How is hyperthyroidism treated?
No single treatment is best for all patients with hyperthyroidism. The choice of treatment will be influenced by your age, the type of hyperthyroidism that you have, the severity of your hyperthyroidism, and other medical conditions that may be affecting your health.
Antithyroid drugs
Drugs known as antithyroid agents—methimazole, carbimazole or propylthiouracil (PTU)— block the thyroid gland’s ability to make new thyroid hormone.
Common minor reactions are red skin rashes, hives, and occasionally fever and joint pains.
A rarer (occurring in 1 of 500 patients), but more serious side effect is a decrease in the number of white blood cells. Such a decrease can lower your resistance to infection. Very rarely, these white blood cells disappear completely, producing a condition known as agranulocytosis, a potentially fatal problem if a serious infection occurs. If you are taking one of these drugs and get an infection such as a fever or sore throat, you should stop the drug immediately and have a white blood cell count that day.
Liver damage is another very rare side effect. You should stop the drug and call your doctor if you develop yellow eyes, dark urine, severe fatigue, or abdominal pain.
Radioactive iodine
The radioactive iodine used in this treatment is administered by mouth, usually in a small capsule that is taken just once. Once swallowed, the radioiodine gets into your blood stream and quickly is taken up by the overactive thyroid cells. Over a period of several weeks to several months (during which time drug treatment may be used to control hyperthyroid symptoms), radioactive iodine damages the cells that have taken it up. Sometimes patients will remain hyperthyroid, but usually to a lesser degree than before. For them, a second radioiodine treatment can be given if needed. More often, hypothyroidism (an underactive thyroid) occurs after a few months. Hypothyroidism can easily be treated with a thyroid hormone supplement taken once a day.
Radioactive iodine has been used to treat patients for hyperthyroidism for over 60 years. No complications from radioiodine treatment have become apparent over many decades of careful follow-up of patients.
Surgery
Your hyperthyroidism can be permanently cured by surgical removal of most of your thyroid gland. This procedure is best performed by a surgeon who has much experience in thyroid surgery. Major complications of thyroid surgery occur in less than 1% of patients operated on by an experienced thyroid surgeon. These complications include damage to the parathyroid glands that surround the thyroid and control your body’s calcium levels (causing problems with low calcium levels) and damage to the nerves that control your vocal cords (causing you to have a hoarse voice).
After your thyroid gland is removed, the source of your hyperthyroidism is gone and you will likely become hypothyroid. Your thyroid hormone levels can be restored to normal by treatment once a day with a thyroid hormone supplement.
Beta-blockers
Beta adrenergic blocking agents block the action of thyroid hormone on your body. They usually make you feel better within hours, even though they do not change the high levels of thyroid hormone in your blood.
