Treatments for Hyperthyroidism: Medications, Surgery, and Other Therapies
Treatment options vary, depending on what’s causing overactive thyroid. Learn more about which therapies and procedures can address the problem and ease symptoms.
Hyperthyroidism, also known as?overactive thyroid, is most commonly caused by Graves’ disease (an autoimmune disorder), thyroiditis (inflamed thyroid gland), or “toxic” thyroid nodules. Hyperthyroidism often leads to a range of symptoms (including weight loss, anxiety, and rapid heartbeat) that may improve or vanish altogether with treatment. (1) There are several effective treatments available for overactive thyroid.
The overall focus of hyperthyroid treatment is to prevent the thyroid gland from overproducing hormones. Some treatments can also help control symptoms and make you feel better, but you’ll first need to address the underlying cause, which is excess?thyroid hormone?production. (1)
Your treatment will depend on your age, the severity of the disease, your physical condition, the type of hyperthyroidism you have, and your personal preferences.
Possible treatments include radioactive iodine, surgery, and various medications. While some people tout the benefits of natural remedies, many have little or no data showing efficacy, and certain natural therapies may actually cause harm. Talk to your doctor before trying any alternative treatments for hyperthyroidism. (1)
Radioactive Iodine Therapy for Overactive Thyroid
Radioactive iodine is one of the oldest and most trusted forms of hyperthyroid treatment. Taking radioactive iodine kills the thyroid cells that produce thyroid hormones. This therapy has been used for more than 60 years. (1) In the United States, more than 70 percent of adults with hyperthyroidism are treated with radioactive iodine, according to the American Thyroid Association. (2)
“Radioactive iodine is a procedure that essentially destroys the thyroid gland, which prevents it from staying overactive,” explains Gregory Dodell, MD, an assistant clinical professor of medicine, endocrinology, diabetes, and bone disease at the Icahn School of Medicine at Mount Sinai in New York City. “It is possible that a patient who has radioactive iodine treatment will develop normal thyroid levels and not need medication. However, it is a possibility that they will become hypothyroid and require medication.”
Radioactive iodine is taken by mouth, after which it’s absorbed by the thyroid gland (quick fact: the thyroid gland is one of few tissues in the body that preferentially absorbs iodine). It shrinks the thyroid and improves symptoms, typically after three to six months. (1) For about two days following the actual procedure, patients themselves are technically radioactive and should isolate from others and avoid sharing items like dishware and towels.
Often, people who have radioactive iodine treatment develop permanent hypothyroidism (underactive thyroid). You may eventually need to take daily medications to replace the thyroid hormone thyroxine. (1)
Some people who undergo this treatment still have hyperthyroidism afterward, but their thyroid gland is usually less active than it was before the therapy.
Surgical Procedures to Treat Hyperthyroidism
Sometimes, doctors recommend a thyroidectomy (surgery to remove all or part of the thyroid gland) to treat hyperthyroidism. (1)
“If a patient has a large thyroid gland or nodules and is hyperthyroid, then surgery may be indicated,” says Dr. Dodell.
This procedure can also lead to permanent hypothyroidism, for which you’ll need to take a daily thyroid hormone supplement. (1,2)
Although rare, the risks of the surgery may include damage to the nerve that controls the vocal cords or to the parathyroid glands (located near the thyroid gland in the neck). If your doctor removes your parathyroid glands, you’ll need to take medication to ensure that your body gets enough calcium. (1)
Medications Used to Treat Hyperthyroidism
A number of different medications may be used to treat hyperthyroidism.
Treatment with these drugs usually lasts a year or longer, but your symptoms will probably improve within 6 to 12 weeks.
Methimazole?and propylthiouracil can both cause serious liver damage, but propylthiouracil poses this risk more often. Other serious side effects of these drugs include a possible?allergic reaction?and an increased risk of infection, and methimazole should not be used while pregnant.
Neither of these medicines causes permanent damage to the thyroid gland, which makes this option preferable for people?who don’t want to have a thyroidectomy. (1)
They can also help prevent palpitations, tremors, nervousness, and a rapid heart rate in people with hyperthyroidism. (1)
These medicines block the effects of thyroid hormone in your body. Common beta blockers include the following:
Graves’ Ophthalmopathy Treatment and Therapies
Graves’ disease is the most common?cause of hyperthyroidism. (3) People with this condition may develop?Graves’ ophthalmopathy?(also known as thyroid eye disease, or TED), which causes bulging eyes,?blurry vision, and sensitivity to light, due to inflammation from hyperthyroidism that causes inflammation behind the eyes. (1,4)
Aside from uncomfortable symptoms, thyroid eye disease can also cause vision loss in up to 20 percent of people. (4) There are several possible treatments for Graves’ ophthalmopathy. (1,4)
Artificial Tears or Ointments?These treatments can offer relief from?dry eyes.
