From the Guidelines
Hyperthyroidism should be treated with antithyroid medications, such as methimazole, or nonreversible thyroid ablation therapy, like radioactive iodine or surgery, particularly in patients with a TSH level that is undetectable or less than 0.1 mIU/L, as recommended by the US Preventive Services Task Force 1.
Treatment Options
- Antithyroid medications: methimazole (10-30mg daily) or propylthiouracil (100-300mg daily in divided doses) to block hormone production
- Beta-blockers: propranolol (20-40mg 3-4 times daily) to manage symptoms like rapid heart rate and tremors
- Radioactive iodine therapy: a single dose of I-131 for long-term management
- Thyroid surgery: total or partial thyroidectomy for definitive treatment
Monitoring and Follow-up
- Regular blood tests to check thyroid hormone levels and adjust medication dosages
- Monitoring for symptoms: weight loss, heat intolerance, anxiety, tremors, and rapid heartbeat
Causes and Complications
- Hyperthyroidism occurs when the thyroid gland becomes overactive, commonly due to Graves' disease, toxic nodular goiter, or thyroiditis
- Without proper treatment, hyperthyroidism can lead to serious complications, including heart problems, osteoporosis, and in severe cases, thyroid storm, a life-threatening condition requiring emergency care, as noted in recent studies 1.
From the FDA Drug Label
Propylthiouracil is a prescription medicine used to treat people who have Graves’ disease with hyperthyroidism or toxic multinodular goiter. The answer to the question about hyperthyroid is that Propylthiouracil is used to treat hyperthyroidism in patients with Graves’ disease or toxic multinodular goiter 2.
- Key points:
- Hyperthyroidism treatment
- Graves’ disease
- Toxic multinodular goiter
- Propylthiouracil is a prescription medicine used for treatment.
From the Research
Definition and Causes of Hyperthyroidism
- Hyperthyroidism is an excessive concentration of thyroid hormones in tissues caused by increased synthesis of thyroid hormones, excessive release of preformed thyroid hormones, or an endogenous or exogenous extrathyroidal source 3.
- The most common causes of an excessive production of thyroid hormones are Graves disease, toxic multinodular goiter, and toxic adenoma 3.
- The most common cause of an excessive passive release of thyroid hormones is painless (silent) thyroiditis, although its clinical presentation is the same as with other causes 3.
Symptoms and Diagnosis of Hyperthyroidism
- Common symptoms of thyrotoxicosis include anxiety, insomnia, palpitations, unintentional weight loss, diarrhea, and heat intolerance 4.
- Patients with Graves disease may have a diffusely enlarged thyroid gland, stare, or exophthalmos on examination 4.
- Patients with toxic nodules may have symptoms from local compression of structures in the neck by the thyroid gland, such as dysphagia, orthopnea, or voice changes 4.
- Etiology can typically be established based on clinical presentation, thyroid function tests, and thyrotropin-receptor antibody status 4.
- Thyroid scintigraphy is recommended if thyroid nodules are present or the etiology is unclear 4.
Treatment Options for Hyperthyroidism
- Hyperthyroidism caused by overproduction of thyroid hormones can be treated with antithyroid medications (methimazole and propylthiouracil), radioactive iodine ablation of the thyroid gland, or surgical thyroidectomy 3.
- Radioactive iodine ablation is the most widely used treatment in the United States 3.
- The choice of treatment depends on the underlying diagnosis, the presence of contraindications to a particular treatment modality, the severity of hyperthyroidism, and the patient's preference 3.
- Treatment options for overt hyperthyroidism from autonomous thyroid nodules or Graves disease include antithyroid drugs, radioactive iodine ablation, and surgery 4.
- The combination of methimazole and propranolol is considered an effective treatment regimen for hyperthyroidism in clinical practice, and may significantly improve the heart rate, bone metabolism and associated hormone levels in patients with hyperthyroidism 5.
- Beta-adrenergic blocking drugs, such as propranolol, can be used to modify the severity of the hyperadrenergic symptoms of hyperthyroidism 6.