source: American Thyroid Association

year: 2020

Graves’ disease is the most common cause of hyperthyroidism (overactive thyroid). It usually affects people between 30-60 years of age and is much more common in women than men. Patients with Graves’ disease, often have enlarged thyroids (goiter) and bulging eyes (exophthalmos). There are three main options to treat Graves’ disease: antithyroid drugs (ATDs), radioactive iodine therapy and surgery.

The most common ATDs in use are methimazole and PTU. ATDs work by decreasing the production of thyroid hormones. When ATDs are stopped, about half of the patients’ thyroid levels remain normal and are then considered to be on remission. Many eventually return to their hyperthyroid state (relapse) and require further treatment. Some patients become hypothyroid (underactive thyroid), known as “burnt-out Graves’, and require lifelong thyroid replacement therapy.

Surgery and radioactive iodine almost always resolve the hyperthyroidism. With surgery, all or nearly all thyroid tissue is removed and thyroid levels go down immediately. With radioactive iodine therapy, permanent damage to the thyroid cells occurs more gradually over several months. After both treatments, the majority of patients become hypothyroid and therefore will require lifelong thyroid replacement therapy.

This study examined the long-term effects of the three treatments (ATDs, radioactive iodine therapy, and surgery) in Swedish patients diagnosed with Graves’ disease.

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