Graves’ disease can be treated with drugs, radioiodine administration or surgery. Because the disease sometimes resolves spontaneously, drugs are used first, such as thiamazole (brand name Strumazol® or Thyrozol®). If the heart rate accelerates or heart rhythm disturbances occur, a beta-blocker is also given temporarily to slow the heart rate back down to normal.
By administering thiamazole, thyroid hormone production will generally almost completely stop and extra thyroid hormone may be given to bring the amount in the blood back to normal, or the thiamazole dose may be reduced.
After at least two years of treatment, treatment can be discontinued on a trial basis if the TSH receptor antibodies have disappeared. That chance of sustained remission is quite high at 30 to 50%. If the disease flairs up again, thiamazole is then restarted. In older children, destruction of the thyroid gland can be discussed as an alternative to another treatment cycle of thiamazole. This results in a lifelong need for thyroxine replacement therapy. Thyroid gland destruction can be performed by administering radioactive iodine or by surgical removal of the entire thyroid gland.