What are the treatment options for a person with an overactive thyroid?

Question

Hello doctor,

My husband has been diagnosed with an overactive thyroid. He received two medicines, tablet Carbimazole 20 mg (twice a day) and tablet Levothyroxine 100 mg. I have an underactive thyroid, so giving him both the tablets seems strange. I researched the NHS website and understood that this combination of medications is for people with a permanent underactive thyroid. Would you please confirm it is correct and safe for him to use both?

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern. Hyperthyroidism can be due to many reasons, including Graves’ disease, multinodular or single nodular goiter. Some endocrinologists prescribe tab Levothyroxine and tab Carbimazole together for active hyperthyroidism and later give Carbimazole alone. In my practice, I only use Carbimazole to bring down T4 (thyroxine) and then titrate its dose, keeping T4 in the normal upper range. There are usually three treatment options. First, medications to control thyroid hormones in Graves’ are given for nearly 18 months and are stopped. Unfortunately, 50 % of patients may relapse and have to use other medications on a long-term basis or choose other modes of treatment. Other options are radioiodine ablation or surgery. Surgery is usually for large goiter. NHS (national health services) in the United Kingdom prefers tab Carbimazole alone for hyperthyroidism and titrating the dose according to the T4 levels.

I hope it makes sense. Thank you.

Answer 2

Hi,

Welcome back to icliniq.com. Thank you for your feedback.

Graves’ disease is an autoimmune disease and can be diagnosed by some eye signs and some rashes on the shins. Some blood tests are available that are positive for TSI (thyroid-stimulating immunoglobulin) antibodies.

Thank you.