Hyperthyroidism (also known an overactive thyroid) occurs when the thyroid gland produces excessive thyroid hormones. This leads to many functions for the velocity of the body. Approximately 2 100 women and 2 men in 1000, develop hyperthyroidism at some point in their lives.
Treatment of hyperthyroidism
Three forms of treatment are available for hyperthyroidism. They each have their advantages and limitations, and doctors prefer over and over again, becauseFor simplicity, cost and availability and also on the severity of hyperthyroidism, existing illnesses and age of the patient. Each of the possible treatments for an overactive thyroid has certain advantages and disadvantages. In general, all three treatments are very effective and in conjunction with a low risk of side effects.
Drug Therapy
Drug therapy includes the use of beta-blockers and antagonists of the thyroid.
Antithyroid(ATD)
Most patients with hyperthyroidism Thyrostatics administered as initial therapy. There are two main Thyrostatics available in the United States: Methimazole (Tapazole) and propylthiouracil (PTU). Interfere with the ability of the thyroid gland to synthesize its hormones and are usually in high doses, to function normally until the thyroid gland (euthyroidism is given). This may be one to two months. PTU is preferred in hyperthyroidism in pregnancyPatients.
Indications and advantages:
Availability and simplicity
ATD drugs work well on the thyroid gland to bring the rapid control of the control of hyperthyroidism and not to cause permanent damage to the thyroid gland
can be used for long-term treatment of the disease, Graves 'disease'.
PTU is the first choice in pregnant women with hyperthyroidism
refuse treatment preferred by many endocrinologists for children and adults who have radioactive iodine
Pre-treatment of elderly patients and cardiac first radioiodine or surgery
both drugs (methimazole and PTU) as safe for use during lactation
Disadvantages, risks and possible side effects:
High rate of relapse (relapse more likely in smokers, in patients with large goiters, and patients with positive thyroid-stimulating antibody levels at the end of therapy). Hyperthyroid condition provides about half of all patients.
PTU can cause elevatedLiver enzymes, hepatitis and immunoallergic
Methimazole can cause cholestasis and rare congenital abnormalities, often
Side effects include rash, fever, gastrointestinal symptoms and pain
Rare side effects is called "agranulocytosis. This is a condition in which white blood cells to fight the infection to disappear from the body. This could be a serious problem if you develop an infection, while white blood cells were low. Fortunately, there is usually a warning, ifIt agranulocytosis - a fever and sore throat. Thyrostatics patients, fever and sore throat should stop the pills and call immediately get a blood test for development. If the blood test shows agranulocytosis, patients must continue Thyrostatic. White blood cells usually return to normal within one to two weeks.
Beta-blocker
There are medications available to immediately manage the symptoms caused by excessive thyroid hormones,a rapid heartbeat. One of the main classes of drugs for the treatment of these symptoms is the beta-blockers (eg Inderal, Tenormin) Lopressor. Some people take a beta-blocker medicine for several weeks, while the amount of thyroxine is reduced gradually by one of the treatments available.
Indications and advantages:
Prompt relief of adrenergic symptoms of hyperthyroidism such as tremor, palpitations, heat intolerance, and nervousness.
The treatment of choice forThyroiditis
First-line therapy prior to surgery, radioactive iodine and thyroid antagonists
Short-term therapy in pregnancy
Disadvantages, risks and possible side effects:
Must be used with caution in elderly patients and patients will be used with existing heart disease, chronic obstructive pulmonary disease or asthma.
Radioactive iodine (radioiodine)
The cells of the thyroid are the only cells of the body are capable of absorbing iodine. The fact that radioactiveIodine in the thyroid cells are damaged or destroyed and are not able to produce more thyroid hormones. Radioiodine therapy includes a drink or swallow a capsule containing radioactive iodine. The dose of radioactivity to the rest of the body is very small and not dangerous.
Indications and advantages:
Inexpensive to manage, highly effective, easy and secure
High cure rate with single dose treatment (80%)
The treatment of choice forGraves 'disease', multinodular goiter, toxic nodes in patients older than 40 years, and relapses of antithyroid
Disadvantages, risks and possible side effects:
Delayed control of symptoms
Hypothyroidism after treatment in most patients with Graves 'disease,' "regardless of dose
Contraindicated in patients who are pregnant or breastfeeding
May cause transient neck pain, flushing, and decreased taste
Radiation thyroiditis in 1% of patients
May exacerbate ophthalmopathy of Graves'
May require pre-treatment with thyroid antagonists in elderly patients or cardiac
The treatment of hyperthyroidism in children remains controversial
Lack of preparation for use in women of childbearing age
Surgery
In a situation in which radioactive iodine is not available and the patient is not responding to ATD patients to undergo surgery. Surgery (thyroidectomy) is the removal of the thyroid. Can be a good option ifHave) a large goiter (swelling of the thyroid, causing neck problems. If too much thyroid removed, usually not a problem, how to take thyroxine tablets to be able to maintain normal levels of thyroxine. Usually c 'is a safe operation, although like all surgery, there is a small risk. This type of treatment requires 5-10 days of hospitalization.
Indications and advantages:
Treatment of choice for people:
greatKropf
can not tolerate antithyroid medicine or antithyroid
who refuse treatment with radioactive iodine
have opthalmopathy (fixed / bulging eyes)
young women and consideration of pregnancy
severe disease who could not stand again
Disadvantages, risks and possible side effects:
Increased morbidity and cost of radioactive iodine
Risk of hypothyroidism orHyperthyroidism relapse
Temporary or permanent hypoparathyroidism or laryngeal paralysis
Patients need to avoid pre-operatively with antithyroid drugs or iodides with Euthyroid thyrotoxic crisis
