and the American Thyroid Association. Her clinical and research interests are in thyroid disease, thyroid nodules, and thyroid cancer. - บันเทิง
I was on antithyroid drugs at least for 3 to 4 years and I’m now in remission and I’m in my second year of remission. I completely changed my diet. I’m feeling great now.
Hi! I am so so happy for you that now you feel better! 🙏🏽😁
I’m wondering what kind of diet are you doing? I just got diagnosed and started taking Methi and would like to h e a kid sooner than later, now I’m afraid I won’t be any time soon! Please let me know what has helped you!
Thank you so much in advance! 💖
I went on a low carb diet with intermittent fasting and lowered my iodine intake also started supplements like Vit D3 with K2, magnesium and others. Stress is very important to get under control. I do know if you are wanting to get pregnant it’s very important to have your thyroid under control. I found a facebook page called ‘Keep Your Thyroid -Hyperthyroid And Graves’ Disease Path To Remission”. ❤️ this woman got me where I am today, I highly recommend her and her group. Just go onto the page and ask questions.
@@Beatrice-nx5ld totally agree. 👍
@@judyPatrwhat is your diet like?
I improved enough to get off the drugs by cutting out wheat and dairy, and reduced sugar
Anyone else on Methimazole for a long time and then have new Thyroid problems and worst TED 9 days post Covid Vaccine???
I saw an ophthalmologist today to check for TED. He says I only have one out of the four traits. I think it's due to my stigmatism but I'm not sure I was confused and the doc seemed rushed. Also, I have Graves disease so I'm majorly underweight
What people with hyperthyroidism need is more research into hyperthyroidism. Nothing has changed in 70 years because of a lack of research into it. There have only been studies on the drugs.
I completely agree
Totally agree I can't take the 2 tablets.I have alergic reaction to one my eyes swelled so bad.And the other tablet I couldn't sleep.I had to take a Steroid to bring down the swelling. In my eyes. I see a new Endocrinologist this week.I want my thyroid gone.I hope you find away to feel better
I’ve been battling this disease going on I believe 4 years now. It’s been a journey of going from hyper to hypo, resulting in 10lbs of weight gain/loss. It’s so frustrating playing with varying dosage levels with each visit with my endo. With each visit, it always ends with a lecture of bullying me to the permanent radioactive treatment. I’ve heard it all. One young PA even yelled at me to the point of tears for not doing this, threatening death upon me. I know the risks, but I’m on very low dose and my liver functions are good. The thought of being permanently hypo with weight gain and being tired all the time is enough for me to push back against their lectures. Though they say there’s no preventative measures, I am proof positive that light exercise could help me get off this disease. I just need to keep up my exercise regiment. Anyway, I am so glad to come across this video… thank you!!! I just wished more endos would hear this. I am certainly going to show mine on my next visit!
I am so sorry to hear about your struggles with doctors. If I may make a suggestion, try and research Functional Medicine Doctors in your area. They have been helping me get to the root cause and treating that (Graves Disease) vs. just treating the symptoms (hyperthyroidism) through things like the AIP diet and repairing my gut. Medication with scary side effects is not the only option!
I would report that doctor if I were you, when doctors try to recommend the RAI i tell them absolutely not and to not talk to me about that because I think It's too dangerous and I have the TED which I found out on my own that your eyes will get even worse because some doctors fail to tell you the truth so you have to be your own advocate.
In Spain they don’t recommend surgery for graves unless it’s absolutely necessary. There most people
Would end up on the thyroid medication (methimazole?) to suppress the levels. Personally k wish so so bad k was still in your shoes. You are doing well not succumbing to what the American doctors want. I felt rushed into my surgery and was given the dumbest reasons to do kt. I was getting better after eating food good and doing supplements, and then my dlc moved my methimazole dose too fast, which caused it to go back to higher. But I’d only been graces less than a year! Outrageous I was pushed into it. My surgery was extremely
Painful, the recovery horrific as they would not prescribe painkillers so as k result my neck healed weird. Yes I’ve learned a lot about life and myself so
Sometimes I even feel grateful for the hell I went through. 58% of patients develop pain issues 10 years lost surgery… not something discussed ever. Don’t give up, keep trying to heal your body, k really think you can ❤ you’re so worth it!! Let me know if you have questions or anything. Blessings ❤
True
Here after a very disappointing appointment with a thyroid specialist..I was given no options just surgery ..this is encouraging
❤ Don't fall for anything yet. Try a strict Carnivore lifestyle. Research DrKenBerry Channel on TH-cam and many others. Many people heal from THYROIDE issues after a good period trying that Lifestyle.
