The main treatment modality for treating hyperthyroidism is to stabilize the thyroxine level to normal. The treatment outcome can be determined by various factors such as an underlying cause, patient’s age, preexisting medical condition, level of thyroid enlargement (goiter) and severity of the condition. The endocrinologist conducts physical examination and obtains the TH blood reports before recommending an appropriate treatment. However, the treatment modality can vary for each patient. Read on to learn the treatment options that are undertaken to treat an overactive thyroid or hyperthyroidism and to effectively manage the condition following the therapy.
Treatment protocol for hyperthyroidism
The medicines administered for hyperthyroidism work by suppressing the level of thyroxine, as produced and secreted by an overactive thyroid gland. The most commonly preferred medication of choice is carbimazole. Carbimazole therapeutically acts by reducing the further production of thyroxine and it has no effect on thyroxine that has been produced and stored in the body. The treatment response with reduced or normally stabilized thyroxine level can be achieved after 4 to 8 weeks of treatment. Moreover, each subjects’ response to prescription carbimazole drug can vary. Hence, a high dose drug is prescribed for the first few weeks of treatment which is then gradually reduced as the thyroxine levels drop down.
Carbimazole is initially prescribed for the duration of up to 1 or 1.5 years. The carbimazole therapy can be discontinued after the condition is stabilized which occurs in about half of cases. Further treatment can be preferred if the condition spikes up again. This treatment protocol can also include combination or alternative treatment with radioactive iodine to control the condition. Most of the cases often require continued, long-term therapy with carbimazole drug to aggressively improve the symptoms. Treatment with other drugs can be preferred as an alternative to long-term carbimazole therapy in case of rare side effects. Women who are pregnant or nursing often require an alternative drug called propylthiouracil.
Beta blocker medicines like atenololand propranolol are recommended for controlling hyperthyroidism symptoms like palpitations, increased heart rate, tremor and agitation.
- Treatment for eye manifestations
Graves’ hyperthyroidism cases should consult an eye specialist in case of severe eye manifestations that may require steroid tablets, surgery, or radiation treatment. Minor eye symptoms of Graves’ disease can be managed with sunglasses,artificial tears, and eye protectors.
Radioactive iodine can be taken in the form of a drink, or capsule that contains iodine. Its main action is to stimulate the production of thyroxine in the body. The radioactive iodine acts by accumulating within the thyroid gland. The part of thyroid tissue that reduces the amount of thyroxine will be gradually destroyed by its concentrated radioactivity. The overall dose of radioactivity to the overall system is relatively low and hence, it is not hazardous. However, it is not recommended for nursing or pregnant women. Additionally, men are suggested to avoid conception for minimum 4 months, while women are advised to avoid pregnancy for minimum 6 months followed by therapy.
Other precautionary measures following radioiodine treatment include avoiding constant contact with others for the duration of 2-4 weeks, based on the dosage of radioactive iodine. This is advised to prevent others from getting exposed to radioactivity. Some of the precautionary measures that are advised include:
- Avoiding close contact (~1 meter)with the infants, children, pregnant or lactating women.
- Other measures include cuddling the kids or making them sit on one’s lap; however, the same contact precautions should be followed even with pets
- Should sleep alone.
- Maintain a distance of more than an arm’s length from others.
- Avoid situations (crowds) that require close contact with people.
- Detailed instructions should be followed as advised by a specialist.
- Thyroid replacement therapy
The doctor obtains regular blood reports to determine the thyroxine level before prescribing an appropriate dose of carbimazole, or radioiodine, depending upon the case. This is crucial in order to avoid extremely low level of thyroxine as a result of high dose treatment plan. In contrary, low dose therapy can poorly control the raised thyroxine levels in the body thus, resulting in complications.
The recommended treatment protocol includes administering either a high dose of carbimazole daily or a one-off high dose of radioiodine. This inhibits the thyroxine production from the thyroid gland. This is followed by the daily administration of thyroxine tablets to stabilize the serum thyroxine levels in the body. This protocol is referred to block and replace therapy as it involves over-treatment followed by the replacement of thyroxine.
The surgical option involves either partial or complete removal of thyroid gland. It is usually recommended in case of large thyroid swelling (goiter) which complicates the airway and swallowing or compression of neck. Thyroxine tablets are usually prescribed followed by an excision of too much thyroid tissue to restore the thyroxine level to normal.
Filed Under: Hyperthyroidism Treatment