The point of RAI in today's world is to completely eliminate the thyroid (“ablate” is the term), and then go on replacement hormone. In previous decades, doctors sometimes tried to give the “Goldilocks” amount of RAI to make the patient not hyper, not hypo, but “just right” (euthroid). That didn't work most of the time, if euthroid was the goal. So, to get us well faster, they typically try to ablate nowadays.
It can take some months of tinkering to find the proper dose of replacement hormone. The replacement hormone is very finely tuned thyroid hormone. So, if we get too much of it, we become hyper again. Too little and we remain hypo. We have to wait a minimum of six weeks after a dose change before having new blood work, in order to avoid going on a hormonal roller coaster. (If the blood is tested too soon, the actual level of replacement needed might not be evident.) We have to be patient during these times.
And, while the replacement hormone starts being used right away in the body, we cannot expect it to be a “feel good” pill. It takes time AT normal levels of hormone for our bodies to heal after the illness that hyperthyroidism caused.
When I had my RAI, I became very pro-active about weight issues and eliminated sugars, and lost weight. I've recently done that again, with the same good results. I allow “nutritional” sweets – i.e. fruit, primarily – but ruthlessly eliminate any sweets that are empty calories. It does make a difference, for me at least. By eliminating empty calories, I've lost almost twenty pounds in the past year. It comes off slowly, but it is staying off. I hope you are feeling much better, and soon.
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