Thyroid Problems

Care & Treatment

Hypothyroidism

Hypothyroidism is usually treated with levothyroxine, a synthetic (man-made) version of thyroid hormone that you swallow.

If your healthcare provider prescribes this medication, be sure to let them know what other prescription and over-the-counter drugs, vitamins, and other supplements you take, and whether you eat certain foods, such as soy, in large amounts. Levothyroxine can interact with certain medications. Soy, vitamins and other supplements, and over-the-counter and prescription medications can affect the way your body responds to levothyroxine.

Your healthcare provider will start you on a low dose of levothyroxine and increase the dose gradually if necessary.  You should take this medication on an empty stomach and at least an hour before you take any other drugs or supplements. If it seems to be causing side effects, let your healthcare provider know immediately. He or she should monitor you and check your thyroid hormone levels on a regular basis.

In adults with dementia and hypothyroidism, thyroid replacement therapy may improve cognition, functional status, and mood.

Hyperthyroidism

Hyperthyroidism can be treated with any of the following.

Anti-thyroid Medicines

Anti-thyroid medications, taken in pill form, can stop the thyroid gland’s overproduction of thyroid hormones. They don’t work for everyone, however, and they don’t work forever. Usually they’re used before treatment with radioactive iodine to control symptoms and to lessen the risk of side effects.

Radioactive Iodine Therapy

Treatment with radioactive iodine involves swallowing the iodine, which is then absorbed by your thyroid gland. Over time, the iodine shrinks the gland so it produces lower levels of thyroid hormones. The treatment doesn’t cause side effects (such as nausea and hair loss) the way traditional radiation treatment or chemotherapy do. After treatment, it may take up to six months for your thyroid levels to drop to normal levels.

After treatment, your healthcare provider may need to lower the doses of other medications you take because the treatment may result in your body metabolizing medications more slowly. Sometimes, the treatment reduces your thyroid levels too much, and you develop hypothyroidism. If this happens, you will need to take medication for hypothyroidism on a daily basis.

Surgery

Thyroid surgery (thyroidectomy), which involves the removal of most of your thyroid gland, may be an alternative to radioactive iodine treatment for some people. The surgery carries some risks, including damage to your vocal cords and parathyroid glands, which help control the levels of calcium in your blood. If you have this surgery you’ll need to take synthetic thyroid on a daily basis for the rest of your life.

Benign Nodules

If your nodule or nodules aren’t cancerous, and they aren’t so big that they’re making it hard for you to breathe or swallow, your healthcare provider may simply recommend that you get exams and thyroid tests regularly to monitor the nodules. If they continue to grow, however, your healthcare provider may also suggest that you have another biopsy. 

If the nodule or nodules are so big that you have difficulty swallowing or breathing, your healthcare provider may recommend surgery to remove them. If you have thyroid nodules that are also producing too much thyroid hormone and causing hyperthyroidism, your healthcare provider may use radioactive iodine to shrink them. A healthcare professional may also prescribe an anti-thyroid medication to lower the levels of thyroid hormones in your bloodstream.  If these approaches don’t work, surgery may be needed.

Cancerous Nodules

If a thyroid nodule is cancerous, surgery is usually necessary. Typically, most or all of your thyroid gland is removed. After the surgery, you will need to take thyroid medications on a daily basis for the rest of your life.

Updated: June 2017