How is Graves' Disease treated?

It is important to realise that Graves' Disease is self-limiting in about 50% of cases. The therapies used for the treatment of the disease are summarised below:

1. Beta-Adrenergic Blockers
These are used initially for the tachycardia and tremors as a result of the iodothyronines potentiating the effects of the catecholamines.

2. Antithyroid Drugs
The main antithyroid drugs used are the thiocarbamides, and the most commonly used drug in this group is carbimazole. This drug interferes with reactions that take place in the iodothyronine synthesis. Propylthiouracil is used in the case of Maternal Thyrotoxicosis and can be used as an alternative to carbimazole in those patients with intolerance.

3. Subtotal Thyroidectomy
Subtotal Throidectomy is a procedure where almost the entire thyroid is surgically removed. This treatment is indicated in some patients where there is compression of the trachea or the patient has relapsed after drug treatment.

4. Radioactive Iodine (Iodine-131)
This is the treatment of choice for many patients. The principle of this treatment is that the thyroid is the only tissue in the body to selectively uptake iodine. The radioactive iodine selectively kills the cells that take up the iodine without causing any harm to the body. A common side effect of this treatment is hypothyroidism.

For an account of radioiodine treatment by one of our patients, see under Radioiodine for Papillary Cancer.