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Hyperthyroidism - Treatments

​There are 3 main treatments:

1. Medication

The 2 most common types of medication are beta-blockers and anti-thyroid drugs


Medication like propranolol and atenolol block the effect of the thyroid hormone on other parts of your body. While they affect the amount of thyroid hormone produced, they do not cure hyperthyroidism; thus, the condition may resurface after a patient halts the medication. 

Please note that individuals who suffer from asthma should avoid beta-blockers

Anti-thyroid Drugs

Drugs such as carbimazole, thiamazole, and propylthiouracil (PTU) act directly on the thyroid gland to effectively reduce thyroid hormone production within a few weeks. 

What are the side effects of Anti-thyroid drugs?

While uncommon, rash, itching or joint paint may occur. 

In rare cases, patients who take these medications may experience low white blood cell count or liver damage. 

2. Radioactive Iodine Therapy (RAI)

This treatment involves the use of radioactivity to destroy thyroid cells slowly over time through small doses of radioactive iodine that is absorbed by the thyroid cells. RAI is orally administered once through a small capsule. It takes about 2-3 months to achieve its full effect but will be naturally removed from the body after a few days. 

Most patients only required one dose of RAI. Occasionally, some may need more the one dose to completely treat hyperthyroidism. 

Take note that RAI is not a suitable treatment for pregnant women and young children.

What are the side effects of RAI?

As iodine is not taken up significantly by other cells, the only common side effect is underactivity of the thyroid gland (also known as hypothyroidism) where too many thyroid cells are destroyed and the remaining gland does not produce enough hormone. 

However, this condition is easily diagnosed and treated through thyroid hormone replacement. The treatment fully replaces the hormone deficiency. Thereafter, patients would only need to undergo check-ups once or twice a year. 

On the other hand, patients with Grave's disease whose eyes are significantly affected may observe that their eye health deteriorates after RAI. In these circumstances, your doctor may prescribe steroids to hinder this side effect. 

What should I do after the RAI?

Avoid close contact with pregnant women and young children for a few days by:

  • Maintaining a 1m distance 
  • Not sharing food or utensils 
Additionally, practice good general hygiene by washing your hands frequently and flushing the toilet after usage. 

Anti-thyroid Medication and RAI

One commonly asked question is: "My hormone levels are now controlled on anti-thyroid medication. Why is my doctor recommending RAI?"

In a nutshell, there is a chance that hyperthyroidism may recur once a patient ceases his medication intake. As a matter of a fact, more than 50% of all patients experience this once they stop taking anti-thyroid medication. In fact, if hypothyroidism has already recurred once, there is a 90% chance of subsequent recurrence as TSH receptor antibodies (TRAb) tend to persist in the blood stream and continuously stimulate the thyroid gland to be hyperactive. If unmanaged, this could lead to serious damage to the heart and bones. 

3. Thyroid Gland Removal Surgery 

Removal of the thyroid gland is particularly recommended for patients that:

  • Have protruding goiter where it can appear cosmetically unattractive
  • Are concerned about cancer in the thyroid 
  • Are considering pregnancy and do not want to be on anti-thyroid medication 

What are the risks of Thyroid Gland Removal Surgery? 

The potential risks include:

  • Hypothyroidism if too much thyroid tissue is removed
  • Persistent hyperthyroid if insufficient tissue is removed
  • Damage to parathyroid glands 
    • Parathyroid glands lie very close to the thyroid and control calcium levels in the blood. When damaged, they must be treated long-term with calcium and vitamin D tablets 
  •  While rare, the nerves supplying the voice box may be damaged and result in a hoarse voice

Speak to our doctors about the ideal treatment to manage hyperthyroidism. 

The information provided is not intended as medical advice. Terms of use. Information provided by SingHealth