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Thyroid (Expert Forum)
Possible change of treatment for GD?
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida
Sarasota - FL
Questions in the Thyroid forum are answered by Dr. Mark Lupo. Topics covered include goiter, graves disease, Hashimoto's thyroiditis, hyperthyroid, hypothyroid, thyroid cancers, thyroiditis, and thyroid stimulating hormone (TSH).
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Possible change of treatment for GD?
by Jenoveva, Feb 11, 2007 12:00AM
First of all, I am an RN, but my field has always been L&D. My knowledge of Endo is limited and probably outdated. I have had GD for 3 yrs. There is no eye involvement at all. I had no outward symptoms of GD before my diagnosis, other than a small goiter which I couldn't see till I lost 50 lbs. I still feel the same when I am euthryroid as I do when I enter the hyper ranges again. I have been taking PTU all this time, with no untoward results. I responded very quickly to the PTU, returning WNL in 4 months time. Whenever I stay WNL x 2 months, he stops the medication to see if I can go into remission. During those 2 months, I took 100 mg q 8hrs x 2 mos. Once he had me on 50 mg q 8r x 2 mos. I can stay WNL for 2 mons off of the PTU, but then I start going hyper again. We have tried this 4 or 5 times now. My doc has me going in for labs q 2 mons. I was considering RAI because I was under the impression that I could only take PTU for a limited time, but now I have found out otherwise and will probably cancel the treatment and take the PTU again. My questions are: 1) is it typical for a patient to go every 2 mos for labs if she has GD and is on PTU (I know of no one else in this situation who goes this often) and 2)should I be staying on PTU for a longer period of time (more than 2 mos) before the doc stops it to see if I go in remission and/or should I perhaps be weaned off of it more gradually, possibly tapering it down to 25 mg q 8hrs for a while? It seems to me that I am jumping too soon into trying for remission after resuming the PTU.
Doctor's Answer
by Mark Lupo, M.D., Feb 16, 2007 12:00AM
, Feb 16, 2007 12:00AM
1) I usually test Graves patients on PTU or Tapazole every 2-3 months. If monitored closely for liver, WBC abnormalities, these meds could be used long-term, but the risks may outweigh benefit and I-131 is usually simpler.
2) I usually taper these meds and not simply stop it from 150-300mg/day -- usually get down to 25mg bid then try to stop.
2) I usually taper these meds and not simply stop it from 150-300mg/day -- usually get down to 25mg bid then try to stop.
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