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1.Anti-thyroid drugs: Carbimazole and propylthiouracil. Main side effects are neutropenia but rashes are also common.
2.Radioactive iodine: Insufficient dosing may lead to recurrent thyrotoxicosis. Patient may eventually develop hypothyroidism. There is a theoretical risk of malignancy associated with radioactive iodine so it is reserved for older patients. Pregnancy is an absolute contraindication.
3.Surgery: usually a subtotal thyroidectomy. Complications are those associated with any surgical procedure but also: damage to recurrent laryngeal nerve leading to vocal cord paralysis, haemorrhage causing tracheal obstruction, hypocalcaemia due to parathyroid damage, thyrotoxic crisis due to release of thyroid hormone during surgery.
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