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Thyroid Health

Treating Hyperthyroidism: What Are Your Options?

Summary & Participants

Hyperthyroidism is a serious hormonal imbalance that can lead to weight loss, anxiety, diarrhea and other symptoms. Treatments are available, and in most cases they involve attacking the primary cause of hyperthyroidism, which is a syndrome called Graves' disease. Join our experts as they discuss Graves' disease and the various treatment options.

Medically Reviewed On: July 23, 2008

Webcast Transcript

HOLLY ATKINSON, MD: Now, well, how do you go about making the decision of what is the right approach for a given individual? Someone listening to this may say, "Oh, my goodness, I'm confused, which should I have? And how do I make that decision?" Melissa, how do you go about making that decision?

MELISSA KATZ, MD: I make the decision with the patient, and ultimately I think it is the patient that makes the decision as to what they prefer. There are many things to take into consideration.

If somebody were to opt for antithyroid medication, you'd have to think about other medications that they were on. There are certain -- there are certain side effects that antithyroid medication, although quite rare, there could be--

HOLLY ATKINSON, MD: Such as?

MELISSA KATZ, MD: Some liver toxicity, in addition to some bone-marrow toxicity. Those are rare, but they can be quite serious. There could also be some joint aches and some rashes that could develop.

The side effects to radioiodine therapy are predominantly hypothyroidism. The majority of patients treated have they thyroid essentially destroyed and they are rendered hypothyroid, requiring taking levothyroxine for the rest of their life. And some patients decline to do that because they really don't want to have to take medication for the rest of their life.

And so I think it's an individual decision. Certainly somebody that has mild hyperthyroidism, someone that has a smaller gland, may respond well to antithyroid medication.

HOLLY ATKINSON, MD: Rick, are there any patient profiles in which you strongly recommend one or the other course?

RICHARD HABER, MD: Yeah, there are. I think that when somebody -- a patient -- is older, which could mean over 50. Or they've had cardiac manifestations of hyperthyroidism, such as cardiac arrhythmias, like the first President Bush had when he became hyperthyroid. In that case -- because the disease is potential life-threatening in an older person with heart problems -- I think it should be definitively and permanently cured, and the safest way to do that is with radioiodine.

The route of treating with antithyroid drugs -- which only sometimes gives a permanent cure is not for those patients. We save that for some of our younger patients. Those with the milder cases, smaller thyroid glands rather than very, very large thyroid glands. The people who have the best chance of being in the 30-50 percent to get some long-term remission from these drugs.

HOLLY ATKINSON, MD: Now, what about a pregnant woman, what would you recommend?

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