Any people in remission for longer than a year? - Question and Answer Forum - Elaine Moore Graves' Disease and Autoimmune Disease Education

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Tuesday, February 07, 2012

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Welcome to The Q&A with Elaine Moore. Registered members are invited to ask any question of Elaine Moore on autoimmune diseases, Graves' disease, other thyroid diseases and subconditions, laboratory work, traditional and complementary medicine, triggers and environmental influences, thyroid and immune disorders in pets and animals, and other relevant areas of inquiry.

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Questions are answered solely by Elaine Moore, a medical writer and clinical laboratory scientist, MT, CLS, with more than 30 years of experience in immunology. Moore has also authored and edited over a dozen books in the area of health sciences and is an editor for McFarland Publisher's Health Topics Series.

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Any people in remission for longer than a year?

9/6/2010 5:52 PM

RobinY

Joined: 9/6/2010

Posts: 1

Any people in remission for longer than a year?

Hello,

I'm new here. Diagnosed with Graves in June after being admitted to the hospital with serious Thyroid Storm. I've been researching ever since. Currently I have an upcoming appt. with a Natropath who specializes in thyroid disease. Four endocrinologists have said I need RAI. On this site I read:

"Additionally, another study found in Thyroid 2000 vol. 10 demonstrated that Graves’ disease patients that exhibited a "smooth" decline in their antibody levels, or population, after ATD therapy and was said to be a predictor of remission. 36 out of 44 patients, or 82%, exhibited a "smooth" decline of TSI levels and were antibody and symptom free 1 year after ATDs were discontinued"

Please help me understand. What exactly does "smooth" mean? My levels reached "normal" in approx. two months of ATD use. Is that smooth? My levels started here:

TSH 0.00 mIU/L (0.46 - 4.68)
Free T4 3.7 ng/dL (0.70-1.40)
Total T3 2.98 ng/mL (0.97-1.69)
TSI 1.6 Index (<1.3)

I'm on a maintence dose of PTU 100 mgs per day. And Atenolol 25 mgs per day as I still shake and have palpatations when off it.

I really don't want the RAI and am looking forward to hear from the Naturalpath what he can give me in the way of hope.

Thank you !!

Robin

9/7/2010 6:33 PM

Elaine

Joined: 8/1/2008

Posts: 3166

Re: Any people in remission for longer than a year?

Hi Robin,

A smooth decline means a steady decline in levels over time rather than great fluctuations. Most people can achieve remission with ATDs and most people experience a steady decline in their levels over time. Also, many doctors recommend RAI because insurance companies prefer it since it's the least expensive treatment over time especially if people have the procedure done quickly.

What's expected with ATDs is that your FT4 should fall back into the normal or reference range after 6-8 weeks of a starting dose, which is usually 300 mg PTU daily. As soon as FT4 is normal, the PTU dose should be reduced regardless of your TSH level. TSH stays low for a long time (suppressed by TSI antibodies) and doesn't mean that you're still hyperthyroid.

A typical maintenance dose after the first 6-8 weeks is 50-150 mg daily. The recommendation is to be on the lowest PTU dose needed to keep FT4 at least at mid-range and preferably closer to the high end of the range regardless of TSH. Over time, the dose is decreased and remission is eventually achieved. Working with a naturopath and making dietary changes can also help. Best, elaine

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Any people in remission for longer than a year?

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