Treating hyperthyroidism
Hyperthyroidism is usually treated with medicines, radioiodine therapy, or thyroid surgery. Your doctor can help you identify the best option based on your age, health, symptoms, and other factors.
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 of your symptoms 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
- may temporarily treat symptoms but are not a permanent cure for Graves’ disease
- may take several weeks or months for thyroid hormone levels to move into the normal range
- take about 1–2 years total average treatment time, but can continue for many years
Seek care right away
While taking antithyroid drugs, 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 the whites of your eyes, called jaundice
- fever, chills, or constant sore throat
Radioiodine therapy
Radioiodine therapy is a common and effective treatment. You can take radioactive iodine-131 by mouth as a capsule or liquid.
- Pros
- Radioiodine therapy slowly destroys the cells of the thyroid gland that produce thyroid hormone.
- In the doses prescribed, 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.
- Radioiodine therapy may worsen symptoms of GO.
Almost everyone who gets radioiodine therapy later develops hypothyroidism. But hypothyroidism is easier to treat than hyperthyroidism by taking a daily thyroid hormone medicine, and it causes fewer long-term health problems.
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 lead to a condition called thyroid storm—a sudden, severe worsening of symptoms if antithyroid medicines are not taken before surgery to 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 and will adjust your thyroid medicine dosage as needed.
In some cases, doctors use surgery to remove part or most of the thyroid gland.
Treating GO
Most cases of GO are mild. The following tips may help you control mild symptoms.
- Eye drops can help relieve dry, gritty, irritated eyes.
- If your eyelids do not fully close, taping them shut at night or wearing an eye mask can help prevent dry eyes.
- If you have puffy eyelids, sleeping with your head raised may reduce swelling.
- Sunglasses can help with light sensitivity.
- Special eyeglass lenses may help reduce double vision, if you have it.
Eye drops can relieve dry, gritty, irritated eyes.If you have severe GO, your doctor may recommend
- steroids or other medicines that reduce your body’s immune response
- surgery to improve bulging eyes or correct changes to your vision
- radiation therapy to the muscles and tissues around the eyes, used rarely
GO often improves with treatment or even resolves on its own. But it can come back or get worse. Triggers include stressful life events and smoking.
Smoking makes GO worse. If you smoke or use other tobacco products, stop. Ask for help so you don’t have to do it alone. You can start by calling the National Quitline at 1-800-QUITNOW or 1-800-784-8669. For tips on quitting, go to Smokefree.gov.