To take the Radioactive Iodine uptake or just stay on medication (Methimazole)?

I had the RAI treatment 20 years ago and I've been happy with it. Any slowing down I did was because my system wasn't over-revved by hyperthyroidism. (Pre-treatment resting pulse was 120, treatment put in back to its normal level in the low 60's.) I take one tablet a day for my thyroid and I haven't had to even think about it for 19 years.

Anxiety, irritability can be symptoms of hyperthyroidism, so yes, anxiety often decreases when the thyroid is adequately treated. Ditto with the tremors. I had elevated heart rate, heat intolerance, rapid muscle exhaustion with exercise, insomnia, tremors and severe irritability. I also had "dumping syndrome" - after a large meal, particularly if I drank any alcohol, I would feel faint, cold, sweat so badly that my clothes would be soaked, and then would often throw up. That was when I stopped drinking at all. I also had two or three less severe episodes a month where I would get nauseated in the evening and have very bad diarrhea for about three hours, followed by very forceful vomiting. All of those symptoms went away within weeks of treatment.

Obviously, the medication is not getting you back to a normal thyroid balance and you still have symptoms. Along with making you feel bad, this is wearing out your organs more quickly than is normal.

I had a good sports medicine doc tell me once that when we're born our hearts have a built-in range of beats. Once they're used up, you start having heart problems or you can die from heart failure. So if your heart rate is increased drastically, you will have a shorter life. I have no idea if that's completely true, but it does sound logical.

If you check out the "Thyroid Basics" discussion at the top of this page, there are links to some good information about hyperthyroidism. That might be helpful to you always.

Good luck, and I hope your results will be as good as mine. Remember, it may take several months to get the medication dosage fine tuned, so be patient.

Funny, I'm a retired registered nurse. It's a pretty small world, isn't it?

My tremors were mostly when I wasn't using the hand. If I was just sitting, my hands would have a tiny shake. I was able to stabilize my hands on something so it didn't affect me. It's amazing how you can use your pinkie finger to prop your hand a bit. I wasn't doing many injections, but was doing quite a few caths as well as ostomy care on children in the outpatient clinic.

My tremors went away within a month of the RAI as my levels fell. So did all the other symptoms. Then I was very hypothyroid for a while until the dosage was adjusted. Since then it's been perfect. I do get TSH, free 4 and T3 every six months.

It stabilized my hand quite a bit to have it anchored even just by the tip of my pinkie. My tremor was quite fine. I wouldn't have wanted to draw blood, but I was able to do these other things okay.

I assume you're confident with the care you've had. While it is safe to stay long term on anti thyroid drugs, it's understandable that you want stability while on them.
Have you been on and off? On consistently? What dose? Do you split or take once a day? Has your doctor offered you the option of block and replace therapy? It's quite effective when administered properly.

There is a Graves support group on yahoo that I haven't checked in on in years but that I found very helpful. Also, Elaine Moore's work.

P.S. about bad effects on the liver: that's why they do a metabolic panel. There are many medications that can be problematic, such as immunosuppressants given for Crohn's. GI's allow a patient's level to be up to 5 x the norm before stopping.
The difference between Crohn's meds and ATDs is that the former are started low and one builds up to a long term therapeutic dose. In the case of the latter, one starts high and lowers the dose, so you can see that there is less stress on the liver. You might want to look into milk thistle (get reliable info) of a diet that's easier on your liver, e.g. less animal protein.