Treatment for hyperthyroidism

Hyperthyroidism is a condition characterized by excessive thyroid hormones in the bloodstream.


Diagnosis of hyperthyroidism (overactivity of the thyroid gland)

The definitive diagnosis of hyperthyroidism is simple if there is already a suspicion. Accurate blood tests are available to confirm or rule out the diagnosis within a day or two.

Thyroid hormone levels, T3 and T4, are measured in the blood and at least one must be elevated to make the diagnosis of hyperthyroidism.
It is also useful to measure the level of thyroid stimulating hormone (TSH).
This hormone is released by the pituitary gland (pituitary gland) into the bloodstream to stimulate the thyroid gland to produce the thyroid hormones.
The pituitary gland constantly controls our thyroid hormone levels, and when it detects even the slightest excess of thyroid hormone in the blood, it stops TSH production.
Consequently, a lowered TSH level in the blood indicates that the thyroid gland produces too many hormones.
Other special examinations are rarely done to distinguish between the different causes of hyperthyroidism.
Since the thyroid gland normally needs iodine to produce thyroid hormones, measuring the amount of radioactive iodine or technetium absorbed by the thyroid gland can be a viable way to measure its activity.
The radiation dose in these tests is very low and does not cause any side effects.
These examinations and the radioactive uptake in the thyroid gland are often important to know what treatment needs to be carried out in a patient with hyperthyroidism.
It is especially important that the doctor knows whether the hyperthyroidism is caused by Graves’ disease.

What tests are needed to diagnose hyperthyroidism?

Blood test

The thyroid stimulating hormone (TSH) produced in the pituitary gland is lowered in hyperthyroidism.
Therefore, the diagnosis of hyperthyroidism is almost always associated with low TSH levels.
If the TSH level is not lowered, other tests must be performed.
The level of thyroid hormones (T3, T4) is higher than normal in hyperthyroidism.

Normal values:
FT3 (free triiodothyronine) 3-6 pg/ml FT4 (free thyroxine) 0.7-2.2 ng/ml TSH (thyrotropic hormone) 0.5-4 U/ml

These figures may vary depending on the laboratory in which the analyses were made.
To be able to say that a patient suffers from hyperthyroidism, all thyroid hormones must have elevated levels.
Sometimes not all are elevated and only one or two measurements show elevated values.
This doesn’t happen often, as most people with hyperthyroidism have all levels elevated above the norm (except the TSH).

Echography of the thyroid gland shows whether the cause is a single lump or the entire thyroid gland.
If the doctor deems it necessary, it is necessary to perform a scintigraphy with a tracer.
Iodine 131 or technetium 99 is injected into a vein.
The scintigraphy machine has a special camera that captures the images of the thyroid gland.

What is the therapy for hyperthyroidism?

The doctor may prescribe so-called beta-blockers to relieve some symptoms, such as tachycardia, arrhythmias, tremor, mood swings, and sweating.
These can help improve the condition while the doctor decides which therapy to recommend to the patient.
Hyperthyroidism can cause very serious problems.
Drugs for the thyroid gland and radioactive iodine are therapies that doctors use most often.
The best treatment depends on a number of factors, including age. Some people need more than one type of therapy.
Radioactive iodine is the most common treatment. Most people are cured after administering a dose.
This therapy destroys parts of the thyroid gland, but does not harm other parts of the body.
Antithyroid drugs (drugs used to inhibit thyroid function) work better for mild symptoms. You have to take them at the same time every day.
These tablets do not harm the thyroid gland. Unfortunately, however, they do not always work.
If they no longer work, it may be necessary to carry out radioiodine therapy.

How to treat hyperthyroidism?

The medical therapy options are:
• Symptom treatment
• Thyrostatics
• Radioactive iodine
• Surgical intervention

Treatment of hyperthyroidism symptoms

There are medications to immediately treat the symptoms caused by excessive thyroid hormones, for example, a heart rate that is far too fast.
Some of the main classic medications used to treat these symptoms are beta-blockers. For example:

  • Propranolol (Obsidan)
  • Atenolol (Tenormin, Atenil, Selobloc)
  • Metoprolol (Beloc, Lopresor)

These drugs counteract the metabolism-enhancing effect of thyroid hormones, but do not alter thyroid hormone levels in the blood.
The doctor determines which patients should receive this treatment based on a number of variables, including the cause of hyperthyroidism, the age of the patient, the size of the thyroid gland, and the simultaneous presence of other conditions.


There are mainly two thyrostatics: methimazole (Thyrozole) and propylthiouracil (PTU).
These drugs accumulate in the tissues of the thyroid gland and block the production of thyroid hormones.
PTU also blocks the conversion of the hormone T4 to the more metabolically active T3.
The greatest risk of these drugs is suppression of the production of white blood cells in the bone marrow (agranulocytosis).
The white blood cells are important for fighting infections.
It is not possible to predict when this side effect will occur, so counting white blood cells in the blood is not helpful.

