Comparison of therapies for treating Graves’ Disease
Graves’ Disease is the most common cause of hyperthyroidism in the United States. The management of hyperthyroidism is important because if left untreated, the effects result in low quality of life and can be detrimental to one’s health. There are 3 forms of treatment available for hyperthyroidism. Each treatment has advantages and disadvantages.The first form of treatment is radioactive iodine (RAI). This therapy targets the thyroid gland with radioactive iodine, causing the shrinkage and destruction of the gland. In some cases, if destruction of the gland results in hypothyroidism, thyroid hormone replacement therapy is needed to restore euthyroidism.There are 2 antithyroid drugs that are used to treat hyperthyroidism in the United States. These are methimazole (MM) and propylthiouracil (PTU). These medications have the ability to block the thyroid from over producing thyroid hormones. The disadvantage are potential side effects of medications such as liver disfunction and low white blood cell count that can cause serious infections as well as other more minor side effects such as itching. Antithyroid medications will promote remission of Graves’ Disease in 25% to 40% of patients when used for at least 1 year. This means that in more than half of the patients treated with medications, there will be a need to use another form of treatment for long term control of Graves’ Disease.The last form of treatment for hyperthyroidism is a thyroidectomy. This is when part or all of the thyroid gland is surgically removed. After surgical removal of the thyroid gland, many patients need thyroid hormone treatment to maintain normal thyroid hormone levels. The major negative possible side effects of this treatment are Hypoparathyroidism, long term hypocalcemia and nerve damage that leads to voice disturbances.Deciding which treatment is best for you requires a conversation with your endocrinologist. All of the treatments come with side effects. Getting the facts and making a well educated decision is the best way to go when it comes to treating your over active thyroid.
