Hyperthyroidism Treatment

  Currently, there are three main approaches to treating hyperthyroidism, including internal antithyroid drug (ATD) therapy, 131I therapy in nuclear medicine, and surgical treatment.  Internal ATD treatment is effective and relatively mild, and the dosage can be adjusted in time during the treatment. The disadvantage is that the treatment duration is long, usually requiring standardized medication for 1-2 years; during treatment, ATD may cause damage to liver, kidney function and hematopoietic system, requiring frequent laboratory tests during treatment and requiring discontinuation of medication if it occurs. In addition, the disadvantage of ATD treatment is that hyperthyroidism is prone to recurrence when the drug is stopped or reduced, and the recurrence rate of ATD treatment has been reported to be around 40%-60%.  131I treatment is simple and usually only one dose of 131I is taken, and the symptoms of hyperthyroidism start to show improvement in about one month after treatment. Therefore, it is suitable for the treatment of patients with hyperthyroidism whose liver and kidney functions are abnormal or whose blood cells are reduced due to ATD treatment. A major complication of 131I therapy is hypothyroidism, and studies have shown that most people with hypothyroidism occurring within one year of 131I therapy (early hypothyroidism) can return to normal after thyroid hormone replacement therapy; however, hypothyroidism occurring after one year of 131I therapy (late hypothyroidism) often requires a longer period of adjustment or lifelong treatment. However, hypothyroidism that occurs after one year of 131I therapy (advanced hypothyroidism) often requires longer-term conditioning or lifelong thyroid hormone replacement therapy.  Surgical treatment usually involves subtotal thyroidectomy for hyperthyroidism, which is a rapid treatment for hyperthyroidism and is suitable for patients with hyperthyroidism with nodules. Some patients still have recurrence of hyperthyroidism or hypothyroidism after surgery.