[Common Diseases] Hyperthyroidism
Hyperthyroidism: An In-Depth Analysis of Treatment Options in Hong Kong | A Comprehensive Comparison of Medication, Radioiodine, and Surgery
Hello everyone, today I'd like to discuss a common endocrine disorder in Hong Kong, particularly among women: hyperthyroidism (HT). According to the Hong Kong Hospital Authority, HT is caused by an overproduction of thyroid hormones by the thyroid gland, leading to an abnormally accelerated metabolism that can affect the heart, muscles, nervous system, and even mood.
Many people, upon hearing they have hyperthyroidism, worry about having to take medication for the rest of their lives, or mistakenly believe surgery is essential. In reality, there are many treatment options, and both public and private healthcare in Hong Kong offer established programs. We've compiled a comprehensive guide to hyperthyroidism treatment , drawing on the clinical advice of Hong Kong endocrinologists and international medical guidelines.
What is hyperthyroidism?
- The thyroid gland is located in the front of the neck and secretes thyroid hormones (T3 and T4) to control the body's metabolic rate.
- Hyperthyroidism refers to excessive secretion of thyroid hormone, which causes the body to operate in a "high-speed" state.
- The most common cause is Graves' disease – an autoimmune disorder in which the immune system produces antibodies that stimulate the thyroid gland to overwork.
- Other causes include toxic multinodular goiter, thyroid adenoma, subacute thyroiditis, etc.
Common symptoms (Hong Kong Department of Health information)
- Rapid heartbeat and palpitations
- Weight loss (even if food intake increases)
- Hand tremors, excessive sweating, and intolerance of heat
- Tension, irritability, and insomnia
- Proptosis (particularly with Graves disease)
- Irregular menstruation
- Muscle weakness and fatigue
⚠️ If the condition is severe and not treated, thyroid storm may occur, leading to high fever, arrhythmia, shock, and even life-threatening.
Hong Kong Hyperthyroidism Treatment Principles
According to the Hong Kong Hospital Authority's Guidelines for the Management of Thyroid Disease and the recommendations of the International Society of Endocrinology, treatment goals include:
- Restore and maintain normal thyroid hormone levels
- Relieve symptoms
- Prevent complications (eg, atrial fibrillation, osteoporosis, thyroid storm)
- Cure or long-term control of the disease
Commonly used treatments include three main categories: antithyroid drugs, radioactive iodine therapy, surgical resection , and symptomatic supportive treatment.
1. Drug treatment (antithyroid drugs)
Principle : Inhibit the synthesis of thyroid hormones and gradually restore thyroid function to normal.
Commonly used medicines in Hong Kong:
- Methimazole
- Propylthiouracil (PTU) : mostly used in early pregnancy or for those who are intolerant to methimazole
Treatment course :
- Typically lasts 12–18 months
- Regular blood tests (thyroid function, liver function, white blood cell count) are required during this period
- Some patients can be cured, but there is also a risk of relapse
side effect :
- Mild: rash, joint pain, stomach upset
- Severe (rare): agranulocytosis, hepatitis (need to stop the drug immediately and seek medical attention)
💡 Public hospitals will give priority to drug treatment, especially for young patients or those with milder conditions; private medical care allows more flexibility in choosing the course of treatment and adjusting dosage.
2. Radioactive Iodine (RAI)
Principle : Oral administration of radioactive iodine-131, which is absorbed by the thyroid gland, destroys overactive thyroid cells and reduces hormone secretion.
Applicable to :
- Ineffective drug treatment or repeated relapses
- Unable or unwilling to undergo surgery
- Older age or those with other chronic diseases
Application in Hong Kong :
- There are nuclear medicine departments in Queen Mary Hospital, Prince of Wales Hospital, etc.
- Private hospitals such as Hong Kong Adventist Hospital and Hong Kong Sanatorium and Hospital also provide
Notes :
- It takes several months for the treatment to show results
- May cause permanent hypothyroidism (requiring lifelong thyroid hormone supplementation)
- Pregnant women and breastfeeding women are prohibited
3. Surgical treatment (thyroidectomy)
type :
- Total Thyroidectomy
- Near-total
- Subtotal
Applicable situations :
- An enlarged thyroid gland that presses on the trachea or esophagus
- Suspected or associated thyroid tumor
- Drugs and radioactive iodine treatment are ineffective or unsuitable
Hong Kong situation :
- Public hospitals are operated by surgical specialists, which are cheap but require waiting time.
- Private hospitals can arrange surgery faster, but at a higher cost
risk :
- Vocal cord nerve damage (hoarseness)
- Parathyroid gland damage (hypocalcemia)
- Most patients require lifelong thyroid hormone supplementation after surgery
4. Symptomatic supportive treatment
- Beta-blockers (such as Propranolol): Reduce palpitations, anxiety, and hand tremors
- Adjust diet: high-calorie, high-protein diet to replenish consumption
- Avoid foods high in iodine (such as kelp and seaweed) to avoid aggravating the condition
Comparison of treatment options (common practice in Hong Kong)
| plan | advantage | shortcoming | Public medical situation | Private medical conditions |
|---|---|---|---|---|
| Antithyroid drugs | Non-invasive and reversible | Long-term medication is required and there is a risk of relapse | Preferred option | More frequent follow-up |
| Radioactive iodine | Non-surgical, one-time treatment may cure the disease | Delayed effect, may cause hypothyroidism | Available in large hospitals with nuclear medicine departments | Can be arranged quickly |
| Surgical resection | Instant effect, can treat tumors | There are surgical risks and lifelong medication is required | Long waiting times for surgical appointments | Quick arrangement but high cost |
Editor's warm summary
While hyperthyroidism can affect the heart, bones, and overall health, Hong Kong's healthcare system offers a variety of effective treatments. Public hospitals generally begin with medication for observation. Only after repeated recurrences or when medication is unsuitable will radioactive iodine or surgery be considered. Private healthcare offers more flexibility in choosing options based on patient needs. After diagnosis, it's recommended to have regular follow-up blood tests and be aware of any sudden heart palpitations, fever, or weakness, as these could be signs of thyroid crisis and require immediate hospitalization.
This article is for reference only and does not constitute any medical advice. The source is referenced from major medical articles