Very helpful video. I have been taking Methimazole for 20 plus years with no issues but recently have developed low platelets. I was told this can be a side effect but I feel like I should be getting other tests to pinpoint the actual cause rather than just being told it's likely the medicine. Maybe it is but I worry there could be something else causing the platelet issue that may be overlooked. In addition, I don't want to stop taking the medicine not knowing if it really is the cause of the problem. I don't want surgery or the RAI. I'd like to just continue with the low dose I am on of Methimazole. Any input would be appreciated.
I’m so surprised with all comments because I cannot feel the same as you… I also have Grave disease and I am actually so tired to change my medication every months for 2 years, I cannot sleep at all as my heart race . Cannot exercice without being in trouble breathing (I am professional ballet dancer) I feel like having a heart attack if a run… I just married and cannot dream of becoming pregnant as still taking 3 pills of mercazole… my liver is struggling…
I plan to do surgery soon to move forward. Living with hyperthyroidism is dangerous but not hypothyroidism. In my case I have a lot of hyperthyroidism symptoms so after hoping and destroying my body for more than 2 years surgery is the best option.
I am not scared of hypothyroidism symptoms and strong enough mentally now to not let me convince I will be tired. I think psychologically I can cope and avoid it and most of the people around me did it with this mentality and just regret waiting for so long before surgery.
Hope it can help :)
I did Radioactive iodine. Wish I did it earlier. Methimazole is terrible on liver, stomach......
@@SVETOCHKA_NICOLE regarding radioactive treatment my doctor told me in my case it will not be effective as my TRAb is too high. He said it will increase again for sure by experience. Also as my goal is to become pregnant this kind of treatment is not recommended 🙁
Took PTU on/off over a period of 20 years before thyroid "burned out" and became hypothyroid. Constant battle w/my Endo who wanted to do surgery. My reason for doing it was to put off the inevitability of eventual hypothyroidism. Glad I held my ground - since becoming hypo I don't feel like the same person (ADD, lethargy). Levothyroxin is NOT a sufficient replacement. Highly recommend long term anti-thyroid meds.
I was on Tapazole (Methimazole) for over 25 years.... and then had my thyroid removed after thyroid changed 9 days post Covid Vaccine.. And I agree, "I don't feel like the same person (ADD, lethargy). Levothyroxin is NOT a sufficient ". I am not happy with how I feel on Levothyroxin and wonder if I would still have my thyroid if I skipped the Covid Vaccine. I would guess my TED is never going to be 100 percent fixed.
Hi did the PTU affect your liver at all?
thank you
Diagnosed with graves 6+ years ago in my 20s. Always felt so pressured into surgery - glad I held my ground. But also caused me to never want to get it fully balanced as this was a fast track to surgery. Never felt sick enough to trade hyper for hypo.
PLEASE talk about a GI Map. Fixed my gut biome = grave’s healed!
Yes, I am very curious about microbiome, nutrition and fitness lifestyle and how it affects/interacts with Rx. @Moderator - pls chime in! (And thank you for this info!!)
Can you tell me more about how to look this up for more information please!
@@queenb5411Dr Peter Osborne's videos on curing autoimmune diseases have been a great help for me❤
I took it for 4 years and then my levels started going down so my Endocrinologist lowered it. Slowly it kept going down and after 5 and a half years I off the medication completely. It’s been almost 4 years and my levels are still normal.
One think I did develop during the time on the medication was vitiligo. I have it mainly around my hairline and neck. My Doctor says it could be from hyperthyroidism or the medication.
