Hyperthyroidism: Should I Use Antithyroid Medicine or Radioactive Iodine?
Hyperthyroidism: Should I Use Antithyroid Medicine or Radioactive Iodine?Skip to the navigationYou may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them. Hyperthyroidism: Should I Use Antithyroid Medicine or Radioactive Iodine?Get the factsYour options- Take radioactive iodine. It destroys part or all of the thyroid
gland.
- Take antithyroid medicine. It lowers the amount of thyroid
hormone in your body.
Graves' disease is the most common
cause of hyperthyroidism. If your hyperthyroidism is not caused by Graves'
disease, this information may not apply to you. Key points to remember- Most people will be cured of hyperthyroidism after one dose of
radioactive iodine. The radioactivity in the iodine
kills most or all of your thyroid gland. This usually leads to
hypothyroidism, which means that your body makes too
little thyroid hormone. When you have hypothyroidism, you need to take thyroid
hormone medicine for the rest of your life.
- If you are pregnant or want to get pregnant within 6 months of
treatment, or if you are breastfeeding, you cannot use
radioactive iodine.
- You can use radioactive iodine after you
have been treated with antithyroid medicine.
- Radioactive iodine is often recommended if you have Graves' disease and are older than 50, or if you have
thyroid nodules that are releasing too much thyroid
hormone.
-
Antithyroid medicine works best if you have only mild
hyperthyroidism. It may also be a good choice if this is the first time you are
being treated for Graves' disease, if you are younger than 50, or if your
thyroid gland is only swollen a little bit (small
goiter).
- Antithyroid medicine does not damage your thyroid gland.
But it doesn't work for everyone, and you may have a
relapse.
FAQs When you have
hyperthyroidism, your thyroid gland makes too much
thyroid hormone. Thyroid hormones control your
metabolism-how your body turns food into energy-and
they influence your heart rate, digestion, muscle and bone strength, and
cholesterol levels. When you have too
much thyroid hormone, all of your body's functions speed up. Without
treatment, hyperthyroidism can lead to: - Heart problems.
- Bone
problems.
-
Thyroid storm. This is a life-threatening condition
that occurs when the thyroid releases a lot of thyroid hormone in a short
time.
Your doctor may recommend radioactive iodine if: - You have Graves' disease and you are older
than 50.
- You have thyroid nodules that are releasing too much
thyroid hormone.
- You have taken antithyroid medicine before and
have had a relapse.
Your doctor may recommend antithyroid medicine if: - Your hyperthyroidism is
mild.
- Your
thyroid gland is only swollen a little bit (small
goiter).
- You are younger than 50 and this is the first time you are
being treated for Graves' disease.
- You are pregnant, want to become
pregnant within 6 months of treatment, or are breastfeeding.
Compare your options | |
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What is usually involved? |
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What are the benefits? |
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What are the risks and side effects? |
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Radioactive iodine
Radioactive iodine
- You take one dose
of this medicine.
- Your symptoms start to go away in 8 to 12 weeks.
- You will probably need to take thyroid hormone medicine for the rest of your
life.
- Most people are cured after
one dose.
-
Side effects include an inflamed thyroid gland.
- Hypothyroidism
(having too little thyroid hormone) usually develops within a year.
Because of this, you will probably need to take thyroid hormone medicine for the rest of
your life.
- This treatment may make thyroid eye disease worse for a
while.
Antithyroid medicine
Antithyroid medicine
- You take this medicine
every day for 1 to 2 years.
- If it works, your symptoms start to go away in 1 to 8 weeks.
Your thyroid hormone levels may stay in the normal range even after you stop
taking this medicine.
- If it doesn't work, you can choose to take
radioactive iodine.
- The medicine is much more effective in people who have mild disease. Up to 30 out of 100 people in the United States will have their hyperthyroidism go away (go into
remission) after taking antithyroid medicine for 12 to 18 months.footnote 1
- The medicine may reduce your risk of
getting
thyroid eye disease.
-
Side effects include rash, itching, joint aches, liver problems, and being
less able to fight infection because of a low white blood cell
count.
