Thyroidectomy after Radiation Treatments

[Kuterkel]

I have been diagnosed with mild hyperthyroidism, my uptake score was 43.  My endocrinologist wants to do radioactive iodine but I am hesitant.  I am leaning towards thyroidectomy because I received mantle and abdominal radiation treatments for Hodgkin's disease in 2003.  I'm concerned this is more radiation than I should have.  I appreciate hearing your thoughts on the issue.  Am I overreacting?  Thank you in advance.  

[Kuterkel]

Those were my feelings exactly.  My thyroid is in good condition, no nodules or cancer, all it really needs is to slow down.  RAI is the best thing, for someone who has never had radiation to the neck.  I talked to my radiation oncologist about it and he thinks the thyroidectomy is the best route.  I feel adding more radiation to my thyroid isn't a good idea.  I want to have all my ducks in a row when I see my endocrinologist.

I read your profile and I thought my thyroid condition was strange, but I think you have me beat!!!  I really feel for you, it must be so difficult to know you don't feel right and yet no doctor will listen to you.  Good luck to you.  ANd thank you so much for your thoughts on my condition.  I certainly am interested in the partial ablation you mentioned.  I will discuss it with my doctor.  Thanks again!!!

[AR-10]

That is complicated and I understand your concern about more radiation. It's a very hard decision to make.

Surgeons don't like working on hyper patients. The risks are greater for the patient. Everyone will push you hard to do the RAI instead.

The radiation to ablate your thyroid is much less than you were exposed to previously. Still, I had to sign a release form saying I knew the treatment could cause cancer.

Maybe, and this is just a maybe, you are a candidate for a mini-ablation. A small dose to impair the function of the gland without destroying it.

If you don't have high antibodies attacking your thyroid, and if you don't have nodules that are going to grow and turn nasty, a very small dose to steer you back to hypo may make the most sense.

Keeping the gland is the best option if it is possible. For many, it isn't practical because the gland is too diseased to allow a person to be stable for long periods of time.

Keeping a gland that has been radiated twice, well, that is another matter. It adds another dimension to the decision.

[Kuterkel]

Oh I forgot to tell you, no nodules, my thyroid appears normal during palpitation and on ultrasound and scan.

[Kuterkel]

Very interesting thyroid history.  I was told after radiation treatments that I would become HYPOthyroid, which I did, for about 2 years.  Then for some reason I went HYPER thyroid.  My endo has followed me closely for 6 months hoping that it would resolve itself.  She put me on Atenolol to slow my heartrate in the meantime.  I go back in 2 weeks for more bloodwork and at that time we will decide whether I will have a thyroidectomy or Radioactive Iodine.  With my radiation history it scares me.  The only levels I have copies of are: TSH .01 and T4 1.3.  Thank you!!!

[AR-10]

Do you have nodules to be concerned about?

What's your thyroid history? Are you freshly diagnosed or have you been on supression drugs for a while?

What are your antibody counts like?