How much daily were you taking right before you were able to stop completely? I'm on 5mg a day now for about 2 years... hoping I can taper off one day
Amazing and thank you for great information!!!! Just diagnosed w Graves’ disease and will stick w methimazole
Thankyou, very informative. I am being rx’d with methinazole 2.5mg po qd since May. My earlier TSH was < 0.03. Since my rx with anti thyroid med my TSH is 2.24 with normal T3 & T4. My initial antibody level was 149. Have not had another level drawn.
I feel much more confident with long term antithyroid rx…….. Thankyou again, very helpful!
I've been on medication for 18 months and I'm so done with feeling anxious every day. It's affecting my job and sanity. I'm going to ask for the surgery at my next endo appt. I need my life back.
My anxiety is terrible also.
Thank you 🙏 great informative talk
Very informative thank you!
Thank you very much, very informative indeed.
Thank you so much for this knowledge really needed it..
Excelent! Best regards from Brazil, Mário.
Thank you so much very educational.!
Thank you for discussing the long term use of anti-thyroid drug (ATD). was diagnosed with hyperthyroidism about 15 yrs ago. Because it was mild and did not have symptoms on the eye, my endo put me on ATD with the hope it would result in remission after gradually decreasing the dosage. I was off medication once but my TSH started to climb up and I am back to taking the ATD. My endo believes I may go into remission one day and this video raised my hopes a bit. As the doctor mentioned, the area of immunology I think gets to the root of the problem and I am thinking about what I can in that area to get remission. 🙏🙏🙏
I have been on neomarcazole for 8-9 years and I do want to consider it long term although doctors are suggesting RAI. Thanks for this video.
Thank you so much for this video ❤
Now I have a whole new standpoint from which to discuss with my endochrinologist next time 🙂
Waiting for my first appointment with an endo to be evaluated for hyperthyroid and this info about the long term studies is extremely interesting! Ty for this convo!
And had radiation iodine treatment in this year I've been feeling terrible and nothing seem to be working not even the medication
How fast did you become hypo?
Fascinating!I've been on varying doses of methimazole for the last two years. I ping pong between hyper and hypo, though seem to be mostly hyper. My Endo wants me to start considering the more permanent options first quarter next year. I wonder if I might be a candidate for longer term meth instead.
ive been on meth almost 5 years some doctors will definitely push surgery or rai just tell them no, thats what i do
Thank you very much for sharing this video. As a young woman with Graves' disease (18 years old) I appreciate the frank and thorough discussion as I consider treatment options. I need all the advice I can get!
Why dont you treath the real issues instead of treathing the syptoms?
Im from sweden
I saw you post twice as if you know something, please share "The real issues!"
Why does is the body attacking itself especially for the people with hyperthyroidism. Can you point to any articles that can help elaborate. If so thanks
yes its inflammation acidosis, we are alkaline by design, so there are foods that cause inflammation, burning inside.. there is way too much food eaten that are so acidic causing acidosis eat whole foods cure disease
flaxseed help me and omega 3
Hypo or hyper
Hyperthyroid speeds up calcium metabolism, calcium is needed for dealing with inflammation. The antibodies always are there. They just get ramped up during inflammation, which is an elegant design really. The reason thyroid would get too out of whack that way is when there isn't enough bone calcium left to easily turn over, so it keeps ramping up. There is plenty of evidence for hyperthyroid and low bone density. The problem is further aggravated when you 'treat' hyperparathyroidism, which allows more remodeling of the bones and clamps down on urinary calcium
I have graves, and have osteoporosis from it, yet my calcium levels are normal, my vitamin d level is normal. So what you’re saying isn’t true for me.
Thyroid hormone increases bone resorption. So the first effect would be more blood calcium, not less. But overall the body uses more calcium (excretes it) with higher thyroid levels, so the blood level remains stable. So you need more calcium intake to prevent bone loss, which sounds like a better approach to me than preventing the body from doing its thing with antithyroid meds.
If you did that, you'd want to take calcium phosphate, not just calcium. I don't know why the supplement company nitwits haven't figured that out.
