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Question  My 77-year old mother has been diagnosed with a slightly over-active thyroid. She shows some of the effects (nervous, emotional, fidgeting etc), but is otherwise healthy. The only pill she has been taking in the past few years is for a slightly high blood pressure. She lives on her own and is very active and independent.I live in the States, my mom lives in The Netherlands, so it is hard for me to keep an eye on her.
I am wondering what the best course to take is for her. She has seen a doctor who gave her a low dosage (10mg) of Strumazol, but it turns out she has bad side-effects. She has lost up to 10 kgs on a petite frame and I am now wondering about the best treatment.
My concrete questions:
-does this condition ever get better by itself?
-is the nuclear iodine treatment her only option when the medication does not agree with her (strumazol)?
-do you know of any specialized institutes for thyroid conditions in The Netherlands?
Response-In relation to your mother:
a. Yes it could get better on its own but this is not particularly commeon. Also the risks of untreated or poorly treated hyperthyroidism in this age group can be very significant eg heart failure and other problems
b. Yes radioiodine is essentially the only option if anti thyroid drugs are unsuitable. Radioiodine is safe,effective and cheap. Thyroxine therapy would probably be required long term. Surgery in this age group is not appropriate unless there is a very large goitre.
c. There are excellent specialist centres in Amsterdam, Rotterdam and Leiden.
My suggestion would be that she should receive radioiodine therapy as soon as possible
John Lazarus, MD