Treatment of Graves’ Disease

Abstract

During the past few years, I have had the opportunity to observe and participate in the care of patients with Graves’ disease in several practice settings and locations. I retired from solo practice of endocrinology and nuclear medicine about 6 years ago. About 1 year later, I started doing locum tenens endocrinology in various parts of the country. I have worked in a small group in the mid-west, a teaching Veterans Affairs hospital in the south, a large health maintenance organization in the northwest, a large multispecialty group in the northern plains, and a multispecialty group in California. In my own practice, I treated at least 90% of my Graves’ disease patients with radioactive iodine (RAI). In some of my locum assignments, I have found that the majority of patients with Graves’ disease are treated by endocrinologists with antithyroid drugs (ATDs). I have seen many of these patients for follow-up and compared their outcomes with my previous practice experience. Although this is admittedly an anecdotal study rather than a scientific one, I think there are some useful lessons to be derived from this experience.