@@SparkyOne549 tpo antibodies in graves disease have been shown to be significantly reduced with vitamin C supplementation
Effects of selenium and vitamin C on the serum level of antithyroid peroxidase antibody in patients with autoimmune thyroiditis, 2019
Vitamin k2 & d3 strengthen them bones and clear out that artery
My 10 yr old daughter was just diagnosed with Graves Disease. I read that the majority of cases are between the ages of 30 - 50 yrs old. Is there anything i should prepare her and myself for? Any advice or helpful information would be greatly appreciated.
Damn. How many peoples lives were ruined by RAI administered too early..
Can carbimazole induced hypothyroidism be reversed if the medication is discontinued?
Yes it pushed me into severe hypo, after omitting the carbimazole I went back hyper within two months
Will taking methimazole change my antibody level? 16:48
My daughter is on tapazole 2.5mg for 8years now. Can she stay on this dose instead of having Radiation or surgery?
Yes she can
Thank you!
Please help my 5 years old daughter have hyperthyroids.thank you for readi g this msg.
What if you have TED? Would you recommend long-term use?
I have TED and this sucks
5-10 years of treatment yet none of that gets to the ROOT CAUSE of the illness!!
Question : Do you ever know someone get completely healed after a therapy or ...? Everybody( and with everybodyI mean doctors and medical literature) speaks about 40 % to 50% of the patients to get healed after years on a anty thyroid therapy( i mean the percentage of patients who hadn't experienced the relapse),but , actually,how many of you, or better say how many of us with Graves disease had have never again a relapse after the long period of treatment ??? Thank you in advance for your kind answers,I really need to know if someone really mend it to get back to the complete healing.
I’m followed in Kuma hospital in Kobe, Japan. None of the people I know there have been in remission after many years trying and hoping. After some did surgery they regretted waiting for so long before. Nobody gain weight (or it was muscle) and nobody had lethargy symptoms. When I asked my doctor about it he said in his patient none of them have reported those symptoms so far… I don’t know if Japanese people are that different with us or if it starts because we are convince we will have those symptoms which can be related to a lot of other external conditions. I will do mine in May so I will have the answer soon but I’m convince it will be the best solution for me
@@leakimanh5064 thank you kindly for all those precious shared information! Japanese are such a great people! I wish you the best possible resolution of this issue and I am waiting for your good news. I hope all the best! ❤️
Can you take both carbimazole and levothyroxine at the same time?
Is there such thing called a block and replacement regime?
I do not know much about block/replace, but yes, I’ve seen it in forums - people do this!
I was recently diagnosed with Graves’ disease and they said I have hyperthyroidism. Yet I’m not skinny(I usually feel bloated), my hands don’t shake, and I’m tired all the time. I’m worried about doing anything to make me more tired and bloated than I already am
hi..what treatment did you do when you are diagnosed with grave disease?
When will modern medicine give a $&#@ about root cause? Autoimmune conditions are due to undiagnosed infections. ID and treat the infection - autoimmunity will disappear. God forbid Drs look into holistic approaches.
I had the problem for 3 weeks and I'm getting the sense that none of my doctors know what causes this. One just says it could be an viral or bacterial infection. I asked if alot of lobster ingestion would do it and she says alot of anything is bad. So yes, none of them know what causes it.
Yes 🙌
You are so right
Holistic 😂😂😂😂😂
Yes for holistic! I have a holistic cardiologist, she’s awesome.
I've been on methimazole for 10 years
And your stll alive??
@@ACXIAO666 lol yes
@@SJ-pw8tx nice did you experience any side effects
Im on methimazole i hate it cut it out im so sick of this methimazole is DISGUSTING
For everyone suffering from autoimmune diseases, I recommended dr Peter Osborne's videos and book "No grain no pain". Videos are free here on TH-cam, to learn a whole lot from for example about your autoimmune system.
GAWD FORBID WE BLAME THE SHOT PUT FOR THIS CONDITION!
never had the shots, and had a thyroid storm last month, but have lupus for twenty years....
4:35
Medicines don’t do sh*t to me
Danm
Look at his face
Goofy aaah Americans