Graves' disease hyperthyroidism medical therapy
{Graves' disease} Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1],Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]
Overview
Hyperthyroidism Therapy
Genreral aspects
- In a small proportion of patients, spontaneous remission occurs.
- Smoking cessation is one of the main stays of treatment.
- Antithyroid drugs are the first line treatment in Europe.
- Ablation therapy either by thyroidectomy or radioactive iodine is more accepted in North America.
- Each treatment approach has advantages and drawbacks. The patient’s preference, after receiving adequate counseling, remains a critical factor in therapy decisions.
The following table summarizes the medical therapy and surgical option for treatment.
| Treatment | Mechanism | Route of administration | Advantages | Disadvantages | Special considerations |
|---|---|---|---|---|---|
| Beta-blockers | Block β-adrenergic receptors;
propranolol may block conversion of T4 to T3 |
Oral; may be administered
intravenously in acute cases |
Ameliorates sweating, anxiety,
tremulousness, palpitations, and tachycardia |
, bradyarrhythmias or Raynaud’s phenomenon |
especially in patients with COPD
blockers as alternative |