Graves’ Disease and Hyperthyroidism Treatment Options

  Graves’ Disease and Hyperthyroidism treatment options vary in their effectiveness, long term results and efficiency. So far, the medicine even after 100 years has not advanced a lot and acknowledges only 3 types of treatment. Please, consider the text below only as additional information.

   1. Medication: In the United States and many other countries two main brands of anti-thyroid medication are used: Methimazole and Propylthioyracil (PTU). The function of both antithyroid drugs is similar: to adjust the levels of the two hormones produced by the thyroid, free thyroxine (FT4) and free triiodothyronine (FT3), and to increase thyroid stimulating hormone (TSH), which is the third important thyroid hormone. For their  normal ranges, please, refer to Thyroid Test Results. The philosophy behind the antithyroid drug treatment is that when the organism gets adjusted to the correct thyroid levels with the help of medication, soon it can do it on its own and the medication can be gradually reduced until no longer needed.  Easy said than done. That’s why this is the slowest known therapy as in many cases the drug dosage should be constantly adjusted until the desired results are achieved. The antithyroid drug therapy is chosen by some doctors as a primary choice of treatment and some others consider it as preparation of the patient for a consequent RAI treatment.

Methimazole. It is used to manage hyperthyroidism associated with Graves’ disease. Methimazole is generally well-tolerated with side effects occurring in 3 out of every 100 patients. The most common side effects are related to the skin and include rash, itching, hives, abnormal hair loss, and skin pigmentation. If you experience any of these side effects, please, consult your physician immediately. They usually appear if the doze is not correct so this should be adjusted as soon as possible. While many people see improvement in their FT4 levels, TSH remains unchanged for a prolonged period of time.

Propylthyoracil (PTU) is the other antithyroid drug prescribed for Graves’ Disease and hyperthyroidism. It is considered safer and usually is better tolerated by people, to my personal observation. It is administered to pregnant women suffering from Graves’ Disease more often as it is considered harmless for the baby and causes minimum birth defects.

The main concern of the doctors here is that the patient may relapse later. Yes, I agree, however it may or may not happen.

2. Thyroidectomy is the second treatment option for hyperthyroidism. This is a surgical removal of the thyroid gland, and is the oldest known treatment option for Graves’ Disease and Hyperthyroidism. Surgery is also an option for people who have a very large goiter, and those who are allergic to, or who may develop severe side effects from the antithyroid drug used to treat hyperthyroidism. Thyroidectomy could be partial or total, depending on the portion of thyroid to be removed. Total thyroidectomy, along with many other side effects will result in permanent hypothyroidism, i.e the patients need to take thyroid medication for hypothyroidism for the rest of their lives.

3.  Radioactive Iodine Treatment (RAI). This is the option most doctors will recommend even though I consider it the most dangerous. It has many side effects as well, and similarly to thyroidectomy will result in permanent hypothyroidism. Thyroid Eye Disease in most of the cases will not improve, but will get worse, as noted in many researches on the subject. Why the doctors prefer to ignore that information or even not disclose it to the patients still remains a mystery to me.

 4. Alternative natural treatments or a combination of antithyroid drug therapy and holistic methods. This I consider the most effective and harmless, but probably is the longest therapy. The Natural treatment system for Graves’ Disease and Hyperthyroidism  will involve change of diet, supplements, herbs, physical exercises, yoga, meditation, to name a few. Life style changes and stress management are also necessary. It is a total makeover and works not only on the symptoms but on the causes of Graves ’ disease and Hyperthyroidism as well. It’s a life changing experience, not just masking the symptoms or destroying vital parts of the body system like the thyroid gland. Both, antithyroid drug therapy and holistic methods can work together for faster results and they can be seen literally in a few weeks.

 5. No treatment, left untreated. This should not happen ever. Graves’ disease and Hyperthyroidism are dangerous autoimmune diseases which, if left untreated may cause a Thyroid Storm, a condition that may lead to death.

19 responses to this post.

  1. Posted by Karen on May 15, 2012 at 2:00 am

    I was diagnosed with Graves disease over two years ago. I am in remission. Did it by slowly reducing the meds after I was stable for 1 1/2, 2 years. Whoo Hoo!!!! June will be 6 months of no meds.


  2. I was diagnosed with Hyperthyroidism and Graves’ disease shortly before my 21st birthday. I also have a goiter. I was made and unhappy. I was disgusted really. I was on medication and couldn’t go out for drinks with friends and had to always make sure I got my medicine during meals. I would sneak tothe bathroom because i was so embarrassed and I didn’t want to have to explain something I still knew nothing about. And I still know nothing.

    In the beginning I refused to take my medication. I felt my life was thrown for a loop. And then to have doctors hint at me that I may never have kids. Was just as horrible. But my PCP and Thyroid specialist felt I was lying and put me on birth control and never told me until I googled. The reason I did so was because no one should have a menstrual cycle for 2months straights. Because of that I missed school and had repeat.

    Unfortunately when I finally accepted it an it began to reduce my goiter’s size. I was happy and less cranky and grumpy. But then my father died and I got removed off his insurance and what little medicine I had left. It stopped working.

    I haven’t had health insurance since May 2009. Haven’t had any medication around that time as well. I’ve hit rock bottom in my life and I’m very unhappy.

    I say if you have thyroid problem of any kind. Get the surgery and have it removed immediately. You can’t get disability for it. No insurance for having it. And doctors that’ll tell you anything just to get your money. Get it removed and live life that way.

    Otherwise your stuck with an in curable disease and no help. I always have pains in my neck. My eye sight has gotten worse. And the muscle spasms hurt like hell. It’s unfair. But what truly hurts its a genetic, hereditary disease. My family refuses to tell me who has it or had it. So not only do I not know where it came from. I don’t know if that person got it fixed or removed or took meds to correct it—nothing.

    So if you find out, demand surgery. Don’t waste time on medications that may not work or make you sick.


    • Posted by sbankova on May 16, 2012 at 2:53 pm

      I can tell you had terrible experience, I am really sorry to hear about that. On a side note: a total thyroidectomy (i.e removing your thyroid permanently) can cause a lot of troubles, including that you will be on medication FOR THE REST OF YOUR LIFE, i.e hypothyroid and there is no way out of this one. These medication has to be prescribed by doctors as well and you need blood tests probably every 3 months until the medication dosage is adjusted. Also, if you have Thyroid Eye Disease- it can make it even worse.

      This surgery will not remove the problem, as many of us want to believe, will just turn it into another problem. It is not a hereditary disease either, so don’t blame your family.

      It can be corrected, I know that. I want to give you more hope, you should know that many people have been where are you right now and you are not alone.



      • Posted by adam on June 4, 2012 at 8:42 am

        graves disease is hereditary so please dont confuse the people. dont give false reassurance. total thyroidectomy will not worsen thyroid eye problem. it is the RAI that worsens exopthalmia. surgery helps to remove uncontrolled hyperthyroidism.

      • Posted by sbankova on June 4, 2012 at 11:43 am

        I don’t think that Graves’ Disease is hereditary, but the way of thinking is, for sure, it runs in the family!! I know people who never had anyone in their family with thyroid disorder, and some others that had family members with Grave’s disease, but they were never affected.

        I don’t call that hereditary disease.

        As per surgery or RAI, everyone makes their own decision, but I have to share the information I know and I believe in. If you personally consider surgery as the best option- please, go ahead, enjoy.


  3. Posted by Angela Franks on May 17, 2012 at 6:00 am

    I’m with you. In the UK the only choice I was given to ‘possibly’ cure my hyperthyroid and Graves, was radioactive iodine – or a full thyroidectomy. After a desperate 5 years of illness AND the loss of my business I opted for the surgery. That was 4 years ago – and nothing has changed. I take the 200 mg of thyroxine every day for the rest of my life, my eyes are swollen and I have no ‘up-vision’ and multiple vision through both eyes, and the many other side effects which are part of the Graves package. I have been refused an ‘impaired vision’ certificate because I “don’t meet the criteria” and had to give up driving and many other things I used to enjoy. My first attempt to return to work (too soon) lasted 8 weeks – and crushed my confidence badly.
    Last year I stood up to my surgeon who wanted to make my eye sockets bigger with no guarantees of the outcome. Since my refusal, I have not been able to see him at all for any checks. So I had to change! I have gradually adapted to my vision and found ways round it. I have taken up many of the crafts that I used to enjoy and although I am much slower and have to take regular breaks to rest my eyes – I have done it! I also took on a receptionist job in a local hotel, part-time. I was straight with my employer about my condition and with some magnified screens and regular breaks, I have conquered it. Meeting so many people has helped me to gain back my confidence issues with my appearance and I feel alive again. I have just been offered another 10 hours – and I think I will take it.
    It took me several years to realise that the medical profession have very little sympathy, time or solutions for this disease. So you have to start looking at what you CAN do – rather than what you CAN’T and build on it. Finding a ‘cure’ for my condition is not now at the forefront – enjoying life is!


    • Posted by sbankova on May 17, 2012 at 3:32 pm

      You’ve been through a lot of pain, I understand how you feel. But I’m glad to hear that you are finding hope and strength to deal with it. You have my full support.



      • Posted by Angela Franks on May 17, 2012 at 10:32 pm

        Thank you Svetla – I wish that one day, there will be ‘hope’ for everyone who has to live with this condition and a cure will be found. In the meantime, your encouragement, advice and understanding means so much, to so many of us.

  4. Posted by Sandra Cavazos on May 23, 2012 at 5:24 pm

    I am very grateful for this article. My sixteen year old daughter has been diagnosed with hyperthyroidism/grave’s disease. She was always symptomatic but many of her symptoms such as muscle pains, lack/inability to keep attention and extreme tiredness were contributed to her being a teenager. It wasn’t until a large goiter appeared and a later a diagnosis that it all started to make sense.

