Recent review on medical treatment of thyroid disease

Kyeong Hye Park; Eun Jig Lee

doi:10.5124/jkma.2012.55.12.1207

J Korean Med Assoc > Volume 55(12); 2012 > Article

Park and Lee: Recent review on medical treatment of thyroid disease

Pharmacotherapeutics

Journal of the Korean Medical Association

Journal of the Korean Medical Association 2012; 55(12): 1207-1214.

Published online: December 18, 2012

DOI: http://dx.doi.org/10.5124/jkma.2012.55.12.1207

Recent review on medical treatment of thyroid disease

Kyeong Hye Park, MD, Eun Jig Lee, MD

Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

Corresponding author: Eun Jig Lee, ejlee423@yuhs.ac.kr

Received October 17, 2012 Accepted October 30, 2012

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Thyroid disorder is a common disease. Graves' disease is the most frequent cause of thyrotoxicosis and pharmacological treatment is current trends worldwide. Because of the severe adverse effects of propylthiouracil, methimazole or carbimazole should be selected as the drug of choice except for special situations such as women in the first trimester of pregnancy, thyroid storm, or in patients with severe side effects to methimazole. Treatment should continue for 12 to 18 months, but duration can be adjusted depending on the patient. For hypothyroidism, synthetic levothyroxine is the mainstay of treatment. In order to avoid overtreatment, the dosage of levothyroxine should be determined in consideration of the patient's age, sex, bodyweight, general condition, and comorbidities. In subclinical hypothyroidism, thyroid hormone replacement is suggested in patients with thyroid stimulating hormone concentrations >10 mIU/L. For non-elderly patients with high titers of thyroid autoantibodies, patients with dyslipidemia, pregnant patients, and women with infertility or ovulatory dysfunction, treatment with levothyroxine can be considered.

Hyperthyroidism; Antithyroid agents; Hypothyroidism; Thyroxine; Thyroiditis

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Table 1

Side-effects of antithyroid drugs

ANCA, anti-neutrophil cytoplasmic antibody.

Table 2

Conditions that increase Levothyroxine requirements