Therapy | Advantages | Disadvantages |
Thionamides | Chance of permanent remission Some patients avoid permanent hypothyroidism Lower initial cost | Minor side effects – Rash, hives, arthralgias, transient granulocytopenia, gastrointestinal symptoms Major side effects – Agranulocytosis, vasculitis (lupus-like syndrome), hepatitis Risk of fetal goiter, hypothyroidism, and congenital anomalies if pregnant Requires more frequent monitoring |
Radioiodine | Permanent resolution of hyperthyroidism | Permanent hypothyroidism Patient must take radiation precautions for several days after treatment, avoiding contact with young children and pregnant women Development or worsening of Graves' ophthalmopathy Rare radiation thyroiditis Patient concerns about long-term oncogenic effects of radiation |
Surgery | Rapid, permanent cure of hyperthyroidism | Permanent hypothyroidism Risks for iatrogenic hypoparathyroidism and recurrent laryngeal nerve damage Risks associated with general anesthesia High cost |
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