Hyperthyroidism goals

The goals of treating hyperthyroidism are to relieve symptoms, to reduce thyroid hormone production to normal levels and achieve biochemical euthyroidism, and to prevent longterm adverse sequelae. 

The goal of therapy is to destroy overactive thyroid cells, and a single dose of 4,000 to 8,000 rad results in a euthyroid state in 60% of patients at 6 months or less. A second dose of RAI should be given 6 months after the first RAI treatment if the patient remains hyperthyroid. 

Pregnancy may be adversely affected by poorly controlled hyperthyroidism, with an increased rate of fetal loss. The goal of treatment during pregnancy is to maintain euthyroidism, using the smallest doses of anti thyroid drugs possible. 

There is, however, still no consensus whether calculated or fixed activities should be administered when treating hyperthyroidism. The goal of the treatment — to aim for the fastest possible elimination of thyrotoxicosis or to try to obtain euthy-roidism - should be discussed with the patient. In Graves disease, post-therapy hypothyroidism is common and occurs in most patients over time. Patients with toxic adenoma often reach euthyroidism off all medications. Most endocrinologists and nuclear medicine physicians would define cure as euthyroidism off medication, or under substitution with thyroxine. 

The goal of radioactive therapy for hyperthyroidism is to destroy just enough of the thyroid gland so that levels of thyroid function return to normal. Full benefits may take several months. 

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