Hyperthyroidism Treatment

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Propylthiouracil anf methimazole are drugs that lower the output of thyroid hormone. These are often the first type of treatment used for hyperthyroidism. Once the levels of thyroid hormone have been reduced to within the normal range with these drugs, the dosage is usually reduced until an appropriate maintenance regimen is determined. Unfortunately, the effect of these drugs is not always permanent, and it is possible for the production of thyroid hormone to be reduced too much. One potentially serious complication that can occur with these drugs is agranulocytosis, a condition in which the production of white cells is "shut off". Fortunately, this is both uncommon and reversible. More common side effects include itching, rashes, nausea, abdominal discomfort, hair loss, and liver stress.

If drugs are ineffective or cause intolerable side effects, your doctor may recommend a procedure to destroy overactive thyroid tissue. This is accomplished by taking radioactive iodine, or I-131. Since the thyroid takes up most of the iodine that enters the body, the effect of the radiation is focused there, and some of the gland's cells are destroyed. The idea is to destroy only enough cells to bring the production of thyroid hormone down to a normal level, but too much is destroyed and permanent hypothyroidism results, necessitating oral treatment with thyroid hormone for the rest of one's life. Treatment with radioactive iodine is not appropriate during pregnancy, as the radiation can harm a developing fetus.

Iopanoic acid, a drug used to aid in visualizing organs in radio logic examinations, has been found to block thyroid hormones, but the body responds less and less to it over several month's time. However, it may be very effective in certain cases. Possible side effects include liver damage, kidney damage, nausea, vomiting, hives, and, paradoxically, hyperthyroidism.

Surgery to remove a portion of the thyroid tissue was once a common approach to treating hyperthyroidism, but it is used more rarely today. Possible problems with this technique include accidental removal of the parathyroid glands, which are located at the back of the thyroid gland and control the body's use of calcium and phosphorous, and damage to the nerve to the vocal cords.

Symptoms of hyperthyroidism can be controlled by a type of drug called a beta-blocker, which blocks the transmission of certain nerve impulses. The drug most often used for this purpose is propranolol. It handles almost all of the symptoms of the condition, even though it has no effect whatsoever on the actual output of thyroid hormone. If hyperthyroidism goes away on its own after a short time, this may be the only treatment necessary, but often more aggressive types of treatment, such as those mentioned above, are necessary. Also, beta-blockers are not suitable for everyone. They should not be taken by anyone with a history of asthma or congestive heart failure, for example.

Treatment of thyroid storm is much the same as for ordinary hyperthyroidism, but is undertaken more aggressively. Propylthiouracil or methimazole is used to lower the output of thyroid hormone, and propranolol is prescribed to lower the heart rate and the stress on that organ. Hydrocortisone, a steroid, is used initially to reduce symptoms. For thyroid storm that occurs during pregnancy, the lowest possible doses of propylphiouracil are used and thyroid function is left somewhat elevated, if possible, until after delivery. This drug appears in lower concentrations in breast milk than methimazole, so it is preferred over that drug. Occasionally, if other measures fail, surgery on the thyroid gland is required.

If hyperthyroidism is due to a tumor elsewhere in the body, treatment consists of surgical removal of the tumor.

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