What are your options once you have a formal diagnosis ? My goal with this post is to present what is out there, combined with a little of my personal experience.
The unfortunate circumstance for hyperthyroidism is that depending on the severity traditional medical treatments are truly limited. Antithyroid medication, beta blockers or radioactive iodine are the most common treatments, on occasion surgical intervention is required. What they don’t tell you, is that it’s a lifelong disease and whatever treatment path you take has to be sustained.
Medications are prescribed almost immediately or at least in my experience that was the first suggestion. The severity of my symptoms were extreme so I was immediately put on a medication called Methimazole. There is another medication called Propylthiouracil as well. I don’t have any personal experience with the second antithyroid agent, so I can’t particularly offer much feedback on that. The point here is that either medication should slow the production of T3 and T4.
The benefit to taking one medication versus another is variable. Methimazole can be taken one, two or three times daily based on your dosage. Methimazole has fewer side effects, and it may reverse hyperthyroidism faster. Propylthiouracil is most commonly prescribed to pregnant women as it has a lower risk of birth defects. The disadvantage is that it has to be taken in equal doses every 8 hours. The problem with the medications is that they aren’t meant for prolonged use and are not a lifelong solution.
Beta blockers such as Propranolol, Atenolol, Acebutolol, Oxprenolol, Nadolol and Timolol are prescribed to decrease the severity of certain symptoms. Those symptoms include rapid heart rate, palpitations, tremors, anxiety and heat intolerance. In my case I was prescribed Propranolol, and I will say that at the time it really helped with the tremors and heart rate as my resting heart rate was between 120 and 130 almost all the time.
As I mentioned in a prior section oral daily medications are not meant for prolonged use and are not a life long solution. Radioactive Iodine may be recommended to stop the thyroid function completely or kill cancer cells in the thyroid tissue. A Thyroid Scan and Radioactive Iodine Uptake test will be performed prior to suggesting this course of treatment. The uptake test and scan is performed with an agent called I-123. I-123 is harmless to thyroid cells but allows the doctor to see how quickly your thyroid will absorb the Radioactive Iodine agent if administered.
My doctor suggested this treatment or surgical intervention based on the fact that I had a goiter and oral medications had not slowed my thyroid function enough to see real relief of my symptoms. I also started to experience decreased liver function because of the use of antithyroid medication over a period. I chose to have the Radioactive Iodine treatment as in my opinion I thought surgery was too extreme.
Radioactive Iodine treatment is a fairly simple process. You are administered a Radioactive Iodine agent called I-131 usually in pill form. After you’ve taken the agent they will give you a list of precautions to take as you are now radioactive and you don’t want to expose other people to radiation by being in close proximity to them. Typically you can return to your normal activities within a week, but that could also vary based on the dosage. I was locked away for approximately 2 weeks due to the dosage I received.
Surgical intervention is not the most common or recommended option for hyperthyroidism as there are less invasive options. There are times when a partial or full thyroidectomy is recommended, such as a hot nodule, abnormally large thyroid gland, or multiple nodules that could be concerning for cancer.
At the end of the story a diagnosis such as this requires some due diligence and you really should look into what all of your options are. Your doctor will make recommendations, but it is entirely up to you whether you agree with those recommendations and proceed with a particular treatment.
The most important part is to be informed as to what is available to you and choose based on what makes sense for you. I almost feel like when it comes to health and doctors that at times we just acquiesce and go along with what we are told we should do. At the end of the day your health is up to you and what you choose to do with that will affect the rest of your life, so why not take control of your health and live your best life.
I hope that this post was informative, please feel free to share any feedback or comment anything you would like to see in future posts.