Prevention and Treatment of Thyroid Disorders

Thyroid gland diseases can result in either overproduction or a lack of thyroid hormone,
thyroid nodules, and/or goiter. Women are more susceptible to thyroid problems than
men.

Prevention
Ways to prevent hyperthyroidism or hypothyroidism are still unknown. Iodine deficiency
is rare in the United States, so there is no approach to avert goiter or thyroid nodules. It
is not advised that a person take additional iodine. Adult multiple vitamin supplements
are abundant in iodine. Radiation will stimulate development of both benign and
malignant thyroid nodules. Excess radiation or unnecessary CT scans of the head and
neck should be avoided and a "thyroid shield" must be used when dental X-rays are
performed.

Drugs for Hyperthyroidism

Beta-blockers: This class of drug blocks many of the body's responses to
hyperthyroidism. This drug reduces tremor, nervousness, agitation, and fast heart rate.
Patients with mild to moderate symptoms of hyperthyroidism are given this drug, and
also as an IV preparation to an individual with the thyrotoxicosis. This drug only blocks
the bodys responses to hyperthyroidism but it does not offer any treatment to the
underlying cause.
Propylthiouracil: This antithyroid drug blocks thyroid hormone synthesis. The full
therapeutic effect of this drug will take several months in order to be achieved. This drug
should be used only during the first trimester of pregnancy, or if there is an intolerance
to thimazole. Itchy rash is one common mild side effect. Leukopenia that results in
weaker defense against infection is a more serious side effect.
Methimazole (Tapazole): This is the favored antithyroid drug in everyone except for
women in the first trimester of pregnancy for hyperthyroidism. This antithyroid drug
blocks thyroid hormone synthesis. This drug may take slightly longer than
propylthiouracil to achieve its full effect. It has similar side effects as propylthiouracil.
Iodide (Lugol's solution, Strong iodine): This drug inhibits the release of thyroid
hormone from the over functioning thyroid gland. This drug must be used in combination
with an antithyroid drug because the amount of thyroid hormone produced can be
increased by iodine which will exacerbate the hyperthyroidism. Nausea and a metallic
taste in the mouth are common side effects.
Radioactive iodine therapy: Hyperthyroidism can be treated with radioactive iodine
swallow which is a different type of radioactive iodine than used for diagnostic scans.

This treatment takes several months to work by scarring down the thyroid gland,
resulting in a smaller- sized gland, often accompanied by hypothyroidism.

Drugs for Hypothyroidism

L-thyroxine (Synthroid, Levoxyl, Levothroid, Unithroid, Tirsosint): This synthetic
drug of thyroxine is the mainstay of thyroid hormone replacement therapy in
hypothyroidism. This is exactly the same hormone that the thyroid manufactures which
is converted to the active product L-triiodothyronine by the body. Side effects are rare,
and it has an excellent safety record.
Triiodothyronine: This is rarely used alone as thyroid hormone replacement due to its
shorter half-life in the bloodstream than L-thyroxine. This drug can cause rapid
increases in triiodothyronine concentration, which can be dangerous in the elderly and
in people with cardiac disease. It may be used in combination with L-thyroxine for
people who have poor symptomatic relief with L-thyroxine alone.
Thyroid extract or "natural" thyroid hormone: This is dried and powdered pig thyroid
gland which is not purified and has a variable amount of T4 and T3. This is not
suggested as a thyroid hormone replacement due to the excess of T3 in this
preparation.

Drugs for Thyroid Nodules and Goiter

There are no good medical treatments to shrink the nodules and surgery is usually
recommended if the thyroid function is normal with thyroid nodules. Radioactive iodine
therapy is a developing treatment of nontoxic goiters/nodules. This treatment is viable
when a patient has a large goiter and surgical treatment is hindered by medical
problems.