Clinical effectiveness of Carbimazole and Propylthiouracil for Hyperthyroidism in Patients of Punjab, Pakistan

Maria Fareed Siddiqui, Sidra Hasnain, Zahra Batool, Mahmood Hussain Qazi, Muhammad Imtiaz, Ismat Fatima, Rabail Alam


Background: The primary objective of any drug for hyperthyroidism is to control clinical manifestations and maintenance of normal levels of hormonal concentrations. It also targets to prevent the recurrence of disease along with minimizing associated risk factors. In this study, effectiveness of oral anti thyroid agents was checked to normalize altered levels of thyroid hormones due to hyperthyroidism.

Methods: The study was comprised of 40 subjects of whom 30 were experiencing hyperthyroidism and were administered anti-hyperthyroid drugs. 10 patients of hyperthyroidism were not taking any medication. Standard dose regimens of carbimazole and propylthiouracil were employed for all 30 hyperthyroid patients under closed monitoring. Physical as well as biochemical analyses of all subjects were done and thyroid profiling was performed for measuring levels of free thyroxine (fT4), free triiodothyronine (fT3), thyroid stimulating hormone (TSH) and antibodies against thyroglobulin (Tg).

Results: Thyroid profiles of medicated hyperthyroid patients were compared with the profiles of non-medicated group. Statistical analysis appeared with non-significant values for all four parameters.

Conclusion: No significant difference was found between medicated and non-medicated groups. We recommend that combinatorial drugs and new derivatives with better efficacy and fewer side effects should be employed to treat hyperthyroidism.

Full Text:



Wirth EK, Sheu S-Y, Chiu-Ugalde J, Sapin R, Klein MO, et al. Monocarboxylate transporter 8 deficiency: altered thyroid morphology and persistent high triiodothyronine/thyroxine ratio after thyroidectomy. European Journal of Endocrinology, (2011); 165(4): 555-561.

Malandrino P, Latina A, Marescalco S, Spadaro A, Regalbuto C, et al. Risk-adapted management of differentiated thyroid cancer assessed by a sensitive measurement of basal serum thyroglobulin. The Journal of Clinical Endocrinology & Metabolism, (2011); 96(6): 1703-1709.

Garber JR, Cobin RH, Gharib H, Hennessey JV, Klein I, et al. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocrine Practice, (2012); 18(6): 988-1028.

Spencer CA, LoPresti JS. Technology Insight: measuring thyroglobulin and thyroglobulin autoantibody in patients with differentiated thyroid cancer. Nature Clinical Practice Endocrinology & Metabolism, (2008); 4(4): 223-233.

Iervasi A, Iervasi G, Bottoni A, Boni G, Annicchiarico C, et al. Diagnostic performance of a new highly sensitive thyroglobulin immunoassay. Journal of endocrinology, (2004); 182(2): 287-294.

Harish K. Thyroglobulin: current status in differentiated thyroid carcinoma (review). Endocrine regulations, (2006); 40(2): 53-67.

De Escobar GM, Obregón MJ, Del Rey FE. Role of thyroid hormone during early brain development. European Journal of Endocrinology, (2004); 151(Suppl 3): U25-U37.

Tallstedt L, Lundell G, Tørring O, Wallin G, Ljunggren J-G, et al. Occurrence of ophthalmopathy after treatment for Graves' hyperthyroidism. New England Journal of Medicine, (1992); 326(26): 1733-1738.

Pinto A, Glick M. Management of patients with thyroid disease: oral health considerations. Journal of the American Dental Association (1939), (2002); 133(7): 849-858.

Feldt-Rasmussen U, Rasmussen AK. Autoimmunity in differentiated thyroid cancer: significance and related clinical problems. Hormones, (2010); 9(2): 109-117.

Abraham P, Avenell A, Watson WA, Park CM, Bevan JS. Antithyroid drug regimen for treating Graves’ hyperthyroidism. Cochrane Database Syst Rev, (2005); 18(2).

Uduak O, Ani EJ, Etoh E, Macstephen AO. Comparative effect of Citrus sinensis and carbimazole on serum T 4, T 3 and TSH levels. Nigerian Medical Journal, (2014); 55(3): 230.

Vitti P, Rago T, Chiovato L, Pallini S, Santini F, et al. Clinical features of patients with Graves' disease undergoing remission after antithyroid drug treatment. Thyroid, (1997); 7(3): 369-375.

Cooper DS. Antithyroid drugs. New England Journal of Medicine, (2005); 352(9): 905-917.

Warnock AL, Cooper DS, Burch HB. Life-Threatening Thyrotoxicosis: Thyroid Storm and Adverse Effects of Antithyroid Drugs. Congestive heart failure, (2014); 130(139): 20.

Samuels MH. The Use of Tests for the Diagnosis and Monitoring of Thyroid Disease. Lab Medicine, (2001); 32(5): 257-259.

Ross DS. Radioiodine therapy for hyperthyroidism. New England Journal of Medicine, (2011); 364(6): 542-550.

Shomon M (2000) Living well with hypothyroidism. New York, Avon Books.

Vanderpump M, Ahlquist J, Franklyn J, Clayton R. Consensus statement for good practice and audit measures in the management of hypothyroidism and hyperthyroidism. The Research Unit of the Royal College of Physicians of London, the Endocrinology and Diabetes Committee of the Royal College of Physicians of London, and the Society for Endocrinology. BMJ: British Medical Journal, (1996); 313(7056): 539.

Ajjan RA, Weetman AP. Medical management of hyperthyroidism. European Endocrine Disease, (2007); 177-80.

Santos RB, Romaldini JH, Ward LS. Propylthiouracil reduces the effectiveness of radioiodine treatment in hyperthyroid patients with Graves' disease. Thyroid, (2004); 14(7): 525-530.

Siersbaek-Nielsen K, Kirkegaard C, Rogowski P, Faber J, Lumholtz B, et al. Extrathyroidal effects of propylthiouracil and carbimazole on serum T4, T3, reverse T3 and TRH-induced TSH-release in man. Acta endocrinologica, (1978); 87(1): 80-87.

Marcocci C, Kahaly GJ, Krassas GE, Bartalena L, Prummel M, et al. Selenium and the course of mild Graves' orbitopathy. New England Journal of Medicine, (2011); 364(20): 1920-1931.


  • There are currently no refbacks.