- Medicine doesn't work for everyone. Relapses are common.
Who would
have thought that the symptoms I was having were caused by my thyroid gland? I
thought that they were just part of growing older. But after I decided to pay
attention and wrote down how I felt and told my nurse practitioner, she did
blood tests that showed that I had an overactive thyroid gland. Then she
referred me to a doctor for treatment. I have never been a guy who liked to
take medicine, so I opted to take radioactive iodine. I like the idea that I
only had to take it once and then it was over and done with. Now I take thyroid
hormone every day. But it's easy to take, and I just see my doctor once or
twice a year for monitoring. Some people
tell me that taking radioactive iodine is the best treatment for my thyroid
condition. But I don't like the idea of taking something that's radioactive.
Maybe I am too cautious. My doctor tells me that the amount of radioactive
iodine is so small that it doesn't cause problems. I just can't get past that
word "radioactive." I have decided to take antithyroid pills. I don't think
I'll have a problem with them. I have a pretty regular kind of life and take
vitamins every day, so remembering to take another pill won't make a big
difference to me. I took antithyroid medicine for my
overactive thyroid about 2 years ago. I had trouble remembering to take the
pills every day, and sometimes when I would go out of town to visit my family,
I would forget to take my pills with me. Now, my thyroid is acting up again. I
don't want to mess with pills. I worry that I might get some of those side
effects from taking medicine. I have decided to take radioactive iodine. I know
that I have a risk of hypothyroidism because of this treatment, but
I am willing to take thyroid hormone pills if that happens. My neighbor
Geraldo took radioactive iodine for his overactive thyroid gland, and his
thyroid gland became underactive. So now he has to take thyroid hormones. I
guess I'll just skip the radioactive iodine and take pills. Besides, my doctor
tells me that because of my age I might even be able to stop taking the pills
and never have to take them again. That sounds good to me. What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to take antithyroid medicine Reasons to take radioactive iodine I'm worried that radioactive iodine will damage my thyroid and I'll have to take thyroid hormone pills for the rest of my life. I can live with the damage to my thyroid, because I know I can take thyroid hormone pills to treat it. More important Equally important More important I don't mind taking pills for a few years to see if that will fix my thyroid problem. I want to get my thyroid problem taken care of quickly. More important Equally important More important I worry more about putting something radioactive into my body than about side effects of antithyroid medicine. I worry more about side effects of antithyroid medicine than about putting something radioactive into my body. More important Equally important More important My other important reasons: My other important reasons: More important Equally important More important Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Taking antithyroid medicine Taking radioactive iodine Leaning toward Undecided Leaning toward What else do you need to make your decision?1.
How sure do you feel right now about your decision? Not sure at all Somewhat sure Very sure Your SummaryHere's a record of your answers. You can use it to talk with your doctor or loved ones about your decision. Next stepsWhich way you're leaningHow sure you areYour commentsKey concepts that you understoodKey concepts that may need reviewCredits | Author | Healthwise Staff |
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| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
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| Primary Medical Reviewer | Adam Husney, MD - Family Medicine |
|---|
| Specialist Medical Reviewer | Jennifer Hone, MD - Endocrinology, Diabetes and Metabolism |
|---|
| Specialist Medical Reviewer | David C.W. Lau, MD, PhD, FRCPC - Endocrinology |
|---|
References Citations - Bahn RS, et al. (2011). Hyperthyroidism and other causes of thyrotoxicosis: Management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Thyroid, 21(6): 593-646. Also available online: http://www.liebertonline.com/doi/full/10.1089/thy.2010.0417.
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them. Hyperthyroidism: Should I Use Antithyroid Medicine or Radioactive Iodine?Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision. - Get the facts
- Compare your options
- What matters most to you?
- Where are you leaning now?
- What else do you need to make your decision?
1. Get the FactsYour options- Take radioactive iodine. It destroys part or all of the thyroid
gland.
- Take antithyroid medicine. It lowers the amount of thyroid
hormone in your body.
