[Therapy of hyperthyroidism: indications, advantages and disadvantages of treatment of the adult and the elderly].

: Hyperthyroid syndromes can be approached in three different ways: medical, surgical and radiant. The medical therapy concerning the treatment of Basedow's disease is based on the extended use of thionamide drugs, which inhibits thyroid hormone biosynthesis and allows progressive recovery to normal glandular function. Agranulocytosis has been reported as the most serious side-effect. Inorganic iodide, lithium salts, beta-adrenergic receptor blocking agents and glucocorticoids have been employed as therapeutic alternatives, though of not common clinical use. Thyroidectomy is preferentially indicated in the treatment of toxic adenoma in fertile age groups and hyperfunctional bulky goiters. The postoperative complications connected with thyroidectomy are the main disadvantages. The use of radioactive iodine is currently the therapy chosen for toxic adenoma after forty years of age and particularly for hyperthyroid syndromes of elderly people, in whom scanty compliance with therapeutic suggestions and the increased postoperative risk make it preferable to other therapies, though incidental development of hypothyroidism after radioactive iodine treatment is not an unusual consequence.