Corticosteroids?These medicines can reduce the swelling behind the eyes and improve symptoms. A common type of?corticosteroids?is?prednisone. The downside to long-term use of prednisone?is the possibility of side effects, such as nausea and dizziness.
Monoclonal Antibody Infusions Teprotumumab (Tepezza) is a recently FDA-approved treatment delivered at a doctor’s office through an IV. In a study in The New England Journal of Medicine, teprotumumab showed a reduction in proptosis (eye bulging) and diplopia (double vision). This prescription medicine is “a promising, potential first-line therapy for treating TAO” (thyroid-associated ophthalmopathy), according to a review of studies in Expert Opinion on Investigational Drugs.
Orbital Decompression Surgery?In this procedure, a surgeon removes the bone between the eye socket and?sinuses. This surgery can improve vision and provide space for your eyes to return to their normal location.
Eye Muscle Surgery?This procedure can correct double vision, which sometimes occurs because scar tissue causes one or more of the eye muscles to become too short. A surgeon cuts the affected muscle from the eyeball and reattaches it farther back.
Radiation?This therapy is sometimes used to reduce swelling, double vision, and vision loss. Radiation can cause unwanted side effects, though, and may slightly increase your risk of developing tumors.
Home or Natural Remedies to Ease Symptoms of Hyperthyroidism
There are no proven supplements or herbs that work for treating hyperthyroidism. But certain lifestyle changes might help you manage your symptoms. It’s important to discuss such remedies with your doctor. “Patients often ask about changes they should make. My answer is almost always, ‘What is good for your body in general is good for your thyroid,’” says Dodell. This includes these lifestyle approaches:
Diet?While there’s no such thing as a hyperthyroid diet, there are certain dietary considerations that people with hyperthyroidism need to be aware of. First, getting enough calcium is important if you’ve had a thyroidectomy. The average adult needs at least 1,000 milligrams per day.?Vitamin D?can also help ward off the effects of a low calcium level on your bones. (1)
Too much iodine in the diet can also worsen hyperthyroid symptoms. Since iodine is used by the thyroid to make the hormone?thyroxine, high iodine intake could lead to even more hormone production by the thyroid gland. Some foods high in iodine include iodized salt, saltwater fish, and seaweed. (5)
Finally, you might need to watch the amount of food you eat when you’re recovering from hyperthyroidism. Since this condition can cause unintentional weight loss, a recovered thyroid gland could level out your metabolism, thereby causing your body to retain some of the energy you take in through calories. Talk to your doctor about your ideal weight and ask if you need to make any adjustments to your eating plan. (1)
Exercise?The following benefits of exercise are especially important for people with hyperthyroidism: (1)
- Better cardiovascular health
- Appetite control
- Weight management
- Increased bone density
- Better mood
Relaxation Techniques?Reducing stress can be just as important to your health as diet and exercise. People with Graves’ disease are at an increased risk of stress-induced health complications, which makes relaxation even more important. (1)
“I have seen patients with hyperthyroidism have a recurrence during a stressful time,” explains Dodell. “It is important to get enough sleep, eat a balanced diet, and find ways to manage stress.”
Meditation, yoga, and Tai Chi can all lessen stress. A short, leisurely walk outside can have a calming effect. Even a few minutes of deep breathing can impact your overall stress level. When repeated daily, relaxation techniques can make you feel better both mentally and physically.
Since there’s no one single treatment measure used for hyperthyroidism, your approach will depend on your overall condition, as well as the severity of your symptoms. If you’re not feeling an improvement in symptoms, see your doctor right away for further testing. With time and patience, you’ll find the treatment plan that works best for you.
Editorial Sources and Fact-Checking
- Hyperthyroidism (Overactive Thyroid): Diagnosis & Treatment.?Mayo Clinic.?November 14, 2020.
- Hyperthyroidism (Overactive).?American Thyroid Association.
- Graves Disease.?MedlinePlus.
- Thyroid Eye Disease (TED or Graves Eye Disease).?Kellogg Eye Center at the University of Michigan Health.
- Iodine.?National Institutes of Health Office of Dietary Supplements. April 28, 2022.
- Douglas RS, Kahaly GJ, Patel A, et al. Teprotumumab for the Treatment of Active Thyroid Eye Disease. The New England Journal of Medicine. January 23, 2020.
- Slentz DH, Nelson CC, Smith TJ. Teprotumumab: A Novel Therapeutic Monoclonal Antibody for Thyroid-Associated Ophthalmopathy. Expert Opinion on Investigational Drugs. July 2020.