Graves' disease is the most common
cause of hyperthyroidism. If your hyperthyroidism is not caused by Graves'
disease, this information may not apply to you. Key points to remember- Most people will be cured of hyperthyroidism after one dose of
radioactive iodine. The radioactivity in the iodine
kills most or all of your thyroid gland. This usually leads to
hypothyroidism, which means that your body makes too
little thyroid hormone. When you have hypothyroidism, you need to take thyroid
hormone medicine for the rest of your life.
- If you are pregnant or want to get pregnant within 6 months of
treatment, or if you are breastfeeding, you cannot use
radioactive iodine.
- You can use radioactive iodine after you
have been treated with antithyroid medicine.
- Radioactive iodine is often recommended if you have Graves' disease and are older than 50, or if you have
thyroid nodules that are releasing too much thyroid
hormone.
-
Antithyroid medicine works best if you have only mild
hyperthyroidism. It may also be a good choice if this is the first time you are
being treated for Graves' disease, if you are younger than 50, or if your
thyroid gland is only swollen a little bit (small
goiter).
- Antithyroid medicine does not damage your thyroid gland.
But it doesn't work for everyone, and you may have a
relapse.
FAQs What is hyperthyroidism?When you have
hyperthyroidism, your thyroid gland makes too much
thyroid hormone. Thyroid hormones control your
metabolism-how your body turns food into energy-and
they influence your heart rate, digestion, muscle and bone strength, and
cholesterol levels. When you have too
much thyroid hormone, all of your body's functions speed up. What are the risks of hyperthyroidism?Without
treatment, hyperthyroidism can lead to: - Heart problems.
- Bone
problems.
-
Thyroid storm. This is a life-threatening condition
that occurs when the thyroid releases a lot of thyroid hormone in a short
time.
Why might your doctor recommend one treatment over the other?Your doctor may recommend radioactive iodine if: - You have Graves' disease and you are older
than 50.
- You have thyroid nodules that are releasing too much
thyroid hormone.
- You have taken antithyroid medicine before and
have had a relapse.
Your doctor may recommend antithyroid medicine if: - Your hyperthyroidism is
mild.
- Your
thyroid gland is only swollen a little bit (small
goiter).
- You are younger than 50 and this is the first time you are
being treated for Graves' disease.
- You are pregnant, want to become
pregnant within 6 months of treatment, or are breastfeeding.
2. Compare your options| | Radioactive iodine
| Antithyroid medicine
|
|---|
| What is usually involved? | - You take one dose
of this medicine.
- Your symptoms start to go away in 8 to 12 weeks.
- You will probably need to take thyroid hormone medicine for the rest of your
life.
| - You take this medicine
every day for 1 to 2 years.
- If it works, your symptoms start to go away in 1 to 8 weeks.
Your thyroid hormone levels may stay in the normal range even after you stop
taking this medicine.
- If it doesn't work, you can choose to take
radioactive iodine.
|
|---|
| What are the benefits? | - Most people are cured after
one dose.
| - The medicine is much more effective in people who have mild disease. Up to 30 out of 100 people in the United States will have their hyperthyroidism go away (go into
remission) after taking antithyroid medicine for 12 to 18 months.1
- The medicine may reduce your risk of
getting
thyroid eye disease .
|
|---|
| What are the risks and side effects? | -
Side effects include an inflamed thyroid gland.
- Hypothyroidism
(having too little thyroid hormone) usually develops within a year.
Because of this, you will probably need to take thyroid hormone medicine for the rest of
your life.
- This treatment may make thyroid eye disease worse for a
while.
| -
Side effects include rash, itching, joint aches, liver problems, and being
less able to fight infection because of a low white blood cell
count.
