Thyrotoxicosis: changing trends in treatment.

A review of treatment of thyrotoxicosis over a 14 year period has led to three modifications in our approach. Firstly, we now treat fewer patients with a prolonged course of carbimazole, recommending surgery as primary treatment in more patients, particularly the young and middle aged severe thyrotoxics. Secondly, we use conventional therapeutic doses of radioiodine very much less frequently, because of the unpredictable response, and when using radioiodine attempt thyroid ablation more frequently. Thirdly, conventional 'ablative' doses are frequently too low.