Patients need to know that if signs of infections such as sore throat or fever develop while taking methimazole or propylthiouracil, they should seek immediate medical attention. Although one must be careful, the actual risk of developing agranulocytosis is less than 1%.
In general, patients should be monitored by their doctor at monthly intervals while taking antithyroid drugs.
The dose must be regulated in such a way that the thyroid hormones are kept at a level that is as normal as possible (euthyroid).
Once the dose has been determined, patients can be monitored by a doctor at three-month intervals if long-term use is planned.
Usually, long-term therapy with antithyroid drugs is only carried out in patients with Graves’ disease, because this disease can be temporarily cured with the drug (controlled hormone levels) without radiation treatment or surgery.

For treatment periods of one to two years, the remission rates are 50% – 70%.
If the disease is in remission, the gland is no longer overactive and the antithyroid drugs are no longer required.
Unfortunately, there is no certainty that thyroid levels will normalize under the drug. Therefore, one should do blood tests every 2 months to see if the dose needs to be changed.

Recent studies have also shown that adding a thyroid hormone to the thyroid actually brings a better result with a higher rate of remission.
The reason for this may be that through an external source for the provision of thyroid hormone, the antithyroid drugs, which can suppress the overactive immune system in people with Graves’ disease, can be taken in much higher doses.

However, this type of therapy is controversially discussed.
If the long-term therapy is interrupted, patients must continue to present themselves to the doctor every three months in the first year, because a recurrence of Graves’ disease is most likely during this time.
If the patient experiences a relapse, therapy with thyrostatic drugs can be carried out again or radioiodine therapy can be considered.

Radioactive iodine in hyperthyroidism

The radioactive iodine is administered in oral form once (tablet or liquid) for the ablation of an overactive thyroid gland.
Radioactive iodine is administered after routine scintigraphy.
Iodine absorption is measured to confirm hyperthyroidism. The radioactive iodine is absorbed by the active cells of the thyroid gland and destroys them. Since the iodine is absorbed only by the active cells of the thyroid gland, the destruction occurs only locally and without diffuse side effects.
Radioiodine therapy has been used safely for over 50 years, the only contraindications are pregnancy and lactation.
This form of therapy is the preferred remedy for Graves’ disease, in patients with serious heart disease, multinodular goiter or toxic adenomas, and in patients who do not tolerate antithyroid drugs.
Radioactive iodine must be taken with caution by patients with eye disorders caused by Graves’ disease, as recent studies have shown that the eye disease can worsen after therapy.

Pregnancy If a woman wants to become pregnant after an ablation, it is advisable to wait 8-12 months after treatment before conceiving.
In general, more than 80% of patients are treated with a single dose of radioactive iodine. The thyroid gland needs about 8-12 weeks after therapy to work normally. Permanent hypothyroidism is the main complication of this form of therapy. A transient hypothyroitic condition can occur up to six months after treatment with radioactive iodine. If hypothyroidism persists for more than six months, replacement therapy for the thyroid gland (with T4 or T3) is usually started.

When to operate? Surgical intervention in hyperthyroidism

Surgery to partially remove the thyroid gland (partial thyroidectomy) was a common form of treatment for hyperthyroidism.
The goal was to remove the thyroid tissue that produced excessive hormones. However, if too much tissue is removed, this can lead to insufficiency in the production of thyroid hormones (hypothyroidism).
In this case, substitution therapy of the thyroid gland begins. The main complication of surgery is injury to surrounding tissues, including innervation of the vocal cords and the four small parathyroid glands in the neck area that regulate calcium levels (calcemia): parathyroid or parathyroid glands.
Accidental removal of these glands can lead to decreased calcium levels, requiring substitution treatment.
With the introduction of radioiodine therapy and therapy with antithyroid drugs, surgery for hyperthyroidism is no longer performed as frequently as it used to be.

The operation is suitable for:
1. pregnant women and children who react negatively to antithyroid drugs;
2. Patients with a greatly enlarged thyroid gland, especially if the surrounding tissue is compressed and there are symptoms such as difficulty swallowing, hoarseness and shortness of breath.

Natural remedies for hyperthyroidism

If hyperthyroidism is not severe and the patient does not want to take medication, he can lead a normal life by changing eating habits and lifestyle.
If the symptoms are disabling and do not allow a normal life, you should consult a doctor in any case.

