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Hyperthyroidism: Difference between revisions





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→‎Antithyroid drugs: Source from 2010 indicating a "block and replace" strategy for using antihythoid medications with thyroid hormone replacement therapy was outdated. 2021 systematic review and 2023 review article from JAMA: The block and replace strategy is not recommended. https://jamanetwork.com/journals/jama/fullarticle/2810692 https://www.frontiersin.org/articles/10.3389/fendo.2020.560157/full
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===Antithyroid drugs===
Thyrostatics ([[Antithyroid agent|antithyroid drugs]]) are drugs that inhibit the production of thyroid hormones, such as [[carbimazole]] (used in the UK) and [[methimazole]] (used in the US, Germany and Russia), and [[propylthiouracil]]. Thyrostatics are believed to work by inhibiting the [[iodination]] of [[thyroglobulin]] by [[thyroperoxidase]] and, thus, the formation of tetraiodothyronine (T<sub>4</sub>). Propylthiouracil also works outside the thyroid gland, preventing the conversion of (mostly inactive) T<sub>4</sub> to the active form T<sub>3</sub>. Because thyroid tissue usually contains a substantial reserve of thyroid hormone, thyrostatics can take weeks to become effective and the dose often needs to be carefully titrated over a period of months, with regular doctor visits and blood tests to monitor results.<ref name="Thyrotoxicosis and Hyperthyroidism"/>
 
A very high dose is often needed early in treatment, but, if too high a dose is used persistently, people can develop symptoms of hypothyroidism. This titrating of the dose is difficult to do accurately, and so sometimes a "block and replace" attitude is taken. In block and replace treatments thyrostatics are taken in sufficient quantities to completely block thyroid hormones, and the person treated as though they have complete hypothyroidism.<ref>{{cite journal | vauthors = Fumarola A, Di Fiore A, Dainelli M, Grani G, Calvanese A | title = Medical treatment of hyperthyroidism: state of the art | journal = Experimental and Clinical Endocrinology & Diabetes | volume = 118 | issue = 10 | pages = 678–684 | date = November 2010 | pmid = 20496313 | doi = 10.1055/s-0030-1253420 }}</ref>
 
===Beta-blockers===

Retrieved from "https://en.wikipedia.org/wiki/Hyperthyroidism"
 




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