MD - Graves disease and hyperthyroidism : what you must know before they zap your thyroid with radioactive iodine : a ground breaking, revolutionary and comprehensive approach

Why Radioactive Iodine Is Not a Good Treatment Option for Patients With Graves Disease

If you are diagnosed with hyperthyroidism due to Graves disease and live in the U.S., you are likely to get the following professional advice from your endocrinologist: Ill arrange for you to receive a pill of radioactive iodine. This will cure your Graves disease.

Wow, that simple, you think. You are genuinely impressed. A moment later, you may ask, Will I need to be admitted to the hospital?

No, its done as an outpatient. You simply ingest a pill and go home. Thats all, your endocrinologist replies.

Will my insurance pay for it? you ask with concern.

Yes. We have never encountered any insurance problems with this procedure, your endocrinologist reassures you.

If you are lucky to have a few more moments of your endocrinologists precious time and are not overwhelmed with the diagnosis of Graves disease, you may think to ask, Any side-effects?

Well, you will likely become hypothyroid (underactive thyroid), but no big deal. We will then place you on a thyroid pill.

For how long? you ask.

Ohhh! Its usually a lifelong treatment. Dont worry. Its a very simple treatment, your endocrinologist mumbles.

Any other side-effects? you bravely ask.

No, absolutely none, your endocrinologist assures you.

Thats how your visit with your endocrinologist usually ends. You trust your physician and follow his advice. In a few weeks, your symptoms of hyperthyroidism (overactive thyroid) subside. You start to feel human again, but a few weeks later, you feel tired, start gaining weight and feel depressed. What happened? You want to find an answer.

You see your physician, who quite professionally breaks the news. Now youve become hypothyroid, as we expected. No big deal. Now Ill put you on a thyroid pill and youll be fine.

Over the next several years, you continue to struggle with your weight, fatigue, muscle aches and pains, thinning of hair, depression and many other symptoms of hypothyroidism. For each of these symptoms, you get placed on more and more medications. If you have good insurance, you may also be referred to various specialists and undergo quite an extensive (and expensive) diagnostic work-up, which may discover more incidental findings, but no real answers. You start to wonder if these symptoms are related to your thyroid. After all, these symptoms started after you received radioactive iodine. You point it out to your physician.

Your thyroid function is within the normal range. Therefore, your symptoms cannot be due to your thyroid condition, your physician replies in an authoritative tone.

You accept your physicians explanation. My doctor is the thyroid expert and obviously knows what hes talking about, you think to yourself. In the meantime, you continue to suffer.

Over the years, I have seen hundreds, if not thousands, of patients with this kind of medical history. I hear a lot of patients say, Ever since radioactive iodine, my life has never been the same, doc.

The fact is most physicians, including endocrinologists, do not know how to adequately replace thyroid hormone once a patient becomes hypothyroid after radioactive iodine treatment. Frankly, they do a lousy job compared to what Mother Nature does. They make it sound like losing your thyroid gland function is no big deal. In fact, it is a big deal . Here is one of the reasons why.

Most physicians, including endocrinologists, treat your radioactive iodine-induced underactive thyroid state with Levothyroxine (Synthroid, Levoxyl and Unithroid are various brand names). Levothyroxine is also called T4. Now, consider this: The thyroid gland produces two thyroid hormones, not one. In addition to T4, it also produces T3, which is also called Liothyronine or Triiodothyronine. Doesnt it make sense to give both of these thyroid hormones, T4 as well as T3, to a hypothyroid patient?

In fact, T3 turns out to be the main hormone that carries out thyroid functions in tissues. Thats why in tissues, additional T3 is generated naturally from T4. This conversion from T4 to T3 takes place due to an important enzyme, called 5-deiodinase. Any malfunction of deiodinase obviously disrupts the conversion from T4 to T3. Unfortunately, most physicians have been brain-washed by pharmaceutical companies with the myth that you just need to give T4 (Synthroid, Levoxyl or Unithroid), since it will get converted into T3. Amazingly, they do not even bother to check T3 level to see if their presumption is true.

The fact is that T3 in the body comes from two sources: direct production from the thyroid gland and conversion from T4 to T3. Hence, in a given hypothyroid patient on T4 alone, T3 level will be suboptimal even if T4 to T3 conversion is normal. This is because that person lacks the amount of T3 that comes directly from the thyroid gland. In addition, the enzyme deiodinase does not function optimally in many people. Subsequently, in these people, even the conversion from T4 to T3 is suboptimal.

T3 is extremely important for our metabolism as well as normal functioning of various organs in the body. There are a few enlightened physicians, including endocrinologists, who treat hypothyroid patients with both T4 and T3. However, even then, there are a lot of issues. The fact is that we cannot do as good of a job as Mother Nature does. So DO NOT lose your thyroid gland