Hyperthyroidism Treatment Options by Yury Bayarski
What is Hyperthyroidism?
Hyperthyroidism (also known an overactive thyroid) occurs when the thyroid gland produces excessive thyroid hormones. This causes many of the body's functions to speed up. About 2 in 100 women, and 2 in 1000 men, develop hyperthyroidism at some stage of their life.
Treatment of Overactive Thyroid
Three forms of treatment are available for hyperthyroidism. Each of them have their own advantages and limitations and physicians prefer one over the other due to reasons of simplicity, cost and availability and also on the severity of hyperthyroidism, existing illnesses and the age of patient. Each of the possible treatments for an overactive thyroid have some advantages and some disadvantages. In general, all three treatments are highly effective and associated with a low risk of side effects.
Drug Therapy
Drug therapy includes the use of beta-blocking agents and antithyroid drugs.
Antithyroid Drugs (ATD)
Most patients with hyperthyroidism are given antithyroid drugs as initial therapy. There are two main antithyroid drugs available for use in the United States: methimazole (Tapazole) and propylthiouracil (PTU). They interfere with the ability of the thyroid gland to synthesize its hormones and are usually given in high doses until the thyroid gland functions normally (becomes euthyroid). This can take one to two months. PTU is preferred in pregnant hyperthyroid patients.
Indications and Benefits:
availability and simplicity
ATD drugs work well to control the overactive thyroid, bring prompt control of hyperthyroidism, and do not cause permanent damage to the thyroid gland
may be used for long-term treatment of Graves' disease.
PTU is preferred choice in pregnant women with overactive thyroid
preferred treatment by many endocrinologists for children and for adults who refuse radioactive iodine
pretreatment of older and cardiac patients before radioactive iodine or surgery
both medications (methimazole and PTU) considered safe for use while breastfeeding
Disadvantages, Risks and Possible Side Effects:
High relapse rate (relapse is more likely in smokers, patients with large goiters, and patients with positive thyroid-stimulating antibody levels at the end of therapy). Hyperthyroid condition returns in about half of all patients.
PTU can cause elevated liver enzymes, and immunoallergic hepatitis
Methimazole can cause rare cholestasis and rare congenital abnormalities
Minor side effects include rash, fever, gastrointestinal effects, and arthralgia
Rare side effect is called "agranulocytosis". This is a condition in which the white blood cells, which fight infection, disappear from the body. This could be a serious problem if an infection developed while those white blood cells were low. Fortunately, there is usually a warning when you get agranulocytosis - a fever and a sore throat. Patients on antithyroid drugs who develop a fever and a sore throat should stop the pills and call right away to get a blood test. If the blood test shows agranulocytosis, patients must remain off the antithyroid drugs. The white blood cells usually return to normal within one to two weeks.
Beta-blocker Medicines
There are medications available to immediately treat the symptoms caused by excessive thyroid hormones, such as a rapid heart rate. One of the main classes of drugs used to treat these symptoms is the beta-blockers (e.g., Inderal, Tenormin, Lopressor). Some people take a beta-blocker medicine for a few weeks whilst the level of thyroxine is reduced gradually by one of the available treatments.
Indications and Benefits:
Prompt relief of the adrenergic symptoms of hyperthyroidism such as tremor, palpitations, heat intolerance, and nervousness.
Treatment of choice for thyroiditis
First line therapy before surgery, radioactive iodine, and antithyroid drugs
Short term therapy in pregnancy
Disadvantages, Risks and Possible Side Effects:
Must be used with caution in older patients and in patients with pre-existing heart disease, chronic obstructive pulmonary disease, or asthma.
Radioactive Iodine (Radioiodine)
The thyroid cells are the only cells in the body that are able to absorb iodine. By giving radioactive iodine, cells in the thyroid are damaged or destroyed and are unable to produce further thyroid hormone. Radioiodine therapy involves taking a drink, or swallowing a capsule, which contains radioactive iodine. The dose of radioactivity to the rest of the body is very low and is not dangerous.
Indications and Benefits:
Inexpensive, highly effective, easy to administer, and safe
High cure rates with single-dose treatment (80%)
Treatment of choice for Graves' disease, multinodular goiter, toxic nodules in patients older than 40 years, and relapses from antithyroid drugs
Disadvantages, Risks and Possible Side Effects:
Delayed control of symptoms
Posttreatment hypothyroidism in majority of patients with Graves' disease regardless of dosage
Contraindicated in patients who are pregnant or breastfeeding
Can cause transient neck soreness, flushing, and decreased taste
Radiation thyroiditis in 1% of patients
May exacerbate Graves' ophthalmopathy
May require pretreatment with antithyroid drugs in older or cardiac patients
Treatment of hyperthyroidism in children remains controversial
Reluctance to use in women of childbearing years
Surgery
In a situation where radioiodine is not available and the patient is not responding to ATD patients are subjected to a surgery. Surgery (thyroidectomy) involves removing part of the thyroid gland. It may be a good option if you have a large goitre (thyroid swelling) which is causing problems in the neck. If too much of the thyroid is removed it is not usually a problem as you can take thyroxine tablets to keep the thyroxine level normal. It is usually a safe operation, although as with all operations there is a small risk. This mode of treatment requires 5-10 days of hospitalization.
Indications and Benefits:
Treatment of choice for people:
with very large goiters
who cannot tolerate antithyroid medicine or fail antithyroid drugs
who refuse radioactive iodine treatment
who have opthalmopathy (staring/bulging eyes)
young women and contemplating pregnancy
with severe disease who could not tolerate recurrence
May be done for cosmetic reasons
Disadvantages, Risks and Possible Side Effects:
Higher morbidity and cost than radioactive iodine
Risk of hypothyroidism or hyperthyroid relapse
Temporary or permanent hypoparathyroidism or laryngeal paralysis
Requires patient to be euthyroid preoperatively with antithyroid drugs or iodides to avoid thyrotoxic crisis
About the Author
Yury Bayarski is the author of OriginalDrugs.com - website which offers health patches and natural health products. Please follow this link if you would like to read about herbal remedy for overactive thyroid
Thyroid Disease
Typically women have a greater chance of having thyroid problems.This is probably to do with the reproductive hormones.
It is vital to both genders and is a little gland in our necksthat controls the rate of function for every cell and gland inthe body.This includes growth,repair and metabolism.
Your thyroid needs to be working pretty well to maintain optimal health.
Thyroid problems often run in families.This could be down to genetics or emotional patterning.
If you have an annual check-up a manual gland exam will be done.If you have a family history of thyroid conditions you should start getting thyroid blood tests at age 20 or earlier if thereare symptoms. If there is no family history or symptoms begin atage 30. A test every 5 years is a good idea after that.
If you think you are consistently burning more calories than you are ingesting but you are not losing weight it's a good ideato get your thyroid checked.The thyroid manages our metabolismso a small imbalannce could result in slower weight loss.
The best way you can support your thyroid function is through goodquality nutrition that includes a medical grade multivitamin.
Women often feel stifled and fail to fully express themselves- trapped voices would best express it.This can manifest as a thyroidimbalance.Be encouraged to speak up for yourself and try to find ways to express yourself creatively.
Seaweed products can be beneficial to people with thyroid problems as it contains iodine.Be sure to keep levels in moderation as toomuch can be harmful.
A good diet and daily exercise should help to keep your thyroid healthy.
Article by Karen O'Neill of http://www.1stthyroiddisease.com

