Understanding the Update to the Treatment Guidelines for Hyperthyroidism
Education & Research For those living with an overactive thyroid, new research could present help for living with, and treating, the condition.
If you have an overactive thyroid, you’ve probably heard someone jealously proclaim, “Wow, you can eat all you want and not gain weight.” Yet this is a complex medical condition that, left untreated, can cause bone loss, muscle wasting, heart problems and even death.
To keep physicians and patients informed on the latest research, an American Thyroid Association task force recently updated its "Guidelines for Diagnosis and Management of Hyperthyroidism and other causes of Thyrotoxicosis." The guidelines were published in Thyroid, an official peer-reviewed journal of the ATA published by Mary Ann Liebert, Inc., publishers and are available for free, via the ATA website.
Treating the condition
Thyrotoxicosis refers to having excessive levels of thyroid hormone in the body and can occur because of hyperthyroidism (overactive thyroid), inflammation of the thyroid, ingesting too much thyroid hormone from external sources, or other causes. Graves’ disease, an autoimmune condition, is the most common cause of hyperthyroidism.
“Another critical finding is that the supplement biotin interferes with thyroid function tests.”
Treatment depends on the exact diagnosis. For Graves’ disease, options include antithyroid medications (ATDs), radioiodine therapy (RAI) and thyroidectomy. Factors affecting the treatment decision include patient preference, pregnancy planning and the presence or absence of thyroid eye disease. For thyroiditis, an inflammation of the thyroid, treatment depends on the type of thyroiditis, but usually involves the prescription of beta blockers — medications that slow the heart rate.
The new ideas
For overactive nodules, RAI or thyroidectomy are commonly used. The new guidelines highlight recent research findings for each option, including a new emphasis on testing for Graves’ antibodies prior to withdrawing ATDs. Another critical finding is that the supplement biotin interferes with thyroid function tests. If you are taking biotin, talk to your doctor before undergoing thyroid testing.
The new guidelines also include updated research on the risk of birth defects with ATDs, plus new recommendations for antibody testing during pregnancy. Keep in mind that guidelines are just that: guidelines. Based on your unique medical and family history, your provider might have different recommendations. Hyperthyroidism is a complex condition, and treatment is not “one size fits all.”