Your doctor will treat your hyperthyroidism to bring your thyroid hormone levels back to normal. Treating the disease will prevent long-term health problems, and it will relieve uncomfortable symptoms. No single treatment works for everyone.
Your treatment depends on what’s causing your hyperthyroidism and how severe it is. When recommending a treatment, your doctor will consider
- your age
- possible allergies to or side effects of the medicines
- other conditions, such as pregnancy or heart disease
- whether you have access to an experienced thyroid surgeon
Treatment options
Hyperthyroidism is usually treated with medicines, radioiodine therapy, or thyroid surgery.
Medicines
Beta-blockers. Beta-blockers are drugs that block the action of substances, such as adrenaline, on nerve cells. They cause blood vessels to relax and widen.
- Pros
- They can reduce symptoms—such as tremors, rapid heartbeat, and nervousness—until other treatments start working.
- They can make you feel better within hours.
- Cons
- They don’t stop thyroid hormone production.
Antithyroid medicines. Antithyroid therapy is the simplest way to treat hyperthyroidism. Methimazole is used most often. Propylthiouracil is often used for women during the first 3 months of pregnancy because methimazole can, on rare occasions, harm the fetus.
- Pros
- They cause the thyroid to make less thyroid hormone.
- Some patients’ symptoms from Graves’ disease may go away temporarily after taking antithyroid drugs.
- Cons
- Antithyroid medicines can cause side effects, including
- allergic reactions, such as rashes and itching
- a decrease in the number of white blood cells in your body, which can lower resistance to infection
- liver failure, in rare cases
- Antithyroid medicines
- don’t provide a permanent cure, but they may allow symptoms to go away temporarily in the case of Graves’ disease
- may take several weeks or months for thyroid hormone levels to move into the normal range
- take about 1–2 years of total average treatment time, but can continue for many years
- are not used to treat hyperthyroidism caused by thyroiditis
Seek care right away
Call your doctor right away if you have any of the following symptoms
- fatigue or weakness
- dull pain in your abdomen
- loss of appetite
- skin rash, itching, or easy bruising
- yellowing of your skin or whites of your eyes, called jaundice
- constant sore throat
- fever, chills, or constant sore throat
Antithyroid therapy is the easiest way to treat hyperthyroidism.
Radioiodine therapy
Radioiodine therapy is a common and effective treatment. You can take radioactive iodine-131 by mouth as a capsule or liquid.
Almost everyone who gets radioiodine therapy later develops hypothyroidism. But hypothyroidism is easier to treat than hyperthyroidism by using a daily thyroid hormone medicine, and it causes fewer long-term health problems.
- Pros
- Radioiodine therapy slowly destroys the cells of the thyroid gland that produce thyroid hormone.
- Radioiodine therapy does not affect other body tissues.
- Cons
- You might need more than one treatment to bring thyroid hormone levels into the normal range, but beta-blockers can control symptoms between treatments.
- Radioiodine therapy isn’t used for women who are pregnant or breastfeeding. It can harm the fetus’ thyroid and can be passed from mother to child in breast milk.
Taking radioactive iodine-131 is a common and effective treatment.
Thyroid surgery
Surgery to remove part or most of the thyroid gland is used less often to treat hyperthyroidism. Sometimes doctors use surgery to treat people with large goiters or pregnant women who cannot take antithyroid medicines.
- Pros
- When part of the thyroid is removed, your thyroid hormone levels may return to normal.
- Cons
- Thyroid surgery requires general anesthesia, which can cause a condition called thyroid storm—a sudden, severe worsening of symptoms. Taking antithyroid medicines before surgery can help prevent this problem.
When part of your thyroid is removed, you may develop hypothyroidism after surgery and need to take thyroid hormone medicine. If your whole thyroid is removed, you will need to take thyroid hormone medicine for life. After surgery, your doctor will continue to check your thyroid hormone levels.
In some cases, doctors use surgery to remove part or most of the thyroid gland.
Researchers are looking into new ways to treat hyperthyroidism. An example is radiofrequency ablation (RFA), a new approach to treating thyroid nodules that cause hyperthyroidism. RFA is used mainly in cases where medicines or surgery won’t help, and is not yet widely available.