Treatments for Hyperthyroidism
Hyperthyroidism can be treated using medicine, radiation, or surgery. Many factors, such as your age and the severity and type of hyperthyroidism, are important in determining which treatment is best for you.
Medications:Antithyroid drugs - such as methimazole (Tapazole) and propylthiouracil (PTU), work by decreasing the production of thyroid hormone. Both are very effective, but many doctors prefer methimazole, since it only needs to be taken once a day (as opposed to 4 times a day for PTU). For pregnant women, PTU is the preferred drug, because scalp problems have been described in infants whose mothers were taking methimazole while pregnant, but under certain circumstances methimazole may be the best medication.
These medications are usually used short-term in both Graves' disease or toxic nodular goiter (prior to treatment with radio iodine or surgery), or long-term in patients with Graves' disease. Although you can expect to start feeling better after several weeks on the medication, your doctor might recommend that you continue taking it for one to two years. After that time, you have about a 20 to 30 percent chance of having a remission, but even after a remission some patients can relapse years later. This means that most people will need to to eventually consider a different type of treatment.
Antithyroid drugs have some minor side effects, such as rash, hives, painful joints, fever, and stomach upset. A more serious complication called agranulocytosis (lack of white blood cells) can occur, but is very rare.
When taking antithyroid drugs, you will have a blood test (for thryoid hormone) done every four to six weeks until the hyperthyroidism is under control.
Beta-blockers - such as atenolol, are often started as soon as the diagnosis of hyperthyroidism is made. While beta-blockers do not reduce thyroid hormone production, they can control many of the bothersome symptoms, such as rapid heart rate, tremors, anxiety, and heat intolerance. Once the hyperthyroidism is under control (by antithyroid drugs, surgery, or radioactive iodine), the beta-blocker is stopped.
Radioactive iodine - Destroying the thyroid with iodine, called radioiodine ablation, is a permanent way to resolve hyperthyroidism. The amount of radiation used is small and does not cause cancer. In fact, it is the most widely used treatment for this condition in the United States.