Thanks so much for your comments. You guys have given me a lot to think about. I'll ask my doctor for more information.
Research Hashi's to the nth degree before you have RAI. Hashi's means you can swing from hypo to hyper and vice verse quickly so test results will always be "off". I have Hashi's, too. There is no quick, easy answer. If you have RAI just because you happen to be currently hyper, there will be different problems because that's mixing apples and oranges. Antibodies are attacking your thyroid because it can become so damaged it is perceived as a foreign object and or it's crammed so full of toxins that the body no longer recognizes it for what it is, so it must be "removed". The attack is what needs to be addressed, then thyroid med can help.
Research hydrocortisone and hashimoto's. Cortef or Isocort can relieve attacks on the thyroid. I'm on Cortef for this exact circumstance now and it's working wonderfully without RAI, which is major overkill if Hashi's is the only issue.
Look for a chiropractor, naturopath and environmental allergist who will work together for you.
Start here
http://en.wikipedia.org/wiki/Hypothyroidism
http://tinyurl.com/lvg4r
http://www.stopthethyroidmadness.com/books-on-thyroid
I highly recommend learning as much as possible about Hashi's before taking permanent action.
An FNA was performed and the results were non-worrisome.
Does anyone have a history similar to mine that would recommend a particular option? I am concerned (however vain it may be) about serious weight-gain if I go the RAI route.
Any opinions?
A problem with RAI and Hashi's is that RAI doesn't always address why the thyroid is being attacked. RAI may remove the thyroid and the ability to attack it because it's removed, but not necessarily the underlying catalyst which can continue to harass the rest of the body.
Research often turns up evidence that an attacked thyroid gland is loaded with toxins. Quieting immune response until the thyroid gland can be purged of toxins and rejuvenated with adequate supplementation can achieve balance without RAI.
You don't cut a finger off if it has a blister that can heal. Being that it's difficult to determine potential to heal, some people opt to level the playing field by cutting to the chase. That works for some people, but may only be a partial solution for others while simultaneously causing additional problems that must also be coped with. There may truly be no other option, but that deserves thorough attention and clear determination.
If the thyroid is being attacked because confused signals are generated by other unbalanced hormone producing glands like the adrenals, hypothalamus or pituitary, again RAI MAY only be PART of a solution and a new set of problems.
Everyone's condition is as unique as a fingerprint and it should be approached with exhaustive study before concluding permanent, irreversible slice and dice is the only option. Of course that is up to each individual.
Wouldn't it be convenient if everyone could benefit from identical treatment? If that were likely though, why are so many people buried in misdiagnosis and inappropriate treatment since the advent of treating TSH results several decades ago?
Mimicing someone else's success identically can only work with identical symptoms, identical genetics, identical environment, identical cirumstances, etc., ... you get the point I'm sure. Your decisions do not need to validate anything other than what you perceive to work best for you after researching, but you already know that so I'm probably "preaching to the choir".
The antibodies mean you have a destructive process (TPO) co-existing with a stimulating process (TSI) -- some call this hashitoxicosis. The significance of the degree of TPO rise is debated --- I think it simply means you definitely a strong autoimmune attack against the thyroid.
2 issues here
1) Are the nodules worrisome? Ie, do they need FNA -- if they are suspicious on FNA, then surgery takes care of all these issues.
2) If nodules not worrisome, the I-131 vs Tapazole? If you keep going back/forth it may be best to knock out the thyroid's ability to make excess hormone --- ie, I-131 and simply treat the hypothyroidism.