- Medicine doesn't work for everyone. Relapses are common.
|
|---|
Personal storiesPersonal stories about treatment for hyperthyroidism
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"Who would have thought that the symptoms I was having were caused by my thyroid gland? I thought that they were just part of growing older. But after I decided to pay attention and wrote down how I felt and told my nurse practitioner, she did blood tests that showed that I had an overactive thyroid gland. Then she referred me to a doctor for treatment. I have never been a guy who liked to take medicine, so I opted to take radioactive iodine. I like the idea that I only had to take it once and then it was over and done with. Now I take thyroid hormone every day. But it's easy to take, and I just see my doctor once or twice a year for monitoring." "Some people tell me that taking radioactive iodine is the best treatment for my thyroid condition. But I don't like the idea of taking something that's radioactive. Maybe I am too cautious. My doctor tells me that the amount of radioactive iodine is so small that it doesn't cause problems. I just can't get past that word "radioactive." I have decided to take antithyroid pills. I don't think I'll have a problem with them. I have a pretty regular kind of life and take vitamins every day, so remembering to take another pill won't make a big difference to me." "I took antithyroid medicine for my overactive thyroid about 2 years ago. I had trouble remembering to take the pills every day, and sometimes when I would go out of town to visit my family, I would forget to take my pills with me. Now, my thyroid is acting up again. I don't want to mess with pills. I worry that I might get some of those side effects from taking medicine. I have decided to take radioactive iodine. I know that I have a risk of hypothyroidism because of this treatment, but I am willing to take thyroid hormone pills if that happens." "My neighbor Geraldo took radioactive iodine for his overactive thyroid gland, and his thyroid gland became underactive. So now he has to take thyroid hormones. I guess I'll just skip the radioactive iodine and take pills. Besides, my doctor tells me that because of my age I might even be able to stop taking the pills and never have to take them again. That sounds good to me." 3. What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to take antithyroid medicine Reasons to take radioactive iodine I'm worried that radioactive iodine will damage my thyroid and I'll have to take thyroid hormone pills for the rest of my life. I can live with the damage to my thyroid, because I know I can take thyroid hormone pills to treat it. More important Equally important More important I don't mind taking pills for a few years to see if that will fix my thyroid problem. I want to get my thyroid problem taken care of quickly. More important Equally important More important I worry more about putting something radioactive into my body than about side effects of antithyroid medicine. I worry more about side effects of antithyroid medicine than about putting something radioactive into my body. More important Equally important More important My other important reasons: My other important reasons: More important Equally important More important 4. Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Taking antithyroid medicine Taking radioactive iodine Leaning toward Undecided Leaning toward 5. What else do you need to make your decision?
Check the facts
1.
Which treatment is more likely to cure hyperthyroidism? You are right. Most people will be cured after one dose of radioactive iodine. But this treatment isn't for everyone. 2.
When does antithyroid treatment work best? You're right. Antithyroid medicine works best if you have only mild hyperthyroidism. 3.
Which treatment eventually leads to hypothyroidism (having too little thyroid hormone) in most people? You are right. This treatment works by killing most or all of the tissue in the thyroid gland. Over time, this leads to hypothyroidism in most people, so they need to take thyroid hormone medicine. Decide what's next1.
Do you understand the options available to you? 2.
Are you clear about which benefits and side effects matter most to you? 3.
Do you have enough support and advice from others to make a choice? Certainty1.
How sure do you feel right now about your decision? Not sure at all Somewhat sure Very sure 2.
Check what you need to do before you make this decision. Credits | By | Healthwise Staff |
|---|
| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
|---|
| Primary Medical Reviewer | Adam Husney, MD - Family Medicine |
|---|
| Specialist Medical Reviewer | Jennifer Hone, MD - Endocrinology, Diabetes and Metabolism |
|---|
| Specialist Medical Reviewer | David C.W. Lau, MD, PhD, FRCPC - Endocrinology |
|---|
References Citations - Bahn RS, et al. (2011). Hyperthyroidism and other causes of thyrotoxicosis: Management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Thyroid, 21(6): 593-646. Also available online: http://www.liebertonline.com/doi/full/10.1089/thy.2010.0417.
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.Current as of:
May 3, 2017 Bahn RS, et al. (2011). Hyperthyroidism and other causes of thyrotoxicosis: Management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Thyroid, 21(6): 593-646. Also available online: http://www.liebertonline.com/doi/full/10.1089/thy.2010.0417. Last modified on: 8 September 2017
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