The eventual goal of any treatment for hyperthyroidism is remission, in which the disease becomes inactive and the symptoms disappear. Physicians differ on how best to achieve this goal, and different patients will experience differing levels of success with the various treatments. Individual patients will also have personal preferences for how they are treated. Some may leap at the chance to put a permanent end to their hyperthyroidism with RAI, while others may prefer trying antithyroid medications first, in the hopes that the treatment will push them into a remission. Others choose medications in the hopes they will not become hypothyroid.
Many people with Graves' disease who try antithyroid medications do indeed go into remission. Those who are more likely to go into remission are usually people with mild hyperthyroidism, who have a small goiter, low levels of antibodies, and no eye disease. In rare cases of Graves' disease, your condition may go into remission on its own without treatment, a phenomenon known as spontaneous remission.
But in some cases, the remission is temporary, and the hyperthyroidism returns. If that happens, you will need to revisit your treatment options again and work with your doctor to devise a plan.