Many symptoms are related to nervousness and restlessness and the eyes are also less reddened and swollen when it is possible to sleep better.
It is important to do regular physical activity at least 4 times a week at medium or high intensity in order to sleep better and be more relaxed during the day.
Reiki, Shiatsu and Yoga are natural therapies for relaxation and work better when done daily or at least 4 times a week.

What should you eat? Diet and nutrition for hyperthyroidism

There are several recommended diets. The author has chosen to cover in this article the blood type diet of Dr. D’Adamo and Dr. Mozzi, the hygienism of Shelton, and the diet recommended by conventional medicine.

According to the blood type diet, a person should eat certain foods based on the particular blood type (0, A, B or AB) and avoid others. A particular food may be beneficial for group 0, but harm people in group A and vice versa.
As a rule, problems on the thyroid gland are caused by cereal products (mostly by those that contain gluten, but also by others), fruits and desserts.
By avoiding these foods or restricting them as much as possible, the thyroid gland should function normally. There are many positive reports about it from patients.
In this type of diet, it is recommended to eat a lot of animal protein and vegetables, especially in people of blood type 0, who make up about 45% of the population.
However, there are some contraindications due to excessive protein:

  • constipation or constipation
  • Halitosis
  • Excessive demands on the kidneys (with the possible formation of kidney stones) and the liver
  • Accumulation of uric acid in the joints (gout)

Hygienism by Shelton (vegan diet)
In addition to explaining the usefulness of fasting cures, Shelton recommends a vegan diet and primarily raw food.
Recommended foods for hyperthyroidism are:

  • Watercress
  • Cabbage
  • Carrots
  • Lemon
  • Tropical fruits: banana, papaya and pineapple
  • Non-tropical fruits: citrus fruits, persimmons, apples and grapes
  • Figs and raisins
  • Corn and polenta
  • Whole grains with low sugar content that avoid blood sugar spikes and satisfy hunger

To avoid:

  • Refined grain products
  • Sweets and sugar (gradually reduce)
  • Animal protein, eggs, milk and dairy products

This type of diet is characterized by the fact that it is very rich in vitamins and minerals, while it affects the frequency of stool and can cause diarrhea, hemorrhoids and glycemia due to fructose.

Differences and similarities of both diets
These two diets have many elements in common: both recommend lots of vegetables, lemon and dried fruits. Foods to avoid include cereals containing gluten and desserts.
The main difference is that the blood type diet recommends meat, fish and eggs (especially for people with blood type 0) and advises against fruit, whereas the hygienistic/vegan diet claims the opposite.

You should try both diets for at least 1 week to see which one brings the most benefits. In this way, you can make a better choice.

Academic medicine
Experts advise patients with hyperthyroidism to take most nutrients through a balanced diet.

Salt is a food not recommended because it is a source of iodine. In addition, a low-salt diet prevents other circulatory disorders such as swollen hands and swollen feet.

Iodized salt should be avoided absolutely, because it can increase thyroid hormone levels.
Do not take medication during pregnancy and breastfeeding. Therefore, it is necessary to cure oneself through diet and observe the rules of natural health care (diet, sun, physical activity, etc.).

Dietary supplement Iodine is an important mineral for the thyroid gland. However, people with an autoimmune thyroid disease may be sensitive to the damaging side effects of iodine.
Taking iodine drops or eating foods high in iodine, such as algae (palmaria palmata, kelp or laminariales), can cause or worsen hyperthyroidism.

Women need more iodine when they are pregnant, about 250 micrograms per day, because the child absorbs the iodine from the mother’s food. In the United States, about 7 percent of pregnant women get too little iodine from food or prenatal vitamins.
With iodized table salt and prenatal vitamins with added iodine, an adequate intake can be guaranteed.
To ensure safe treatment, taking supplements such as iodine should be discussed with the doctor.

How long does the disease last? Expectations, treatment and prognosis

Hyperthyroidism is generally treatable and rarely life-threatening.
Some causes can disappear without treatment.
Hyperthyroidism caused by Graves’ disease usually worsens over time. This disease carries many complications, some of which are serious and can affect the quality of life.

Controls for hyperthyroidism

Regular check-ups are recommended, even after completion of treatment.
Regular blood tests (at least once a year) are very important to check proper thyroid hormone (thyroxine) levels.
The family doctor can prescribe examinations.
This happens because some people may develop hyperthyroidism at a later date.
Other patients who have been successfully treated may develop a hypothyroidism condition in the future.
In this case, as a rule, thyroxine tablets are taken.

Prevention of hyperthyroidism

Those who suffer from an overactive thyroid gland may experience a slight deterioration if they live by the sea or go on holiday by the sea, because there the iodine concentration is slightly higher.
A holiday in the mountains would be better.
However, the iodine must be swallowed to enter the cycle, so there is no evidence that the sea air causes deterioration.

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