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Hyperthyroidism Treatment Options
What Is the Best Treatment for Hyperthyroidism?
before welearn about the hyperthyroidism treatment let’s understand the condition-
Thyroid gland makes thyroid hormone, thyroxine which affects a person’s physical energy, their weight and their mood. It is located in the front portion of the neck. Thyroid gland takes iodine supplied by the diet and synthesizes thyroid hormone (1).
Among the energy regulating hormones thyroid hormone is the most important hormone. Thyroid hormone can increase the rate of metabolism and plays an important role in growth process.
Different factors affecting hyperthyroidism treatment:
Thyroid hormone, thyroxine
Thyroid hormone is made from iodide and tyrosine, an amino acid. Thyroid hormone thyroxine is also called T4 as it contains four iodine atoms. The active form of T4 is T3 which is also known as triiodothyronine and it is formed by removal of one iodine atom from T4 (2).
Thyroid stimulating hormone
The quantity of thyroxine secreted by the thyroid gland is regulated by the thyroid stimulating hormone (TSH) which plays an important role in determining hyperthyroidism treatment. TSH is secreted by the pituitary gland which is present at the base of the brain.
The amount of TSH pituitary gland releases into the blood stream depends on the amount of T4. If there is less thyroxine being secreted by the thyroid gland then the TSH secreted will be more, hence the need for hyperthyroidism treatment with utmost care (2).
The functional disorders of thyroid are related to the gland producing too little thyroid hormone (hypothyroidism) or too much thyroid hormone (hyperthyroidism) and hence the hyperthyroidism treatment. Hyperthyroidism is a condition in which excess thyroid hormone is synthesized and secreted by the thyroid gland (3).
Hyperthyroidism can also be described as excessive concentration of thyroid hormones in tissues because thyroid synthesizes increased amounts of thyroid hormones, excessive release of already formed thyroid hormones or may be because of an endogenous or exogenous extrathyroidal source and hence the need for hyperthyroidism treatment(4).
Symptoms of hyperthyroidism and hyperthyroidism treatment
It is not necessary that everyone who has hyperthyroidism will have the same symptoms. Common symptoms seen in people who are afflicted with hyperthyroidism (3, 4, 5) are listed below
- Tachycardia, increased heartbeat
- Fatigue and weakness
- Tremor, trembling of hands
- Disturbed sleep
- Weight loss but appetite is the same or may increase
- Heat intolerance
- Hyperpigmentation (especially face and neck)
- Polydipsia, increased thirst
Diagnosis (hyperthyroidism treatment)
When a doctor suspects hyperthyroidism a blood test will be ordered. Serum thyroid stimulating hormone (TSH) will be measured as it has the highest sensitivity and specificity for diagnosing thyroid problems for further hyperthyroidism treatment(3).
When the TSH levels are low it indicates an overactive thyroid gland producing excess of thyroid hormone. Low TSH levels occasionally indicate a problem with pituitary gland and it may result in secondary hypothyroidism (2). If the serum TSH is low subsequently further tests in which serum T3 and T4 content are measured to see if there is subclinical hyperthyroidism or overt hyperthyroidism (3).
hyperthyroidism treatment (6)
The aim of the hyperthyroidism treatment is to bring back the hormone levels to normal. hyperthyroidism treatment may involve antithyroid drugs, radioactive iodine ablation, and surgery. It cannot be said which single treatment works for everyone.
The hyperthyroidism treatment depends on several factors which the doctor will consider before suggesting the best course of treatment.
- Severity of the problem
- Allergies to medication
- Side effects of medication
- If the patient is pregnant
- If the patient is having any heart problems
Antithyroid drug therapy is a conservative approach and the most commonly used form of hyperthyroidism treatment. But the relapse rate is high. The other two options are more definitive but they need lifelong therapy for hypothyroidism that follows those treatments.
Beta blockers may be prescribed to reduce the symptoms of hyperthyroidism till a proper treatment is decided.
Antithyroid medication may be given which reduces the production of thyroid hormone. These medicines have side effects.
Any medication given is prescribed by the doctors taking into account several factors.
Radioactive iodine ablation
In this hyperthyroidism treatment radioactive iodine is taken in the form of pills which kills thyroid cells but does not affect other tissues. Because the thyroid cells are destroyed many of the individuals develop hypothyroidism which is easier to treat.
This is the most commonly used hyperthyroidism treatment. This hyperthyroidism treatment is not used for pregnant and lactating women as it is not good for the baby.
This is not a hyperthyroidism treatment that is used commonly as it involves surgery where part of the thyroid gland or most of it is removed. It is used for people who cannot take antithyroid medicines. But even these people may develop hypothyroidism.
The best hyperthyroidism treatment would be suggested by the doctor depending on several factors which are specific to the individual. It is suggested to follow the health providers directions to overcome the problem of hyperthyroidism.
- Centers for Disease Control and prevention (2014). HTDS Guide – About Thyroid Disease: Section Summary. https://www.cdc.gov/nceh/radiation/hanford/htdsweb/guide/thyroid.htm
- American Thyroid Association (2014).Thyroid Function Tests. https://www.thyroid.org/thyroid-function-tests/
- De Leo, S., Lee, S. Y. and Braverman, L. E. (2016) Hyperthyroidism, Lancet (London, England). Vol. 388(10047).https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5014602/
- Kravets, I. (2016) Hyperthyroidism: Diagnosis and Treatment, American Family Physician. Vol. 93(5).https://www.aafp.org/afp/2016/0301/p363.html#sec-3
- Mayo Clinic (2018). Hyperthyroidism (overactive thyroid). https://www.mayoclinic.org/diseases-conditions/hyperthyroidism/symptoms-causes/syc-20373659
- National Institute of Diabetes and Digestive and kidney diseases (2016). Hyperthyroidism (Overactive Thyroid). https://www.niddk.nih.gov/health-information/endocrine-diseases/hyperthyroidism#treatment