Hyperthyroidism treatments

Hyperthyroidism is an excessive concentration of thyroid hormones in tissues caused by increased synthesis of thyroid hormones, excessive release of preformed thyroid hormones, or an endogenous or exogenous extrathyroidal source. The most common causes of an excessive production of thyroid hormones are Graves disease, toxic multinodular goiter, and toxic adenoma. The most common cause of an excessive passive release of thyroid hormones is painless (silent) thyroiditis, although its clinical presentation is the same as with other causes. Hyperthyroidism caused by overproduction of thyroid hormones can be treated with antithyroid medications (methimazole and propylthiouracil), radioactive iodine ablation of the thyroid gland, or surgical thyroidectomy. Radioactive iodine ablation is the most widely used treatment in the United States. The choice of treatment depends on the underlying diagnosis, the presence of contraindications to a particular treatment modality, the severity of hyperthyroidism, and the patient's preference. Hyperthyroidism is an excessive concentration of thyroid hormones in tissues causing a characteristic clinical state. In the United States, the overall prevalence of hyperthyroidism is 1.2%, and the prevalences of overt hyperthyroidism and subclinical hyperthyroidism are 0.5% and 0.7%, respectively. Clinical recommendation Evidence rating References The choice of treatment modality for hyperthyroidism caused by overproduction of thyroid hormones depends ...

Dear Dr. Roach: I had a thyroidectomy, and I take levothyroxine. Instructions for the medication say not to take it within four hours of having calcium. No discussion of the drug has clearly stated whether this only refers to calcium supplements or whether this also includes high-calcium foods. I usually take levothyroxine when I wake up, between 2 a.m. and 3:30 am, to avoid breakfast dairy products (i.e. yogurt, cheese and soy milk) and dinner foods (broccoli, leafy greens, dairy and soy). I go to bed fairly early. I eat mainly plant-based, plus dairy. I have asked some doctors and pharmacists only to have them answer with the question: “Doesn’t that apply only to supplements?” I don’t know! That’s why I’m asking. I want my thyroid prescription to work as it is supposed to. Can you shed light on this issue? — E.G. Dear E.G.: Large amounts of elemental calcium do decrease the absorption of the thyroid hormone, thyroxine (Synthroid and others). If you were to take thyroxine at the same time as a large calcium pill, you could expect the thyroid medicine to be about 7% to 8% less absorbed. (Iron and caffeine also decrease thyroid hormone absorption.) A glass of cow’s milk taken at the same time decreases thyroid hormone absorption. Soy milk has not been studied, but I would expect calcium-fortified soy milk to be similar to milk, yogurt and perhaps some high-calcium cheeses, in their ability to reduce thyroxine absorption. However, I think you may be taking things too far. O...