Thyroid Cancer / Nodules & Hyperthyroidism Expert Forum
Alternatives to thyroidectomy?
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Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.

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Alternatives to thyroidectomy?

My Dad was recently diagnosed with hyperthyroidism.  The doctor has just told him that his thyroid will need to be removed.  He said that the doctor gave him a choice of surgery or taking a pill that will "dissolve" the thyroid within 6 months to a year.  I wasn't at the doctor's office with him, so I don't know all the facts, but I would like to know if this is true.  Is there really a pill that will dissolve the thyroid?  He says that the pill will only have to be taken once and he will have to avoid contact with anyone for 3 days.  Any information you can give me will be great.  Thank you.
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The pill is radioactive iodine (I-131) and is a common treatment for hyperthyroidism.  It delivers a therapeutic dose of radiation to the thyroid and essentially destroys it. In cases of "hot" nodules that produce hyperthyroidism, there can be preservation of normal thyroid with selective destruction of the over-active nodules.  It works about 85% of the time with the first dose but may result in hypothyroidism requiring lifelong levothyroxine treatment (similar to a complete thyroidectomy).

Surgery has the advantage of being nearly 100% effective at treating the hyperthyroidism and there is no delay of 3-6 months in waiting to see if the treatment worked.  The trade-off is surgical risk of damage to nerves to vocal cords and loss of parathyroid (calcium balancing hormone) function --  but these risks are very low (50 thyroid surgeries/year on average).
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Mark Lupo, M.D.Blank
Thyroid & Endocrine Center of Florida
Sarasota, FL
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