Managing Hyperthyroidism: Medication Challenges and Allergic Reactions

Thyroid issues = Hyperthyroidism medication, urticaria, and medication-related problems?

I was diagnosed with hyperthyroidism in mid-October last year (taking only one pill a day).
I started with the first medication, Methimazole, but after three days I felt extremely uncomfortable, fatigued, unable to eat or sleep.
I switched to the second medication, Propylthiouracil, and after a month and a half, I developed hives all over my body.
I then switched to the third medication, Neomercazole, and after another month and a half, I started experiencing hives again.
The doctor mentioned that although my thyroid hormone levels are within the normal range, I need to take medication for at least 1 to 1.5 years for the thyroid antibodies to disappear.
However, there are no alternative medications for hyperthyroidism, so I can only take one hyperthyroid pill and one antihistamine pill daily.
Since I do not have symptoms like bulging eyes, a thick neck, or tremors, the doctor said surgery is not necessary.
Initially, I was diagnosed with hyperthyroidism due to extreme fatigue.
Is it really necessary to take these medications for a year? Will long-term use of antihistamines have any effects on my body? Are there truly no alternative medications for hyperthyroidism? I feel extremely drowsy and fatigued from the antihistamines (as I am quite sensitive to Western medications).
What should I do, doctor? Thank you.

kitty, 40~49 year old female. Ask Date: 2020/01/21

Dr. Lin Jianliang reply Internal Medicine

There are generally two to three types of medications used to treat hyperthyroidism, and typically, treatment lasts for one to two years.
If medication is not suitable, surgical intervention or radioactive iodine therapy may be considered.
Antihistamines commonly have side effects such as dizziness and drowsiness.

Reply Date: 2020/01/21

More Info

Managing hyperthyroidism can indeed be challenging, especially when it comes to medication side effects and allergic reactions. Based on your experience, it seems you've encountered significant discomfort with the medications prescribed for your condition. Let's break down your situation and address your concerns.

Firstly, hyperthyroidism is often treated with antithyroid medications such as methimazole (甲美樂), propylthiouracil (僕樂彼), and others. These medications work by inhibiting the production of thyroid hormones, which can help normalize thyroid function. However, as you've experienced, they can also lead to side effects, including allergic reactions like urticaria (hives) and systemic symptoms such as fatigue and malaise.

1. Duration of Treatment: Your doctor mentioned that you may need to continue medication for 1 to 1.5 years until the thyroid antibodies decrease. This is a common approach, as hyperthyroidism can be a chronic condition that requires long-term management. The goal is to maintain stable thyroid hormone levels while minimizing side effects. If your thyroid function tests are within normal limits, it indicates that the medication is working, but the duration of treatment can vary based on individual circumstances.

2. Allergic Reactions: The urticaria you've experienced is concerning and suggests that you may have a sensitivity to the medications. It's important to communicate these reactions to your healthcare provider. They may consider alternative treatments or adjunct therapies to manage your symptoms. In some cases, switching to a different class of medication or adjusting the dosage can help mitigate side effects.
3. Long-term Use of Antihistamines: You mentioned taking an antihistamine (暢寧錠) to manage your allergic reactions. While antihistamines can be effective for treating allergic symptoms, long-term use can lead to side effects such as sedation, fatigue, and cognitive impairment. It's crucial to monitor how you feel and discuss any persistent symptoms with your doctor. They may recommend a different approach to managing your allergies or suggest a temporary break from the antihistamine.

4. Alternative Treatments: If you continue to have adverse reactions to the antithyroid medications, you might want to discuss other treatment options with your healthcare provider. These could include radioactive iodine therapy or, in some cases, surgery, depending on the severity of your hyperthyroidism and your overall health. It's essential to weigh the benefits and risks of each treatment option.

5. Lifestyle Adjustments: In addition to medication, lifestyle changes can also support your treatment. Maintaining a balanced diet, managing stress, and getting regular exercise can help improve your overall well-being. Additionally, consider discussing with your doctor the possibility of working with a nutritionist or a specialist in integrative medicine who can provide guidance tailored to your needs.

In conclusion, managing hyperthyroidism can be complex, especially when faced with medication side effects and allergic reactions. It's essential to maintain open communication with your healthcare provider, report any adverse effects, and explore alternative treatment options if necessary. Your health and comfort should always be the priority, and together with your doctor, you can find a management plan that works best for you.

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