Treatment of Low and High Thyroid

Treatment of under active Thyroid (Hypothyroidism)

This is a sort of natural treatment, replacing the deficient hormone. We now prepare in the laboratory same thyroid hormone (same chemical nature) that is produced by our thyroid gland, so the chance of reaction or not tolerating is not there. You need to take the tablet regularly in empty stomach and in the correct dose.

Remember iron and calcium tablet do not allow thyroid tablet to get absorbed from the stomach. So, if you are on iron or calcium tablet, there should be a gap of four hours between the two.

Treatment of Overactive Thyroid (Hyperthyroidism)

Initial treatment of overactive thyroid is always with tablet that suppresses the thyroid gland (Carbimazole and Propylthiouracil). They are safe but very rarely can reduce the blood count and which will make you prone for infections, particularly throat infection. So, when you develop sore throat, you should stop the tablet immediately and see your doctor for a blood count. The rest will be done by your doctor.

The next part of treatment depends why the thyroid is overactive. If you have one or more nodule/s that/those is/are overactive, Radioiodine treatment is better. As thyroid is the gland in the body which handles iodine, radioiodine enters the thyroid gland and destroys the overactive areas. The dose we use does not damage other organs. Sometime, your thyroid may become under active after radioiodine and that can be easily treated with thyroid hormone, as above.

The treatment can be continued for a long period depending on the response. After giving a trial for 12-18 months, we stop and see how your thyroid behaves. If it becomes overactive again, we can either restart the tablets or give radioactive iodine. These days with improvement in monitoring facility and availability of anti-thyroid medicines and radioiodine, we rarely require operation to remove the overactive thyroid gland.

How long to continue treatment?

Overactive thyroid: We try medical treatment for around 12-18 mths, if not controlled we prefer radioactive iodine. With the advancement of medical science, surgery is very rarely required as a treatment of overactive thyroid.

Under active thyroid: While you are on treatment with thyroid hormone, it is not possible to tell how much of the thyroid hormone in blood is coming from the tablet and how much from the gland because the thyroid hormone we give now is exactly the same in chemical structure as that of the body’s own thyroid hormone. The only way is to stop your tablet for six weeks and repeat the blood test. If you are genuinely under active, your symptoms will come back and you should understand that your own thyroid gland is unable to give you normal amount of thyroid hormone and you need to supplement from outside. This type of trial of stopping and watching is usually recommended only once 12 to 18 months after starting treatment in adults and after 2 years in children.