What to Know About Hyperthyroidism Treatment

Hyperthyroidism, often called an overactive thyroid, is when the thyroid gland makes too much thyroid hormone, which can speed up the body's systems and cause symptoms like fast heartbeats and weight loss.

Hyperthyroidism is a serious condition that requires prompt medical attention. Fortunately, there are many different ways to treat it. If you think you might have hyperthyroidism, see your healthcare provider, who can talk to you about how the condition will affect you and offer treatment options.

This article provides a comprehensive overview of treatments for hyperthyroidism. It reviews the three most effective and efficient options available and addresses strategies for regulating thyroid levels successfully.

Hyperthyroidism
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How Is Hyperthyroidism Treated?

Your healthcare provider will work to balance your hyperthyroidism by returning your thyroid hormone levels to normal. This prevents potential long-term health issues and relieves any uncomfortable symptoms you might be experiencing. It's important to remember that there isn't a one-size-fits-all solution.

The type of treatment you receive depends on what's causing your hyperthyroidism and how serious it is. Your healthcare provider will consider factors such as:

  • Age
  • Potential allergies or side effects from medications
  • Other existing conditions (like pregnancy or heart disease)
  • Access to an experienced thyroid surgeon

Treatment options for hyperthyroidism include:

Each option has its benefits and considerations, and your healthcare provider will help guide you toward your best option.

Prescription Medications

The primary medications utilized to treat an overactive thyroid are referred to as antithyroid drugs. These medications work by decreasing the production of thyroid hormones.

Antithyroid Drugs

In the United States, the two common antithyroid drugs are:

  • Methimazole (MMI)
  • Propylthiouracil (PTU)

Methimazole usually has fewer side effects and brings about a quicker reversal of hyperthyroidism compared to PTU, so it usually is the favored option.

The usual side effects of antithyroid drugs encompass skin rashes, fever, and joint issues. Should a fever develop, seeking prompt medical attention is essential, as it could indicate a rare blood disorder called agranulocytosis.

Additional Medications

For cases in which an overactive thyroid causes irregular or fast heartbeats, a beta-blocker (often propranolol) might be prescribed. Individuals with bulging eyes resulting from Graves' disease can also benefit from steroid treatment.

Ablation

Ablation is a medical procedure that treats hyperthyroidism by targeting and reducing the activity of the thyroid gland. There are different methods of ablation, but the two main ones are radioactive iodine ablation and laser ablation.

Radioactive Iodine Ablation

Radioactive iodine ablation is a medical procedure to treat hyperthyroidism. This treatment by gradually reducing thyroid activity, alleviating symptoms like rapid heartbeat and anxiety.

Patients receiving radioactive iodine ablation can often go home on the same day unless a higher dose than typical is needed, which might require a hospital stay for monitoring. You'll either swallow capsules or liquid containing the radioactive iodine, which your thyroid absorbs. The nuclear medicine team might perform scans to track iodine's absorption. Here are a few points to remember about this therapy:

  • With lower doses, you can return home the same day.
  • Higher doses may require a hospital stay for monitoring.
  • Patients swallow radioactive iodine in capsules or liquid.
  • The thyroid absorbs iodine.
  • Radiation targets thyroid cells, including cancer cells.
  • Generally safe for most cells, high doses might have rare effects.

Thyroidectomy Surgery

Another treatment for hyperthyroidism can involve surgery to remove the overactive thyroid gland or nodules. The entire thyroid might be removed depending on the condition, while only half could be removed for certain toxic nodules.

Before surgery, it's important to control hyperthyroidism using medications like ATDs (thionamide antithyroid drugs), beta-blockers, and sometimes a special iodine liquid for Graves' disease.

Surgical removal of the thyroid is generally safe. Possible complications include:

  • Damage to the parathyroid glands that regulate calcium levels, leading to low calcium
  • Potential damage to the nerves controlling vocal cords, resulting in a hoarse voice

You will need hormone replacement if the entire thyroid gland is removed since your body can't produce thyroid hormones without it. Normal thyroid levels are reestablished with daily thyroid hormone replacement. In cases of partial thyroid removal, your healthcare provider will assess the need for thyroid hormone replacement after surgery.

How Long Does Hyperthyroidism Treatment Take?

The time it takes for hyperthyroidism treatment to work can vary by treatment method, the severity of the condition, and how well your body responds to the treatment. Here are some common treatment options and their typical timelines:

Antithyroid Drugs

If you take antithyroid drugs like methimazole or propylthiouracil, treatment usually lasts one to two years. During this time, your healthcare provider will monitor your thyroid levels regularly to adjust the dosage and ensure your thyroid function returns to normal. Some patients stay on these medications long term.

Radioactive Iodine Ablation

If you opt for radioactive iodine treatment, the timeline can vary. Some people start to feel better within a few weeks, but it might take four to 12 weeks or longer for the treatment to have its full effect. Additionally, you might need more than one dose of radioactive iodine to fully normalize thyroid function.

