Graves' hyperthyroidism in nonpregnant adults: Overview of treatment
- Douglas S Ross, MD
Douglas S Ross, MD
- Section Editor — Thyroid Disease
- Professor of Medicine
- Harvard Medical School
Graves' disease is an autoimmune disease that may consist of hyperthyroidism, goiter, eye disease (orbitopathy), and occasionally a dermopathy referred to as pretibial or localized myxedema. Hyperthyroidism is the most common feature of Graves' disease, affecting nearly all patients, and is caused by thyroid-stimulating hormone (TSH, thyrotropin)-receptor antibodies (TRAb) that activate the receptor, thereby stimulating thyroid hormone synthesis and secretion as well as thyroid growth (causing a diffuse goiter). The presence of TRAb in serum and orbitopathy on clinical examination distinguish the disorder from other causes of hyperthyroidism.
This topic will provide an overview of treatment options for Graves' hyperthyroidism in nonpregnant adults. The pathogenesis of Graves’ disease, the clinical manifestations and diagnosis of hyperthyroidism, other causes of an overactive thyroid gland, as well as treatment of Graves’ disease in pregnant women and children are reviewed in more detail in separate topic reviews. The treatment of hyperthyroidism due to other etiologies is reviewed in the individual topics.
●(See "Diagnosis of hyperthyroidism".)
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- THERAPEUTIC APPROACH
- Symptom control
- Decrease thyroid hormone synthesis
- - Choice of therapy
- - Thionamides
- - Radioiodine ablation
- - Surgery
- Adjunctive therapies
- - Iodinated contrast agents and iodine
- - Other medications
- Skeletal health
- MONITORING AFTER TREATMENT
- Thyroid function tests
- Weight gain
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS