The Treatment of Hyperthyroidism
Authors: J M Hershman
Journal: Annals of Internal Medicine (1966)

Diagnosis and Treatment1 June 1966The Treatment of HyperthyroidismJEROME M. HERSHMAN, M.D.JEROME M. HERSHMAN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-64-6-1306 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptHyperthyroidism is a syndrome of metabolic and pathologic disturbances resulting from the action of excessive circulating thyroid hormone on peripheral tissues. In 1835, Robert Graves (1)*recorded the history of a young lady with nervousness, severe palpitation, weakness, weight loss, exophthalmos, and enlargement of the thyroid which was at first soft but then became firmer and asymmetrical. Ninety-three years later, Plummer (4) differentiated hyperthyroidism associated with nodular goiter without exophthalmos from Graves' disease. However, there are many cases intermediate between the conditions described by Graves and Plummer which tend to obscure the distinction between them (5). Diffuse goiter may become...References1. GRAVES RJ: Clinical lectures. London Med. Surg. J. 7: 516, 1835. Google Scholar2. PARRY CH: Elements of Pathology and Therapeutics, Vol. 2. Underwood, London, 1825, p. 111. Google Scholar3. KELLY EC: Calleb Hillier Parry. Med. Classics 5: 3, 1940. Google Scholar4. PLUMMER HS: Function of the thyroid gland containing adenomatous tissue. Trans. Ass. Amer. Physicians 43: 158, 1928. Google Scholar5. MEANS JH: The Thyroid and Its Diseases. J. B. Lippincott Co., Philadelphia, 1937, p. 282. Google Scholar6. VANDERLAAN WP: Cause of hyperthyroidism, in Clinical Endocrinology. I. Edited by ASTWOOD, E. B. Grune & Stratton, New York, 1960, p. 193. Google Scholar7. HERMANNQUARTON HTGC: Psychological changes and psychogenesis in thyroid hormone disorders. J. Clin. Endocr. 25: 327, 1965. CrossrefGoogle Scholar8. MCKENZIE JM: Bioassay of thyrotropin in man. Physiol. Rev. 40: 398, 1960. CrossrefGoogle Scholar9. CHRISTENSENBINDER LKV: A case of hyperthyroidism developed in spite of previous hypophysectomy. Acta Med. Scand. 172: 285, 1962. CrossrefMedlineGoogle Scholar10. MCKENZIE JM: Pathogenesis of Graves' disease: role of the long-acting thyroid stimulator. J. Clin. Endocr. 25: 424, 1965. CrossrefGoogle Scholar11. STERLINGCHODOS KRB: Radiothyroxine turnover studies in myxedema, thyrotoxicosis, and hypermetabolism without endocrine disease. J. Clin. Invest. 35: 806, 1956. CrossrefMedlineGoogle Scholar12. MEANSDEGROOTSTANBURY JHLJJB: The Thyroid and Its Diseases. McGraw-Hill, New York, 1963. Google Scholar13. PLUMMER HS: Results of administering iodine to patients having exophthalmic goiter. JAMA 80: 1955, 1923. Google Scholar14. MEANS JH: The Thyroid and Its Diseases. J. B. Lippincott Co., Philadelphia, 1937, p. 332. Google Scholar15. ASTWOOD EB: Treatment of hyperthyroidism with thiourea and thiouracil. JAMA 122: 78, 1943. CrossrefGoogle Scholar16. VANDERLAANSWENSON WPO: Results of surgical treatment in Graves' disease. New Eng. J. Med. 236: 236, 1947. CrossrefMedlineGoogle Scholar17. GOLDMAN L: Experiences with thyroidectomy in a thyroid clinic, in Transactions of the American Goiter Association—1940. Charles C Thomas, Publisher, Springfield, Ill., 1949, p. 244. Google Scholar18. HAYLESKENNEDYBEAHRSWOOLNER ABRLOHLB: Exophthalmic goiter in children. J. Clin. Endocr. 19: 138, 1959. CrossrefGoogle Scholar19. BARTELS EC: Hyperthyroidism—an evaluation of treatment with antithyroid drugs followed by subtotal thyroidectomy. Ann. Intern. Med. 37: 1123, 1952. LinkGoogle Scholar20. COLCOCKKING BPML: The mortality and morbidity of thyroid surgery. Surg. Gynec. Obstet. 114: 131, 1962. MedlineGoogle Scholar21. ASPER SP: Treatment of hyperthyroidism. Arch. Intern. Med. (Chicago) 106: 878, 1960. CrossrefMedlineGoogle Scholar22. PAINTER NS: Results of surgery in treatment of toxic goitre. A review of 172 cases. Brit. J. Surg. 48: 291, 1960. CrossrefMedlineGoogle Scholar23. GREENWILSON MGM: Thyrotoxicosis treated by surgery or iodine-131. With special reference to development of hypothyroidism. Brit. Med. J. 1: 1005, 1964. CrossrefMedlineGoogle Scholar24. CASSIDY CE: The treatment for hyperthyroidism. Med. Clin. N. Amer. 46: 1201, 1962. CrossrefMedlineGoogle Scholar25. JONESFOURMAN KHP: Prevalence of parathyroid insufficiency after thyroidectomy. Lancet 2: 121, 1963. CrossrefMedlineGoogle Scholar26. DAVISFOURMANSMITH RDPJW: Prevalence of parathyroid insufficiency after thyroidectomy. Lancet 2: 1432, 1961. CrossrefMedlineGoogle Scholar27. ASTWOOD EB: Mechanism of action of antithyroid compounds, in Brookhaven Symposia in Biology No. 7, The Thyroid, 1955, p. 61. Google Scholar28. ALEXANDER NM: Iodine peroxidase in rat thyroid and salivary glands and its inhibition by antithyroid compounds. J. Biol. Chem. 234: 1530, 1959. CrossrefMedlineGoogle Scholar29. MALOOFSOODAK FM: Intermediary metabolism of thyroid tissue and the action of drugs. Pharmacol. Rev. 15: 43, 1963. MedlineGoogle Scholar30. STANLEYASTWOOD MMEB: 1-Methyl-2-mercaptoimidazole: an antithyroid compound highly active in man. J. Clin. Endocr. 44: 588, 1949. Google Scholar31. GREERMEIHOFFSTUDER MAWCH: Treatment of hyperthyroidism with a single daily dose of propylthiouracil. New Eng. J. Med. 272: 888, 1965. CrossrefMedlineGoogle Scholar32. ASTWOOD EB: Use of antithyroid drugs during pregnancy. J. Clin. Endocr. 11: 1045, 1951. CrossrefGoogle Scholar33. HERBSTSELENKOW ALHA: Hyperthyroidism during pregnancy. New Eng. J. Med. 273: 627, 1965. CrossrefMedlineGoogle Scholar34. VANDERLAANSTORRIE WPVM: A survey of factors controlling thyroid function with special reference to newer views on antithyroid substances. Pharmacol. Rev. 7: 301, 1955. MedlineGoogle Scholar35. ASTWOOD EB: Management of thyroid disorders. JAMA 186: 585, 1963. CrossrefMedlineGoogle Scholar36. HERSHMANGIVENSCASSIDYASTWOOD JMJCEEB: Long-term outcome of hyperthyroidism treated with antithyroid drugs. J. Clin. Endocr. In press. Google Scholar37. SOLOMONBECKVANDERLAANASTWOOD DHJCWPEB: Prognosis of hyperthyroidism treated by antithyroid drugs. JAMA 152: 201, 1953. CrossrefMedlineGoogle Scholar38. MCCULLAGHCASSIDY EPCE: Propylthiouracil: 4-6 year follow-up of selected patients with Graves' disease. J. Clin. Endocr. 13: 1507, 1953. CrossrefMedlineGoogle Scholar39. DOUGLASKENNIE DAT: Thiouracil in the treatment of toxic goitre. Brit. Med. J. 2: 1387, 1952. CrossrefMedlineGoogle Scholar40. MANSON DI: Late results of treatment of thyrotoxicosis with thiouracil compounds. Edinburgh Med. J. 60: 321, 1953. MedlineGoogle Scholar41. GOODWINSTEINBERGWILSON JFHA: Long-term therapy of thyrotoxicosis with thiouracil compounds. Brit. Med. J. 1: 422, 1954. CrossrefMedlineGoogle Scholar42. ASPENSTROM G: Late results with propylthiouracil treatment of hyperthyroidism in a goiter region. Acta Med. Scand. 147: 63, 1953. CrossrefMedlineGoogle Scholar43. TROTTER WR: Nonsurgical treatment of thyrotoxicosis. Proc. Roy. Soc. Med. 54: 869, 1961. CrossrefMedlineGoogle Scholar44. WILLCOX PH: Twelve years' experience of antithyroid treatment. Postgrad. Med. J. 38: 275, 1962. CrossrefMedlineGoogle Scholar45. REVENOROSENBAUM WSH: Observations on the use of antithyroid drugs. Ann. Intern. Med. 60: 982, 1964. LinkGoogle Scholar46. CASSIDY CE: Use of a thyroid suppression test as a guide to prognosis of hyperthyroidism treated with antithyroid drugs. J. Clin. Endocr. 