Understanding Graves' Disease -- Diagnosis and Treatment
What Are the Treatments for Graves' Disease? continued...
You probably won't notice any changes for several days after taking the radioactive iodine, but if your thyroid gland feels inflamed and sore, acetaminophen, ibuprofen, or aspirin can offer some relief. Over the next several months, the thyroid's hormone secretion should gradually begin to drop. During this time you need to see the doctor for periodic checkups to determine how well the treatment is progressing. Chances are good that a single dose of radioactive iodine will be sufficient to correct hyperthyroidism. However, if the condition hasn't improved three months or so after your initial treatment, your practitioner may give you a second dose of iodine. Once the doctor has decided that your Graves' disease is effectively under control, you will still need to have routine checkups to make sure that your thyroid levels remain within the normal range.
It should be noted that most people become hypothyroid after taking radioactive iodine for Graves' disease. If this occurs, you will have to take thyroid replacement medication for the rest of your life.
Although radioactive iodine treatments are generally safe, they cannot be given to pregnant women because the chemical may destroy the thyroid gland in the fetus. Therefore, you must make sure that you are not pregnant before you take radioactive iodine for Graves' disease. It is best to let several months pass after your last dose of radioactive iodine before becoming pregnant; confirm the length of time you should wait with your doctor. Except during these periods following the treatment, radioactive iodine poses no health risks for women who want to become pregnant, and it will not affect the fertility of either women or men.
Antithyroid drugs such as propylthiouracil and methimazole (Tapazole), which interfere with thyroid hormone production, can be used to treat Graves' disease. After you begin treatment, it may take several months for hyperthyroid symptoms to subside. This is because the thyroid has already generated and stored enough hormone to keep it circulating at elevated levels. Once the stores are drained, hormone production should drop to its normal level. Although your disease may seem to go away entirely, you might still need drug therapy to keep your thyroid operating properly. Even if your case of Graves' disease does go into remission and your doctor says it's safe to stop taking medication, you will need to be evaluated every year or so to make sure hyperthyroidism has not returned since relapse is common.
Beta-blockers such as atenolol (Tenormin), propranolol (Inderal), and metoprolol (Lopressor), frequently prescribed to treat heart disease and high blood pressure, are also used by some patients to alleviate the heart palpitations and muscle tremors that characterize Graves' disease. Before prescribing beta blockers for this condition, however, your doctor needs to know if you are asthmatic or have any kind of heart trouble. These drugs aren't a cure; instead they are given to block some of the effects of thyroid hormones. They are used in conjunction with other treatments.