Surgery (Thyroidectomy)

Recovery from thyroid surgery typically takes a few weeks, but the treatment might span several months. This includes presurgical preparation, the surgical procedure, and the postoperative follow-up appointments to monitor your recovery and thyroid hormone levels.

Beta-Blockers

Beta-blockers help control rapid heart rate and anxiety. These medications work quickly to manage hyperthyroidism symptoms and are often used as a short-term solution.

Can Hyperthyroidism Be Cured?

Hyperthyroidism can often be effectively treated and managed, and in some cases, it can be considered cured. The outcome depends on the underlying cause of hyperthyroidism, the chosen treatment method, and how well your body responds to the treatment.

Here are a few scenarios:

Antithyroid Drugs

With proper treatment and monitoring, thyroid function can return to normal with antithyroid medications. The condition can be so well-managed that it might be considered "cured." However, these medications are often taken long term, and people may experience relapse after discontinuing the medications.

Radioactive Iodine Ablation

Radioactive iodine treatment can lead to long-lasting or permanent normalization of thyroid hormone levels. In some cases, this treatment can essentially "cure" hyperthyroidism, but it's important to note that it might also result in hypothyroidism (underactive thyroid), which requires lifelong thyroid hormone replacement.

Surgery

A thyroidectomy can be a cure for hyperthyroidism, especially in cases of Graves' disease or toxic nodules. However, this approach also carries the risk of postsurgical hypothyroidism and requires lifelong thyroid hormone replacement.

What Are the Treatment Risks?


The side effects of hyperthyroidism treatments vary by treatment method used. It's important to discuss potential side effects with your healthcare provider before starting any treatment.

Here are some side effects associated with different hyperthyroidism treatment options:

Antithyroid medication risks include:

  • Skin rash or hives
  • Joint pain or swelling
  • Nausea, vomiting, or upset stomach
  • Drowsiness or dizziness
  • Muscle plain
  • Itching
  • Loss of taste

Radioactive iodine ablation risks include:

  • Nausea or vomiting
  • Sore Throat or neck discomfort
  • Dry mouth
  • Taste changes

While not an immediate side effect, radioactive iodine treatment can lead to an underactive thyroid (hypothyroidism) over time.

Thyroid surgery risks include:

  • Pain or discomfort
  • Swelling or bruising around the incision area
  • Damage to the nerves controlling the vocal cords can lead to hoarseness or changes in voice.
  • Damage to the parathyroid glands during surgery can result in low calcium levels, leading to muscle cramps or tingling

Beta blocker risks include:

  • Decrease in blood pressure, leading to dizziness or fainting
  • Tiredness or fatigue
  • Constipation
  • Diarrhea

It's important to remember that not everyone will experience these side effects. Your healthcare provider will help you understand the potential side effects of the chosen treatment and how to manage them. Regular communication with your healthcare team is essential to address any concerns and adjust your treatment plan as needed.

What Happens If Hyperthyroidism Is Left Untreated?

Neglecting to treat hyperthyroidism can result in significant health issues, including:

  • Irregular heartbeats, potentially leading to blood clots, stroke, heart failure, and other cardiac complications.
  • Development of Graves' ophthalmopathy, an eye condition causing double vision, light sensitivity, and eye discomfort. In rare instances, it might result in vision loss.
  • Weakening of bones and susceptibility to osteoporosis.
  • Fertility problems.
  • Pregnancy complications, including premature birth, low birth weight, high blood pressure during pregnancy, and miscarriage.

Are There Complications From Hyperthyroidism?

A thyroid storm is an extremely rare but life-threatening condition that occurs when the thyroid gland suddenly releases a massive amount of thyroid hormones into the bloodstream. This surge in hormones leads to severe hyperthyroidism.

A thyroid storm is considered a medical emergency that requires immediate treatment, as it can rapidly affect various body systems and lead to serious complications.

Possible complications may include:

Symptoms of a thyroid storm include:

  • High fever
  • Rapid heartbeat and irregular heartbeat
  • Restlessness and agitation
  • Severe sweating and heat intolerance
  • Tremors
  • Confusion or delirium
  • Nausea, vomiting, and diarrhea
  • Bulging eyeballs

Other Hyperthyroidism Treatment Options

Research has shown that the anti-thyroid medication propylthiouracil is a safer alternative to methimazole for treating hyperthyroidism during the first trimester of pregnancy. Healthcare providers will switch to methimazole in the second and third trimesters because it has less liver toxicity.

Hyperthyroidism is less commonly found in children and adolescents; however, treatment options are generally similar as they are for adults.

Summary

Hyperthyroidism, caused by excessive thyroid hormone production, demands immediate attention. Treatment options include antithyroid medications, radioactive iodine therapy, and thyroid surgery. If you or a loved one is experiencing symptoms of hyperthyroidism, see your healthcare provider immediately for a proper diagnosis and treatment plan.

19 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Sarah Jividen, RN
Sarah Jividen, RN, BSN, is a freelance healthcare journalist and content marketing writer at Health Writing Solutions, LLC. She has over a decade of direct patient care experience working as a registered nurse specializing in neurotrauma, stroke, and the emergency room.