Evaluation of Anti-Thyroid Drugs, Radioactive Iodine and Surgery in Patients with Hyperthyroidism

The aim of this study is to evaluate anti-thyroid drugs, radioactive iodine and surgery for treatment of patients with hyperthyroidism. Medical records of 1022 patients who referred to endocrinology clinic between 1999 to 2005 were evaluated. Demographic information, onset of disease, thyroid gland weight based on to clinical examinations before and after treatment, thyroid function tests, onset for relapse, onset for hypothyroidism, and side effect for treatment methods were recorded. Statistical analysis was done. For Grave's disease, after long term treatment with anti thyroid drugs and a 31±16 month follow up, there were 39.6% euthyroid cases without side effects; after treatment with radioactive iodine and a 30±11 m follow up there were 18% and after treatment by surgery and a 13 m follow-up there were 7% cases, difference was statistically significant (P<0.001). In TMNG, there were 33% euthyroid cases after treatment with iodine radioactive; and a 29±19 months follow up and after surgery there were 29% after 18±12 months of follow up. There were no significant changes (P=0.363). Surgery complications were 36%. In patients with toxic adenoma, there were 70% euthyroid cases after treatment with radioactive Iodine and a 27±10 m follow up, and for surgery there were 75% such cases after 16±8 months of follow up (P=0.502). Surgical complications were not seen in patients treated for toxic adenoma. The first step in the treatment of Grave's is long-term treatment with anti-thyroid drugs. In TMNG, radioactive iodine therapy is preferred, because of the high rate of complications effects for surgery.