- Pictures of Hyperthyroidism - Slideshow
- Pictures of Thyroid Medical Anatomy
- Pictures of Thyroid Conditions - Slideshow
- Thyroid FAQs
- Patient Comments: Hyperthyroidism - Symptoms
- Patient Comments: Hyperthyroidism - Treatments
- Patient Comments: Hyperthyroidism - Experience
- Find a local Endocrinologist in your town
- Hyperthyroidism definition and facts
- What is hyperthyroidism?
- What are the symptoms of hyperthyroidism?
- What causes hyperthyroidism?
- What is graves' disease?
- What is thyroiditis (inflammation of the thyroid)?
- What are other causes of hyperthyroidism?
- Which types of doctors treat hyperthyroidism?
- How is hyperthyroidism diagnosed?
- How is medications treat hyperthyroidism?
- Medications that treat symptoms of hyperthyroidism
- Antithyroid drugs for hyperthyroidism
- Radioactive iodine for hyperthyroidism
- Surgery for hyperthyroidism
- What should I do if I think I have hyperthyroidism?
Quick GuideHyperthyroidism Symptoms and Treatment
Radioactive iodine for hyperthyroidism
Radioactive iodine is given orally (either by pill or liquid) on a one-time basis to ablate a hyperactive gland. The iodine given for ablative treatment is different from the iodine used in a scan. (For treatment, the isotope iodine 131 is used, while for a routine scan, iodine 123 is used.) Radioactive iodine is given after a routine iodine scan, and uptake of the iodine is determined to confirm hyperthyroidism. The radioactive iodine is picked up by the active cells in the thyroid and destroys them. Since iodine is only picked up by thyroid cells, the destruction is local, and there are no widespread side effects with this therapy.
Radioactive iodine ablation has been safely used for over 50 years, and the only major reasons for not using it are pregnancy and breast-feeding. This form of therapy is the treatment of choice for recurring Graves' disease, patients with severe cardiac involvement, those with multinodular goiter or toxic adenomas, and patients who cannot tolerate antithyroid drugs. Radioactive iodine must be used with caution in patients with Graves' related eye disease since recent studies have shown that the eye disease may worsen after therapy. If a woman chooses to become pregnant after ablation, it is recommended she wait 8-12 months after treatment before conceiving.
In general, more than 80% of patients are cured with a single dose of radioactive iodine. It takes between 8 to 12 weeks for the thyroid to become normal after therapy. Permanent hypothyroidism is the major complication of this form of treatment. While a temporary hypothyroid state may be seen up to six months after treatment with radioactive iodine, if it persists longer than six months, thyroid replacement therapy (with T4 or T3) usually is begun.
Surgery for hyperthyroidism
Surgery to partially remove the thyroid gland (partial thyroidectomy) was once a common form of treatment for hyperthyroidism. The goal is to remove the thyroid tissue that was producing the excessive thyroid hormone. However, if too much tissue is removed, an inadequate production of thyroid hormone (hypothyroidism) may result. In this case, thyroid replacement therapy is begun. The major complication of surgery is disruption of the surrounding tissue, including the nerves supplying the vocal cords and the four tiny glands in the neck that regulate calcium levels in the body (the parathyroid glands). Accidental removal of these glands may result in low calcium levels and require calcium replacement therapy.
With the introduction of radioactive iodine therapy and antithyroid drugs, surgery for hyperthyroidism is not as common as it used to be. Surgery is appropriate for:
- pregnant patients and children who have major adverse reactions to antithyroid medications.
- patients with very large thyroid glands and in those who have symptoms stemming from compression of tissues adjacent to the thyroid, such as difficulty swallowing, hoarseness, and shortness of breath.
What should I do if I think I have hyperthyroidism?
If you are concerned that you may have an excess amount of thyroid hormone, you should mention your symptoms to your doctor. A simple blood test is the first step in the diagnosis. From there, both you and your doctor can decide what the next step should be. If treatment is warranted, it is important for you to let your doctor know of any concerns or questions you have about the options available. Remember that thyroid disease is very common, and in good hands, the diseases that cause an excess of thyroid hormones can be easily diagnosed and treated.