25: 155, 1965. CrossrefGoogle Scholar47. KREVANSASPERRIENHOFF JRSPWF: Fatal aplastic anemia following use of potassium perchlorate in thyrotoxicosis. JAMA 181: 162, 1962. CrossrefMedlineGoogle Scholar48. INGBAR SH: Physiological considerations in treatment of diffuse toxic goiter. Arch. Intern. Med. (Chicago) 107: 932, 1961. CrossrefMedlineGoogle Scholar49. CANARYSCHAAFDUFFYKYLE JSMBJLH: Effects of oral and intramuscular reserpine in thyrotoxicosis. New Eng. J. Med. 257: 435, 1957. CrossrefMedlineGoogle Scholar50. LEEBRONSKYWALDSTEIN WYDSS: Studies of the thyroid and sympathetic nervous system interrelationship. II. Effect of guanethidine on manifestations of hyperthyroidism. J. Clin. Endocr. 22: 879, 1962. CrossrefMedlineGoogle Scholar51. CASSIDYASTWOOD CEEB: Evaluation of radioactive iodine (I131) as a treatment for hyperthyroidism. New Eng. J. Med. 261: 53, 1959. CrossrefMedlineGoogle Scholar52. DUNNCHAPMAN JTEM: Rising incidence of hypothyroidism after radioactive iodine therapy in thyrotoxicosis. New Eng. J. Med. 271: 1037, 1964. CrossrefMedlineGoogle Scholar53. SKILLERNMCCULLAGHCLAMEN PGEPM: Radioiodine in diagnosis and therapy of hyperthyroidism. Hyperthyroidism caused by hyperfunctioning thyroid adenoma. Arch. Intern. Med. (Chicago) 110: 888, 1962. CrossrefMedlineGoogle Scholar54. SHELINELINDSAYMCCORMACKGALANTE GESKRM: Thyroid nodules occurring late after treatment of thyrotoxicosis with radioiodine. J. Clin. Endocr. 22: 8, 1962. CrossrefMedlineGoogle Scholar55. POCHIN EE: Leukaemia following radioiodine treatment of thyrotoxicosis. Brit. Med. J. 2: 1545, 1960. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Chicago, IllinoisFrom the Section of Metabolism and Endocrinology, Department of Medicine, Northwestern University Medical School, Chicago, Ill.Requests for reprints should be addressed to Jerome M. Hershman, M.D., Veterans Administration Research Hospital, 333 East Huron St., Chicago, Ill. 60611.*Calleb Hillier Parry described the same condition in 1786 which was published in his posthumous writings in 1825 (2, 3); nevertheless, the eponym, Graves' disease, has been established by usage. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byWhither thyrotoxicosis?Hypothyroidism following partial thyroidectomy for thyrotoxicosis and its relationship to thyroid remnant sizeHyperthyroidismUltrasound-Guided Biopsy and Ablation in the NeckManagement guidelines for hyperthyroidismTotal thyroidectomy for Graves' diseaseEverything you wanted to know about Graves' diseaseHemangiomaNEED FOR ALBUMIN ADJUSTMENTS OF URGENT TOTAL SERUM CALCIUMPLACE OF RADIOACTIVE IODINE IN TREATMENT OF THYROTOXICOSISInvited commentaryTHE DIAGNOSIS AND TREATMENT OF THYROTOXICOSISTotal thyroidectomy in the management of graves' diseaseThe treatment of thyrotoxicosis by radioiodineHyperthyroidism. Causes, etiology of Graves’ disease, clinical features, general aspects of treatmentSurgery of the ThyroidMyxedema: Recognition and TreatmentKontrollierte HyperthyreosetherapieTreatment of thyrotoxicosis — the current position Part II: Drug therapy and thyroidectomyBenefits and risks in nuclear medicine.Pathogenesis and Treatment of ThyrotoxicosisA New Look at Radioiodine Therapy of ThyrotoxicosisA FOLLOW-UP OF THYROTOXIC PATIENTS TREATED BY PARTIAL THYROIDECTOMY 1 June 1966Volume 64, Issue 6Page: 1306-1314KeywordsAnxietyEndocrinologyHyperthyroidismLesionsThyroidThyroid hormonesThyroidectomyWeight loss ePublished: 1 December 2008 Issue Published: 1 June 1966 PDF downloadLoading ...