Treatment and Medication Options for Graves’ Disease
With the right treatment, Graves’ disease can be well controlled. The three treatment options for Graves’ disease are medicine, radioiodine therapy, and thyroid surgery. Your doctor will help you decide which treatment is best for you based on your age, whether you are pregnant, or whether you have other medical conditions.
Radioiodine Therapy
Radioiodine therapy entails taking radioactive iodine-131 (I-131) orally as a capsule or liquid. I-131 slowly destroys the cells of the thyroid gland that produce thyroid hormone. In some cases, you may need more than one radioiodine treatment to bring your thyroid hormone levels into the normal range, but it’s not likely.
Medication Options
Researchers have been exploring the use of targeted immunotherapy drugs to treat Graves’ disease and clinical trials are underway. But for now, medications used to treat Graves’ disease include:
Beta-Blockers Beta-blockers don’t stop your thyroid from producing thyroid hormone, but they can quickly improve symptoms such as an irregular heartbeat, tremors, anxiety, irritability, heat intolerance, sweating, diarrhea, and muscle weakness. Beta-blockers include:
- propranolol (Inderal LA, InnoPran XL, Hemangeol)
- atenolol (Tenormin)
- metoprolol (Lopressor, Toprol-XL)
- nadolol (Corgard)
Antithyroid Medicines Antithyroid medicines – generally methimazole (Tapazole) or propylthiouracil (PTU) in rare instances such as the first trimester of pregnancy – cause your thyroid to make less thyroid hormone by preventing the thyroid from using iodine to make hormones. They don’t cure Graves’ disease, but for many people they control the hyperthyroidism while you’re on the medication and reduce symptoms.
Antithyroid medicines can cause the following side effects:
- Allergic reactions, including rashes and itching
- A decrease in the number of white blood cells in your body, which can lower resistance to infection
- Rarely, liver failure
Methimazole can be used for 12 to 18 months and then discontinued if your levels of thyroid hormone and antibodies are normal. If levels remain elevated, chances for remission are much lower, and treatment with antithyroid drugs can be prolonged safely and may increase chances of remission. However, if hyperthyroidism due to Graves’ disease continues beyond six months, your doctor may recommend either radioactive iodine or surgery.
Thyroid Surgery
Surgery to remove the thyroid gland effectively cures hyperthyroidism, but you’ll then need to take thyroid hormone medicine every day for the rest of your life. Surgery may be used to treat people with large goiters, people with moderate to severe Graves’ ophthalmopathy, and pregnant women who want to avoid the effects of antithyroid medicines on the fetus (radioiodine therapy isn’t safe during pregnancy).
Complementary Therapies
Stress may trigger Graves’ disease or make it worse, so stress-relieving practices can help, such as meditation, taking a warm bath, and walking.
Treating Graves’ Ophthalmopathy
The majority of Graves’ ophthalmopathy cases are mild, and eye drops can help relieve the irritation and sunglasses can help with light sensitivity. If you can’t fully close your eyes, taping your lids shut at night or wearing an eye mask can help prevent dryness.
For severe cases, steroids may be prescribed. Surgery can improve bulging eyes and correct vision changes.
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