Thyroid Treatment

                  When treating hyperthyroidism, three methods are commonly utilized:  antithyroid drugs, radioactive iodine, and thyroidectomy.  Currently, there are two classes of antithyroid drugs available to hyperthyroidism patients.  One drug is methimazole, which acts on the autoimmune response to the thyroid.  Autoimmune reactions of the thyroid gland, caused by the conversion of thyrocytes to antigen presenting cells, can be amplified by abnormal expression of ICAM-1.  Methimazole inhibits IFN-γ and H₂O₂-induced expression of ICAM-1, effectively diminishing the autoimmune affects.  During treatment, it is administered at a dose of 10-40 mg/day.  Treatment is continued after signs disappear in order to maintain the inhibitory effects.   

                 Propylthiouracil, which is another antithyroid drug, inhibits thyroxine synthesis.  Thyroxine is a thyroid hormone which is overproduced in hyperthyroid patients.  Propylthiouracil inhibits its synthesis by binding to and inactivating thyroid peroxidase.  This also inhibits the conversion of thyroxine to tri-iodothyronine, another thyroid hormone.  Collectively, these effects reduce the symptoms of hyperthyroidism.  The drug is administered at a dose of 100-600 mg/day and continued after improvements are recognized.  The dose is calibrated based on a patient’s medical history and thyroid levels.   

                 Another method of hyperthyroid treatment is the use of radioactive iodine.  The radioactive iodine isotope, ¹³¹I, is administered to patients who either have not responded to medication or have an advanced case of hyperthyroidism.  ¹³¹I acts by destroying the thyroid cells that come into direct contact or are within a four to five mm range.  The method of administration is ingestion.  The body automatically processes ingested iodine by absorbing it and transporting it into the thyroid.  While historically, small doses were administered over time, this method has been reevaluated to be more dangerous than necessary.  Therefore, the current accepted approach is to administer one large dose.  While there are various side effects associated with the ingestion of a radioactive material, the consequences of avoiding treatment are far more severe.   

                 An alternative to the use of radioactive iodine is a thyroidectomy.  A thyroidectomy is the partial or full removal of the thyroid.  Like ¹³¹I, it is used as a last resort method of treatment for hyperthyroidism.  Thyroidectomy is an invasive procedure which results in the need for permanent thyroid hormone therapy.  However, the absence of the procedure when it is necessary only facilitates more dangerous consequences.   

 Hypothyroid treatment can be performed with supplements.  See details here.