You can help your physician assess your situation by thinking ahead of time about the problems that you have been experiencing and when they might have started. Also, be sure to mention any previous history of thyroid or hormonal problems, and any family history that you are aware of.
Once testing has been performed, ask your physician to go over your blood tests with you so you can get some idea of whether your thyroid is mildly or more severely overactive. Also, ask if your physician is sure you have Graves’ disease, or could you have some other form of hyperthyroidism.
Some forms of hyperthyroidism last only a few weeks, and then they get better by themselves. These do not require treatment with antithyroid drugs, radioactive iodine, or surgery, though beta-blockers are often helpful.
Remember that you have the final say about your treatment. If you are considering medications and your physician recommends PTU, ask about taking methimazole. It is just as effective as PTU, and you can usually take half the number of pills every day.
For example, taking three tablets (10 milligrams each) of methimazole each morning is equivalent to taking two tablets (50 milligrams each) of PTU three times each day. Neither medication is very expensive.
If you are considering surgery, be sure that you are referred to a surgeon who is experienced in performing thyroidectomies and who continues to do them frequently. When you talk to the surgeon, ask whether many of his or her patients have had problems after surgery with hoarseness or low calcium levels. It is also important that the anesthesiologist who puts you to sleep for surgery has had experience working with hyperthyroid patients.
Many primary care physicians do a good job of caring for patients with Graves’ disease. However, if your questions are not being answered to your satisfaction, or if you feel as though you are not making progress with your therapy, then ask for a second opinion from a physician who specializes in treating thyroid problems and other hormonal conditions.
Such specialists are called endocrinologists. Referrals to an endocrinologist and an eye specialist (ophthalmologist) are also important if you have Graves’ eye disease.
If you have severe eye disease that may require surgery, then you will need to see an ophthalmologist who specializes in the treatment of Graves’ eye disease. Most ophthalmologists do not have experience with this type of surgery.
On rare occasions when a patient’s vision is threatened, such a referral needs to be made on an urgent basis.