Graves' disease hyperthyroidism medical therapy

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{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

  • Does not influence course of disease
  • Use cautiously in patients with asthma, CHF

, bradyarrhythmias or Raynaud’s

phenomenon

  • Use cardioselective beta-blockers,

especially in patients with

COPD

  • Use calcium-channel

blockers as alternative

References

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