    As a mother, I am saddened that this disease has affected my daughter. I feel a sense of desperation because I don’t know how to help her and well, she is sixteen and it’s hard to get her to do what is good for her. She was recently prescribed Methimazole 20MG daily. Her T3/T4 levels did not react to it so; the Dr. upped the dosage to 30MG daily. Now, she is breaking out in hives and has extreme itching after taking her medicine. I just contacted her endocrinologist because of this article. Thank You!


    • Posted by sbankova on May 23, 2012 at 6:44 pm

      Hi Sandra,

      I’m sorry to hear about your daughter and I know how difficult is to make her do things that are good for her. I have 15 year old daughter too and I can definitely relate to what you are saying. They want to do everything their way, and learn from their own mistakes. Stress is a big factor here, she needs to relax a lot and get enough sleep. And by the way- I’ve heard Flax seed oil helps goiter to “shrink”, as one of my subscribers said. Hope this may help.



  5. Posted by Sandra Cavazos on May 23, 2012 at 11:02 pm


    Thank you for the flax seed oil suggestion. I am going to go buy some. Any suggestions as far as dosage?

    I just got word back from the doctor. He wants me to take her off the medication and would like to schedule her for oblation (Radioactive Iodine Treatment). I told him I was not ready to take that step as she has only been taking medicine for a few days short of a month. He says he fears the allergic reactions may get worse. I feel disappointed. He is supposed to be one of the “best” in my area and he is so ready to quit. I told him that there has to be other alternatives. He only offered to lower he dosage back down to 20MG/daily and that we would discuss Radioactive Iodine Treatment in more depth at her next appointment. I refuse to go that route…especially without a fight…..what do I do?


    • Posted by Tanya on July 17, 2012 at 4:46 pm

      There is another med that is supposed to be better tolerated. Can’t remember the name just now, but worth asking or looking online.


  6. Posted by sbankova on May 24, 2012 at 2:26 pm

    Sandra- what do you do? You fight for your daughter and her health. RAI is a permanent solution, she will be hypothyroid for the rest of her life, there is no way back. She will probably gain weight that can not be controlled and hundreds of other complications. But will she understand your decision for RAI one day?

    She is going through puberty, hormones up and down, in a few years she won’t even remember. In teenagers and kids this disease has very good’s manageable. I’m talking from all the emails I got last 7 years from people like you.

    There is another article on my blog ” The 10 Why’s of a difficult thyroid patient”.
    Choose another doctor. Insist for another medication. Be difficult for her.

    As per Flax seed oil- this is a supplement, follow the instructions on the label. For sure, it won’t make the things worse.



  7. Posted by Tanya on July 17, 2012 at 4:50 pm

    Could you elaborate on The Natural Therapy for Hyperthyroidism. I have been trying to research diet and I get a lot of conflicting information! I have gone gluten free and am trying to eat more goiterous foods. One thing I am unclear about is foods containing iodine. Some sites say to limit iodine intake others say it is needed for a healthy thyroid whether hyper or hypo.



    • Posted by sbankova on July 18, 2012 at 8:12 am

      Hi Tanya,

      my personal opinion is that when your thyroid is overactive, i.e hyperthyroid, foods with high iodine content should be avoided. My experience also shows that it helps hyperthyroidism.


      • Posted by Tanya on July 19, 2012 at 3:36 pm

        Hi Svetla,
        Is this everything on Natural Therapy? Just reducing iodine intake? I have read several studies which say you need to give your thyroid iodine to help it balance out whether you have hyper or hypo.


  8. Hi Tanya,

    this is absolutely not everything on Natural therapy- diet counts for just about 25% of the whole healing process, to my personal opinion. Then you have vitamins and supplements, herbs, physical exercises and meditation, life style changes, mental aspects etc. I have a whole website and 6 books about different therapies. It is impossible to summarize all this in one sentence. There is no “one thing cure all”, which I’ll be glad to share if I know.

    You asked specifically about the iodine content in foods and I shared my opinion. I don’t know about the studies you are mentioning but think logically: if you are hungry- you eat food, if you are full- you don’t eat any more. If you are neither hungry or full- you are in balance. If you are full- you don’t eat more food to bring your body in “balance”, do you? To the best of my knowledge one of the reasons for hypothyroidism is lack of iodine in the diet, and in the water, hyperthyroidism is the opposite. I am saying one of the reasons. Why would you give more iodine to your body then? That’s why for hypothyroidism is recommended to eat iodine rich products for example, because this also speeds up the metabolism and all processes in the body. Hyperthyroidism is the opposite- we need to slow down- everything. It’s already boosted at its maximum.

    You are absolutely free to follow any diet you feel is right for you, your body knows better than me, but again, diet is not everything. For example consuming aspartame products (diet coke etc.) is more dangerous than consuming sea food (rich of iodine), and no matter how much broccoli you eat (goitrogenous food) this alone will not cure hyperthyroidism. At the same time you can keep the low- iodine diet, but if you are under tremendous stress and this is not changing, cure may never come. I wish hyperthyroidism treatment is that simple, but it is not.

    Let me know if you have any other specific questions, I’ll be happy to answer to the best of my knowledge and experience.


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