How thyroid diseases are treated


Hyperthyroidism:

Once your overactive thyroid is diagnosed by blood tests, therapy will reflect the type of your hyperthyroidism, your age and health status, and how serious the overactivity is. The treatment options are:

Anti-thyroid drugs, which prevent the thyroid gland to produce new thyroid hormones without destroying the thyroid gland6

Radioactive iodine radiation, which destroys thyroid tissue and stops thyroid hormone production6

Surgical removal of parts or of the whole thyroid gland6 The last two options will lead to hypothyroidism, which is managed by adding levothyroxine

In women, having radioactive iodine treatment before becoming pregnant usually eliminates the need for antithyroid drugs. For prophylactic reasons a woman should wait at least six months after radioactive iodine treatment before trying to become pregnant.5 Men who have had radioiodine treatment should wait four months before fathering a child.5

Hypothyroidism:

Once your underactive thyroid is diagnosed by blood tests your physician will prescribe the missing thyroid hormones by T4 replacement. You will be given levothyroxine, a synthetic thyroxine that works exactly like the thyroid hormone produced by your thyroid gland7, which usually improves or normalizes menstrual irregularities in women and sperm abnormalities and erectile dysfunction in men, thus restoring fertility.5 If your hypothyroidism results from too little iodine in your diet, you will be given iodine supplements.

Mild hypothyroidism

When your thyroid hormone levels are only slightly abnormal (subclinical), your doctor may simply monitor your thyroid function, because there is no consensus on the benefits of treating patients with subclinical thyroid disease. Ask your doctor if he or she will treat your thyroid problem more aggressively to restore your fertility. When it comes to pregnancy, even mild untreated hypothyroidism in the mother is treated with thyroid hormone replacement therapy to prevent an adverse effect on brain development of the baby.14

References

  • 1- Poppe, K, Glinoer D, Tournaye H et al. Thyroid function and assisted reproduction. In: The Thyroid and Reproduction, METS Riga 2008. Georg Thieme Verlag
  • Stuttgart 2009; 33-38.
  • 2- American Thyroid Association. General Information (2012) http://www.thyroid.org/thyroid-eventseducation-media/about-hypothyroidism Accessed October 2012.
  • 3- Healy DL, Trounson AO, Andersen AN. Female infertility: causes and treatment. Lancet 1994; 343:1539–1544.
  • 4- Meikle AW. The interrelationship between thyroid dysfunction and hypogonadism in men and boys. Thyroid 2004; 14 (Suppl 1): S17-S25.
  • 5- Krassas GE, Poppe K, Glinoer D (2010) Thyroid function and human reproductive health. Endocr.Rev. 2010 31:702-755.
  • 6- The American Thyroid Association (2012) Hyperthyroidism http://www.thyroid.org/what-is-hyperthyroidism/Accessed October 2012.
  • 7- The American Thyroid Association (2012) Hypothyroidism Brochure. http://www.thyroid.org/whatis-hypothyroidism Accessed October 2012.
  • 8- Bercovici JP. Menstrual irregularities and thyroid diseases. Feuillets de biologie 2000; 74: 1063-1070.
  • 9- Vanderpump MPJ, Tunbridge WMG, French JM et al. The incidence of thyroid disorders in the community: A twenty-year follow-up of the Whickham Survey. Clin
  • Endocrinol 1995; 43: 55-69.
  • 10- Green BB, Weiss NS, Daling JR. Risk of ovulatory infertility in relation to body weight. Fertility and Sterility 1988; 50 (5): 721-726.
  • 11- The Hormone Foundation’s Patient Guide to the Management of Maternal Hypothyroidism Before, During, and After Pregnancy. De Groot LJ, Stagnaro-Green A,
  • Vigersky R, The Hormone Foundation 2007 http://www.hormone.org/Resources/Patient_Guides/upload/mgmt-maternal-hypothyroidism-070609-2.pdf.
  • Accessed October 2012.
  • 12- Grassi G, Balsamo A, Ansaldi C et al. Thyroid autoimmunity and infertility. Gynecol Endocrinol 2001; 15: 389–396.
  • 13- Beyond Infertility. Polycystic Ovary Syndrome (PCOS). U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. National Institutes of Health; Eunice Kennedy
  • Shriver National Institute of Child Health and Human Development 2008 http://www.nichd.nih.gov/publications/pubs/upload/PCOS_booklet.pdf.
  • Accessed October 2012.
  • 14- De Groot L, Abalovich M, Alexander EK, Amino N, Barbour L et al. Management of Thyroid Dysfunction during Pregnancy and Postpartum: An Endocrine Society
  • Clinical Practice Guideline. J Clin Endocrinol Metab 2012; 97 (8): 2543-2565.
  • If you want to know more about thyroid and fertility, visit the following websites:
  • http://www.thyroidweek.com/
    Patient information provided for International Thyroid Awareness Week
  • http://www.hormone.org/
    Patient information by the Endocrine Society
  • www.fertility.com
    Patient information by Merck Serono
  • http://www.webwiki.de/thyroid-fed.org
    Patient information by the Thyroid Federation International
  • www.thyroid.org
    Patient information on thyroid health published by the American Thyroid Association (ATA)
  • The information in this website is not intended as a substitute for informed medical advice. You must consult a suitably qualified healthcare professional on any problem or matter which is covered by any information in this website before taking any action.
    This website was created in November 2012.
    Please refer to the Privacy and Legal Statement on the aforesaid website when reading this.