Goiter medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Pharmacologic medical therapy for Goiter involves normalizing hormone levels and treating the inflammation. Treatment regimen involves Lugol’s iodine, antithyroid drugs and β-adrenergic blockers. In some cases, radioactive iodine may be used to treat an overactive thyroid gland.

Medical Therapy

• Pharmacologic medical therapy is recommended among patients with Goiter.
• In cases of hypothyroidism, thyroid hormone replacement with levothyroxine may help resolve hypothyroidism symptoms and also help with the slow release of TSH (Thyroid Stimulating Hormone) from pituitary which would result in the decrease in the size of the goiter.
• In hyperthyroidism, treatment targeted at normalizing hormone levels is considered.
• In cases of inflammation of thyroid gland, medication to treat the inflammation are generally prescribed. For goiters associated with hyperthyroidism, you may need medications to normalize hormone levels.
• Radioactive Iodine: In some cases, radioactive iodine may be used to treat an overactive thyroid gland. Radioactive iodine is prescribed as an oral medication which helps destroy thyroid cells resulting in the decreasing the size of the goiter. This therapy may also lead to under-activity of the thyroid gland.
• Lugol’s iodine:
  • ↓ Thyroid hormone synthesis
  • ↓ Vascularity
• Antithyroid drugs eg Carbimazole:
  • Used to restore the patient to a euthyroid state
• β-adrenergic blockers E.g. propranolol:
  • ↓ tachycardia and palpitations
  • Used to restore the patient to a euthyroid
  • It also ↓ vascularity