Hi, everyone. I'm not sure what to do. I have had Graves disease on and off for 17 years. I have sent it into remission many times with thyroid suppressants (PTU and methimazole). I had a relapse four years ago, a few months before my first noticeable MG symptoms appeared. I think I also had another relapse in the past three years, treated again with methimazole for a couple of months. Neither the hyperthyroidism nor the methimazole seemed to affect my MG symptoms, though I wonder if the methimazole I took in the spring of 2009 for several months caused, or unmasked, the MG symptoms that first appeared in the fall.

Well, I think I'm having another Graves relapse. But I've since read that methimazole can have an immunomodulatory effect that worsens MG or causes an MG crisis. My endo says, "Well, let's do the radiation then." But I really, really don't want to radiate my thyroid, for two reasons. First, my Graves relapses have been progressively fewer and further between and milder over the past 15 years. My endo and I had hoped that the last relapse would be the end of it. If I'm this close to a lasting remission, it seems nuts to radiate now. Second, I am afraid that if I radiate, it will take months before my thyroid is finished dying (with spurts of thyroid hormone released as it dies) and months more before I get the dose of synthroid right. In other words, I'm afraid that the radiation treatment will cause me months of fluctuating hyper and hypo symptoms. I will be anxious, a bit crazy, exhausted, insomniac, and depressed. I don't feel like I can face those symptoms, on top of the MG.

I looked up the abstracts of methimazole in MG studies, and it seems really sketchy to me. I mean, it was like one case study of a person, plus one cat. On the other hand, it's long been suspected that treating Graves makes MG worse, but no one knows why, for sure. On the other hand, I've also read that untreated hyperthyroidism makes MG worse. Worse if you treat it, worse if you don't.

So, I'm confused and discouraged. Any thoughts? Thanks.

Abby