- Drug treatment with antithyroid drugs
- Ablation of the thyroid gland with Radioactive Iodine (RAI)
- Surgery to remove all or part of the thyroid
The focus for those with hyperthyroidism or Graves' disease, therefore, is to normalize thyroid function, if possible, and minimize any symptoms and side effects of the overactive thyroid.
Antithyroid Drug TreatmentAntithyroid drugs have been in use since the 1940s. They are given to help normalize the thyroid levels and eliminate symptoms by making it more difficult for the body to use iodine to produce the thyroid hormone. There are two key antithyroid drugs:
Methimazole -- Methimazole (pronounced meth-IM-a-zole), also known by its brand name, Tapazole (pronounced tap-UH-zole) and sometimes called "thiamazole," is used around the world.
Propylthiouracil -- Propylthiouracil (pronounced proe-pill-thye-oh-YOOR-a-sill) -- is usually abbreviated as PTU. There are no brand names of PTU in the United States; only generic PTU is available. PTU has two effects: not only does it inhibit the thyroid from using iodine to produce thyroid hormone, but it also inhibits T4-to-T3 conversion.
Carbimazole -- Carbimazole (pronounced car-BIM-a-zole) metabolizes to methimazole and is known by its brand name Neo-Mercazole. Along with PTU, and methimazole, it is used in the United Kingdom and in other places outside the United States.
Methimazole is the preferred antithyroid drug in the United States, except during the first trimester of pregnancy. Because of the risk of liver damage, PTU is not recommended, especially for children, and is only recommended by the FDA in cases where radioactive iodine or surgery are not options, and methimazole is ineffective or can not be tolerated. More information on antithyroid drugs is available in the following articles: