Advice requested on the issue of overactive thyroid treatment.

[JimHuaHin]

About 20 years ago I was diagnosed with an underactive thyroid gland, hypothyroidism, for which a medication was prescribed, and all was well, until ...

 

7 years ago my thyriod function tests started changing, and I moved between an underactive and overactive thyroid, hypothyroidism and hyperthyroidism.  After 3 years the thyriod stabilsed, and I have been taking medication. Methimazole, for the past 4 years.

 

My doctor now advises me that due to possible damage from the long-term use of this medication to my liver, I need to stop taking the medication, and undergo a procedure called iodine ablation or I-131 thyroid ablation.

 

I understand the procedure and have read about it on various medical sites.

 

My question - have any members undergone this procedure and what were the results, especially adverse long-term impacts.

 

Many thanks in advance.

[Sheryl]

I do nto recall any member having had this. But I can recommend an excellent thyroid specialist if you want a second opinion:

 

https://www.bumrungrad.com/en/doctors/Jun-Srimanunthiphol

 

This procedure is usually done after thyroid surgery for thyroid cancer. Have you had surgery?

[JimHuaHin]

On 2/23/2023 at 1:06 PM, Sheryl said:

I do nto recall any member having had this. But I can recommend an excellent thyroid specialist if you want a second opinion:

 

https://www.bumrungrad.com/en/doctors/Jun-Srimanunthiphol

 

This procedure is usually done after thyroid surgery for thyroid cancer. Have you had surgery?

Thank you Sheryl.

 

I have already consulted with 2 overseas-qualified (USA) endocrinologists, who basically told me the same diagnosis and prognosis.

 

I have neither had surgery for this conditon, nor diagnosed with thyriod cancer.

 

However, I have read about a few people who have had long-term side-effects from treatment (possibly due to high dosage treatment); but a dear friend, now in her 80s, decided to continue using Methimazole, in a lower dosage than advised since her early 60s, and to forgo the radiation treatment, and she is still stong and healthy at this time.

 

Thus, I wanted to seek the experiences of others before I make a decision.

 

Again, many sincere thanks for your advice.

 

 

[Krabi King]

Hi,

Did a search for Thyroid issues on the forum and landed here.

My daughter, who is only 24 (lives in Bangkok), has been on Methimazole (hyperthyroidism) for years already and although she had times with improvement, she is again swinging up to the high end of T4. Last time checked was 1.74. She still uses her doctor down South for her medicine prescription and now he has prescribed 3 tablets, 2 x per day. The most she ever had to take I think. I also think this will not be a good thing for her liver, and she already had skin issues which according to side effects can be related to her medicine.

It's time she sees a specialist in Bangkok to re-evaluate her condition. It's been too long now.

So I also want to ask @Sheryl if she knows any other recommended specialists other than at Bumrungrad. We are all on Thai insurance and BRR is a bit out of our budget unfortunately. Pointing us in any direction is highly appreciated.

Thanks 🙏🏼

[Sheryl]

1 hour ago, Krabi King said:

So I also want to ask @Sheryl if she knows any other recommended specialists other than at Bumrungrad. We are all on Thai insurance and BRR is a bit out of our budget unfortunately. Pointing us in any direction is highly appreciated.

Thanks 🙏🏼

 

The best specialist is at Bumrungrad, and a simple consultation will not cost that much -- likely around 2,500 baht plus labs. If you want, can get the labs done first at a laboratory - she needs thyroid panel, unless one has been done recently, and AST/ALT (liver enzymes). Bria labs is good. https://www.brianet.com/en/labolatory/.

 

If Dr. Jun recommends an ablation procedure or surgery then check back with me as that would indeed be costly at Bumrungrad.

 

To be clear, when you say "Thai insurance" do you mean a private health insurance? If so, which company and policy? Does it explicitly exclude care at Bumrungrad?

 

Or do you mean Thai SS or universal cover. Is your daughter a Thai citizen?

[Krabi King]

Thank you very much for replying, Sheryl.

Yes, she's a Thai citizen and has social insurance at the moment. She had some additional private insurance before but then her thyroid condition was pre-existing so not covered.

The idea of just a consultation first at BR is definitely an option.

We also have been enquiring at Vimut Theptarin. Do you know anything about them?

Thank a lot so far already!

[Sheryl]

By "social insurance" do you mean Social Secutity? If so then the hospital is she registered at under SS  would be where to obtain ablation or surgery if indicated. (If she gets consultation with Dr. Jun get her recommendationd in writing).  Which is that? And why does she stay registtered there if now living and working in Bangkok?