Hyperthyroidism, or an overactive thyroid, can be treated through several approaches depending on the underlying cause, severity, patient age, health status, and personal preferences. The main treatment options include:
1. Anti-thyroid Medications
- Drugs such as methimazole and propylthiouracil reduce the thyroid gland's production of hormones. These medications typically take several weeks to months to improve symptoms and are usually taken for 12 to 18 months or longer
- Propylthiouracil is preferred during the first trimester of pregnancy due to lower risk to the fetus.
- Side effects can include rash, joint pain, upset stomach, and rarely, serious liver damage or a drop in white blood cells, which requires immediate medical attention
- Some patients achieve long-term remission, but hyperthyroidism can recur after stopping medication
2. Beta Blockers
- These do not reduce thyroid hormone levels but help control symptoms like rapid heart rate, tremors, and anxiety while other treatments take effect
- Beta blockers are generally used short-term and are not suitable for people with asthma
3. Radioactive Iodine Therapy
- Involves taking radioactive iodine orally, which is absorbed by the thyroid gland and gradually destroys overactive thyroid cells, reducing hormone production
- It is a common and effective treatment, often leading to hypothyroidism, which requires lifelong thyroid hormone replacement therapy
- Not suitable for pregnant or breastfeeding women or those with severe eye problems from hyperthyroidism.
- Precautions after treatment include avoiding close contact with children and pregnant women for a few weeks and delaying pregnancy for several months
4. Surgery (Thyroidectomy)
- Removal of part or all of the thyroid gland may be recommended if there is a large goiter, severe eye disease, intolerance to other treatments, or recurrence after other therapies
- Surgery results in hypothyroidism, necessitating lifelong thyroid hormone replacement
- It is less commonly used but may be preferred in pregnancy or when other treatments are contraindicated
Additional Notes
- Patients should avoid excessive iodine intake during treatment.
- Treatment choice is individualized, often involving an endocrinologist's guidance
In summary, hyperthyroidism treatment involves medications to reduce hormone production, symptom control with beta blockers, radioactive iodine to ablate thyroid tissue, or surgery to remove the gland, with lifelong hormone replacement needed if the thyroid becomes underactive
