The indications for antithyroid therapy are shown in Fig. 17.48. Absolute indications for drug therapy are pregnancy and thyrotoxic crisis. In North America, the dosage of antithyroid drugs required to control hyperthyroidism is generally higher than that required in Europe, and the relapse rate is greater, possibly because of the higher iodine intake in that part of the world. This results in a higher prevalence of drug side effects and favours the use of alternative treatment regimens such as radioiodine therapy.
Immunosuppressive therapy with corticosteroids and other drugs such as azothioprine and cyclosporin A is not justified because of toxicity and the availability of other, safer forms of therapy.
