Anti-thyroid drugs are active ingredients that inhibit the hormone metabolism of the thyroid gland and are mainly used in various forms of hyperthyroidism. In addition to the pharmaceutical anti-thyroid drugs, there are also some herbal or homeopathic substances that should only be considered therapeutically in the case of slight hyperthyroidism.
What are anti-thyroid drugs?
As Anti-thyroid drugs are substances that normalize thyroid function by inhibiting the synthesis or secretion of thyroid hormones or the incorporation of iodine into the precursors of thyroid hormones and bring about a remission of clinical symptoms.
In general, substances with a thyrostatic effect are divided into so-called iodination and iodization inhibitors as well as iodides, which intervene in the hormone metabolism of the thyroid in different ways.
Thyrostatic drugs are usually used in the therapy of various subforms of hyperthyroidism (overactive thyroid gland) such as Graves' disease, functional thyroid autonomy and iodine-induced hyperthyroidism.
Medical application, effect & use
The three different substance groups of the Anti-thyroid drugs develop their effect at different points of attack of the metabolism of the thyroid gland or the thyroid hormones and serve to normalize and stabilize the thyroid function.
So-called thiourea derivatives have an inhibitory effect on peroxidases (iodization inhibitors). These enzymes catalyze the reduction of peroxides, which in turn are necessary for the incorporation of iodine into the thyroid hormones and the binding of the precursors monoiodotyrosine and diiodotyrosine. These anti-thyroid drugs are used in particular for Graves' disease, in the pre- and post-treatment of radioiodine therapy, in the run-up to a surgical procedure and in a thyrotoxic crisis.
In the case of goiter formation and hypersensitivity reactions (including fever, urticaria), the application of these anti-thyroid drugs is contraindicated.Perchlorate (iodination inhibitor), on the other hand, primarily reduces the transport of iodide into the thyroid gland by inhibiting the uptake of iodide by the thyrocytes. Perchlorate has only a narrow therapeutic range and is usually used for rapid iodide blockade of the thyroid gland or prophylactically prior to radiological examinations with iodine-containing contrast media, especially in those affected in whom the contrast medium can trigger a thyrotoxic crisis.
In high doses, iodides reduce hormone secretion by blocking the enzymes that release thyroid hormones in the blood so that they can no longer be effective. Iodides are only applied preoperatively, mostly in combination with thiourea derivatives, or in the short term in thyrotoxic crises.
Herbal, natural & pharmaceutical anti-thyroid drugs
Vegetable Anti-thyroid drugs contain, as single or combination therapeutics, primarily lycopi herba or extracts or extracts from lycopi herba. Above all, the lithosperic acid contained in the leaves of the plant is said to have a lowering property on the thyroid hormones by inhibiting the transport of iodine.
The thyrostatic agent should only be used if the thyroid is slightly overactive with nervousness and / or rhythm disorders (so-called vegetative-nervous disorders). In addition, it should be taken into account that preparations containing Lycopi herba can impair radioisotopic examinations of the thyroid gland. In addition, wolfwort is contraindicated in the case of an enlargement of the thyroid gland without functional impairment.
As part of a homeopathic therapy, in addition to Lycopi herba Chininum arsenicosum (Chininarsenit), Lycopus virginicus (Virginian Wolfstrapp), Adonis vernalis (Adonis rose), Fucus vesiculosus (colloquially bladder wrack), Potassium iodatum (especially with Schuessler Salt No. 15) slight hyperfunction with nervous heart complaints.
Common and therapeutically proven chemical-pharmaceutical agents are primarily perchlorate, which, as an iodination inhibitor, inhibits the absorption of iodide, as well as the thiourea derivatives thiamazole, carbimazole and propylthiouracil, which act as iodination inhibitors and reduce the synthesis of thyroid hormones.
Risks & side effects
Thyrostatic therapy measures can lead to various undesirable side effects depending on the dosage. With low doses, hypersensitivity reactions (drug eruptions) and occasionally also joint pain can be observed.
In particular, high doses lead to pronounced suppression of the thyroid gland, through which the pituitary gland stimulates TSH secretion to increase hormone incretion and thus can cause hyperplasia. Other side effects of anti-thyroid drugs are changes in the blood count (leukopenia, granulocytopenia or agranulocytosis), goiter (enlarged thyroid), liver damage, hypothyroidism (underactive thyroid), jaundice (jaundice), progression of exophthalmos (bulging eyes) and gastrointestinal complaints.
In addition, the use of Anti-thyroid drugs be avoided, as these cross the placental barrier, affect the thyroid gland of the growing child and can lead to hypothyroidism.
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