Vnitr Lek 2015, 61(10):868-872

Management of hypothyroidism and hyperthyroidism

Jan Jiskra

III. interní klinika 1. LF UK a VFN Praha, přednosta prof. MUDr. Štěpán Svačina, DrSc., MBA

Functional thyropathies present significant health risks for patients. Advanced functional thyropathies are always treated while indications for therapy of subclinical thyropathies are individual and often controversial. It is widely agreed that these disorders should be diagnosed and individuals should be followed. The drug of choice in substitution therapy of hypothyroidism is levothyroxine, in the treatment of hyperthyroidism it is methimazole. Administration of propylthiouracil should be limited to the first trimester of pregnancy, because its serious hepatotoxicity has been described. Hyperthyroidism based on thyroid nodules and immunogenic hyperthyroidism not reaching long-term remission, need to be treated radically: by surgery or radioiodine treatment. When radiation protection requirements are met, radioiodine can also be administered on an outpatient basis. Exceptionally, small doses of methimazole can be administered over an extended period of time in individual cases.

Keywords: hyperthyroidism; hypothyroidism; levothyroxine; methimazole; propylthiouracil; radioiodine ¹³¹I; total thyroidectomy; thyroid stimulating hormone

Received: August 17, 2015; Accepted: September 25, 2015; Published: October 1, 2015  Show citation