other antithyroid drug, propylthiouricil, take three to six weeks to bring the thyroid under control. Methimazole isn’t like penicillin or allergy medications, which begin to work within minutes of taking them. Because a dose of methimazole takes weeks to work, you might as well take your daily dosage all at once. You may even question why we start with multiple daily doses. As Tevya says in Fiddler on the Roof, it’s tradition. Taking several pills at one time often helps you remember to take the medication. You can more easily remember to take your pills once instead of multiple times a day. I usually give more medication to the person who has a higher free T4 and less to the person with a close to normal free T4. But I suspect that the lower dose works just as well in both cases.
Insisting on Radioactive Iodine Treatment At my insistence I was placed on PTU and Inderal. (Author’s note: This is the same as propranolol.) My endocrinologist never even suggested it, they wanted me to do radioactive iodine and I refused, insisting I wanted to try the anti-thyroid drug first. Anyway, I have done great on a block and replace regimen and my endocrinologist is now wanting me to stop the PTU to see if I obtain remission. I am more than willing to do that, however, my endocrinologist has made it clear that if remission is not obtained he is insisting on RAI and stated he “would discharge me as a patient” if I did not agree to the RAI. I feel that I am being bullied into this treatment and I am very concerned as I have some eye involvement. I have called around and thus far all the endo’s that I have contacted all have the same mindset . . . RAI or nothing!!! You must find some doctors near you who will listen! As I note above, my preferred treatment is antithyroid drugs. If you can’t find a doctor who will go along with your wishes, check Chapter 3 and find a doctor according to the ways I suggest. You don’t have to take any treatment that you don’t want, even if (although it’s not the case here) the treatment is life-saving. You may consider a trip to Europe, where all the doctors use antithyroid drugs in preference to radioactive iodine. If you figure out the cost of office visits and medicine in the United States, you may find out you save money. I’ve received a large number of e-mails exactly like this one. Doctors tell their patients they have to take radioactive iodine, which is ridiculous and very unsatisfactory. No doctor has the right to tell patients they have to do anything. You have the final decision about how you want to be treated. If a doctor insists on something you don’t want, find another physician.