Treatment

Treatment depends on the cause and the severity of symptoms. Hyperthyroidism is usually treated with one or more of the following:

• Antithyroid medications

Carbimazole (10-20mg 8-hourly) blocks thyroid hormones synthesis and also poccesses immunosuppressive effects that will affect Graves’ disease process. After 2-3months at full dose, carbamazole is gradually reduced over the next 12-18 months to 5 mg daily. The most severe adverse effect of carbamazole is agranulocytosis, a disorder in which there is a severe acute deficiency of certain blood cells (neutrophil). All patients starting treatment must be warned to terminate the carbimazole and seek an urgent blood count if they delevop a sore throat or unexplained fever.

• Radioactive iodine (which destroys the thyroid and stops the excess production of hormones)

It is administered orally as sodium¹³¹ I.  It is contraindicated in pregnancy and while breast-feeding. It accumulates in the gland and results in local irritation and tissue damage with return to normal thyroid function over 4-12 weeks.

• Surgery to remove the thyroid

Suntotal thyroidectomy should only applied on patients who hadve been rendered euthyroid. Antithyroid drugs must be stopped 10-14days before the operation and replaced with oral potassium iodine, that inhibits release of thyroid hormone and reduce the vascularity of the gland. The complications include bleeding, hypothyroidism, hypoparathyroidism, hypocalcaemia, recurrent laryngeal nerve palsy and recurrent hypertension.

If the thyroid must be removed with surgery or destroyed with radiation, you must take thyroid hormone replacement pills for the rest of your life.

Beta-blockers such as propranolol are used to treat some of the symptoms, including tachycardia, sweating, and anxiety until the hyperthyroidism is controlled.