Treatment of Hyperthyroidism

Treatments available for hyperthyroidism are effective and there are treatments for all common types of hyperthyroidism. Your doctor will recommend a treatment based on your age, physical condition and the severity of your disorder.

Currently available treatments for hyperthyroidism include:

• radioactive iodine,
• anti-thyroid medications,
• beta blockers and
• surgery (thyroidectomy).

Radioactive iodine: This is the most common type of medication recommended for permanent treatment of hyperthyroidism. The advantage of radioactive iodine is that thyroid cells are the only cells in the body that have the ability to absorb iodine and other cells in the body do not absorb iodine. Therefore, with radioactive iodine, the thyroid cells that absorb and concentrate it are damaged or killed, but there is very little radiation exposure (or side-effects) for the rest of the body. Radioiodine is given orally (by mouth) and so there is no need for hospitalisation. After taking radioactive iodine, it takes about one to two months before the thyroid cells are killed, but the radioactive iodine is completely eliminated from the body within a few days. Most patients need a single dose of radioactive iodine for cure. As it causes permanent damage to thyroid gland, you may eventually need to take medication every day to replace thyroxine.

Anti-thyroid medications: These medications (such as propylthiouracil and methimazole) act slowly and gradually reduce symptoms of hyperthyroidism. They act by reducing the amount of hormone produced by the thyroid gland. Improvement is observed in about six to 12 weeks, but treatment has to be continued for least a year and often longer. Some people may have permanent cure of the problem while others may experience a relapse after stopping treatment.

Beta blockers: These drugs are basically used to treat high blood pressure. They do not reduce the levels of thyroid hormone, but are useful to treat rapid heart rate and prevent palpitations caused because of excess thyroid hormones. Therefore, they may be given until your thyroid levels are closer to normal.

Surgery (thyroidectomy): Some people, who cannot tolerate anti-thyroid drugs and don't want to have radioactive iodine therapy, may be recommended thyroid surgery, though this option is used occasionally to treat hyperthyroidism. During thyroidectomy, most part of your thyroid gland is removed. Some complications of this surgery include damage to your vocal cords and parathyroid glands. The parathyroid glands are located at the back of your thyroid gland. They help to maintain the level of calcium in your blood. Lifelong treatment with levothyroxine is needed after the surgery to maintain normal amounts of thyroid hormone in your blood. If the parathyroid glands are also removed, medication will be needed to maintain blood-calcium levels in the normal range.

Management of Graves' ophthalmopathy: Graves' disease is a common complication of hyperthyroidism. It affects the eyes (Graves' ophthalmopathy) and the symptoms may vary from mild to severe. Mild signs and symptoms may be treated by avoiding wind and bright lights and using artificial tears and lubricating gels. People with more severe symptoms may need treatment with corticosteroids such as prednisone to reduce swelling behind your eyeballs. Some cases may need assistance of a surgical procedure such as orbital decompression surgery or eye muscle surgery to control symptoms.