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Forum Name: Endocrinology Topics

Question: Birth Control


 TerraL - Tue Feb 21, 2006 4:55 pm

I am a 24 year old female who was diagnosed with Grave's Disease when I was 16. I took PTU for 6 months, and was monitored for another 12 months and declared in remission. My symptoms have recently come back and my new doctor has informed me I should undergo radioactive iodine treatment. I am sexually active, but with no plans to become pregnant anytime in the remotely near future. My doctor insists that I must take birth control pills if I want to undergo RAI treatment in case of accidental pregnancy. I truly would prefer to not take birth control (I am very responsible about my use of condoms, and am pro-choice) but he insists that it is required before he will refer me to a radiologist. Is he right, or should I find a new doctor who is more sensitive to my wishes?

My second question is: I am concerned with becoming hypo- after my treatment. Everything I have read cautions that it is likely to happen. Are there any treatments or options I could consider that could minimize this risk? I have responded positively to PTU in the past (and my current condition has improved with PTU), so am worried that ablation and reversion to an underactive thyroid is extreme. I know that it is unhealthy to continue to relapse every 8 years, but is there a possibility of a minimal dosage of RAI supplemented by PTU or another medication when necessary? As you can tell, I am young and concerned about long term medication. I would prefer to take as few pills as possible throughout my lifetime.

Thank you,
Terra
 Theresa Jones, RN - Thu Mar 16, 2006 12:01 pm

User avatar Hi TerraL,
My question for you, is your physician your primary care physician or an Endocrinologist? Grave's disease is generally treated with the use of radioactive iodine or antithyroid drugs in conjuction with beta blockers. To my knowledge, there isn't a specified amount of radioactive iodine to destroy a certain amount of the thyroid and thus can't be regulated. Of course you already know that this condition may be treated with antithyroid medications as it has in the past, how effectively with this course, I would be unqualified to specify. The concern of your current physician regarding pregnancy is due to the fact that there is a possibility of destruction of the fetus's thyroid due to the radioactive iodine. My suggestion to you is if you are not currently being evaluated by an Endocrinologist I would suggest that you do so to identify what options are best for you.
Sincerely,
Theresa Jones, RN

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