Treatments for Hyperthyroidism
Your Treatment Plan Depends on a Variety of Factors
There are a number of hyperthyroidism treatments available. The best plan for you depends on your symptoms, the cause of your hyperthyroidism, and what treatment option makes you most comfortable. In determining the most effective therapy, your doctor will also take your medical history, physical examination, and any diagnostic tests into consideration.
Below are the most common treatments for hyperthyroidism.
- Antithyroid Medications: Antithyroid medications (sometimes written anti-thyroid) prevent the thyroid from producing excess amounts of T4 and T3 hormones. There are 2 types of antithyroid medications used in the US—propylthiouracil (PTU) and methimazole (also known as Tapazole). Your symptoms should gradually subside within 3 months, though you may need to stay on the medication for more than a year (and will need to be gradually tapered off). These 2 medications target the thyroid gland directly to reduce T4 and T3 hormone production.
Sometimes, your physician may also prescribe a third type of antithyroid medication that is known as a beta blocker (eg, propranolol or metoprolol) and works more generally throughout the body. It belongs to a class of medications used for many medical conditions, such as treatment of hypertension and cardiac arrhythmias.
Hyperthyroidism can cause a dangerous increase in heart rate in some patients. In these cases, your doctor may use beta blockers to reduce your heart rate. Beta blockers are not for everyone, though. If you have asthma or diabetes, these medications may aggravate your condition.
- Radioactive Iodine: This oral medication is absorbed by your thyroid gland. Radioactive iodine works by gradually destroying the thyroid. This, in turn, reduces your hyperthyroid symptoms. This treatment is effective at permanently curing hyperthyroidism, and there are very little side effects on the rest of your body. Some may require a repeat of this treatment. But since you will no longer have a thyroid, you will need to take thyroid hormone replacement therapy to replenish the lack of thyroid hormones.
- Surgery: The total or partial surgical removal of the thyroid is called a thyroidectomy. A thyroidectomy, when performed by an experienced surgeon, is a safe and effective treatment.
As with any surgical procedure, it poses some small risks, including potential damage to your vocal cords and parathyroid glands.
Surgery tends to be recommended for certain types of hyperthyroidism. These include, for example, Graves' disease with eye changes (exopthalmos) and larger and nodular thyroid goiters. As with radioactive iodine, you will likely need to take thyroid hormone replacement therapy after surgery to supply your body with healthy levels of thyroid hormones.
In choosing your treatment, make sure you understand and discuss all the risks, benefits, and side effects with your doctor. Each of the treatments above has a balance of risks and benefits—you and your doctor should discuss why one treatment may be more suitable and the right option for you. The ultimate goal for treating hyperthyroidism is to lower the amount of thyroid hormones to establish a healthy balance. This balance is essential to your body's ability to function at its best.
- Mayo Clinic Hypothyroidism Treatments and drugs page. Mayo Clinic Web site. http://www.mayoclinic.com/health/hyperthyroidism/DS00344/DSECTION=treatments-and-drugs. Accessed June 29, 2009.
- Skugor, M. Treating Hyperthyroidism. In: The Cleveland Clinic Guide to Thyroid Disorders. New York: Kaplan Publishing; 2009:69-71.
- Treatment Guidelines for Patients with Hyperthyroidism and Hypothyroidism. American Thyroid Association Web site. http://www.thyroid.org/professionals/publications/documents/GuidelinesHyperHypo_1995.pdf. Accessed June 29, 2009.