Treating hypothyroidism

Hypothyroidism is an underactive thyroid. This has no cure. But treatment can ease most or all symptoms. Treatment is done with daily thyroid hormone pills. These pills replace the hormone your thyroid doesn’t make. You'll likely need to take a daily pill for the rest of your life.

Your healthcare provider will change your dose to reach the right hormone levels. Take the thyroid hormone pill on an empty stomach. Take it without other medicines. And take it at the same time each day. This is to make sure it works as it should.

Over time, your dose may be changed. The medicine has few side effects if the dose is right for you. But if the dose is too high, you may have symptoms of an overactive thyroid. These include:

• Nervousness

• Grouchy mood

• Fast or irregular heartbeat

• Shaking (tremors)

• Trouble sleeping

• Brittle hair

If the dose is too low, you may have symptoms of an underactive thyroid. These include:

• Low energy

• Sleepiness

• Memory problems

• Weight gain

Tell your provider if you have any symptoms of thyroid problems. Also let them know if you're prescribed any new medicines. Tell them if you take any estrogen or testosterone. These will change the dose of thyroid hormone that's right for you. Your dose will also need to increase if you're pregnant.

Treating hyperthyroidism

Hyperthyroidism is an overactive thyroid. Treatments include:

• Anti-thyroid medicine. This can reduce the amount of thyroid hormone made by your thyroid gland. Reactions from this medicine are rare. But in some cases, it can cause an unsafe drop in white blood cells. It can also cause liver damage. Talk with your healthcare provider for more information. If you have a fever or sore throat while taking this medicine, tell your provider right away.

• Radioactive iodine ablation. This is the most common treatment. It’s done by taking a pill or liquid dose of radioactive iodine. This destroys the thyroid cells that are making too much hormone. You may need daily thyroid hormone pills after this treatment.

• Surgery. This removes part or all of your thyroid gland. After surgery, you may need to take daily thyroid hormone pills.

• Beta-blockers. The treatments above may be used alone. Or they may be used with beta-blockers. These are medicines that can reduce symptoms caused by too much thyroid hormone.

Treating nodules

If you have noncancer (benign) nodules, you may not need treatment right away. Instead, your healthcare provider may advise regular exams and ultrasound tests. This is to see if the nodules grow. You may need to take a dose of thyroid hormone. This is to help shrink the nodules. If you need other treatment, it may include:

• Anti-thyroid medicine. If a benign thyroid nodule is causing an overactive thyroid, your provider may first treat it with this medicine. If this doesn’t work, you may need 1 of the treatments below.

• Radioactive iodine ablation. This is the most common treatment for hyperthyroidism. It’s done by taking a pill or liquid dose of radioactive iodine. This destroys the thyroid cells that are making too much hormone. You may need daily thyroid hormone pills after this treatment.

• Radiofrequency ablation. This is a minimally invasive procedure that uses heat to destroy cells. Imaging tests are used to guide a thin needle through the skin or through a cut (incision) and into the tissue. High-frequency energy passes through the needle. This causes the tissue around it to heat up and destroy nearby cells. Healthy cells are not destroyed.

• Surgery. This may be done to treat nodules that are causing symptoms. Symptoms can include choking or trouble swallowing. Surgery removes part or all of your thyroid gland. After surgery, you may have radioactive iodine ablation. You may also need daily thyroid hormone pills.

If you have radioactive iodine ablation

Radioactive iodine ablation uses tiny amounts of radiation. But it's a safe treatment. Your healthcare provider will talk with you about any risks and possible problems. You'll likely receive the iodine at the hospital and go home the same day. The risk from the radiation to yourself and others is very small. But you may need to stay away from other people for a few days. It's most important to stay away from children and pregnant people.