What is the first line treatment for hyperthyroidism?

The first-line treatment for hyperthyroidism, particularly in cases of Graves' disease, is methimazole. Methimazole works by inhibiting the enzyme thyroid peroxidase, which is crucial for the synthesis of thyroid hormones. By blocking this enzyme, methimazole effectively reduces the amount of thyroid hormone produced by the thyroid gland, leading to a decrease in symptoms associated with hyperthyroidism, such as palpitations, anxiety, and weight loss.

The choice of methimazole as first-line treatment is based on its efficacy and safety profile. It tends to have fewer side effects compared to other treatments, such as radioactive iodine, and can be a preferable option for many patients, especially younger individuals or those who may wish to preserve thyroid function. Additionally, it can be used in combination with beta-blockers to manage symptoms like tachycardia.

Other options such as levothyroxine are not indicated as they would provide thyroid hormones and exacerbate hyperthyroidism. Radioactive iodine ablation is typically considered for longer-term management or in patients who do not respond to methimazole or for whom methimazole is not appropriate. Propranolol, while useful for symptomatic relief of hyperthyroid symptoms, does not address the underlying hyper