Table 1

 Treatment of thyrotoxicosis in young people

MedicalRelatively simplePotentially life threatening side effects
Relatively cheapMost appropriate regimen unknown
Non-invasiveCompliance issues
Low remission rates
Surgical (totalDefinitiveSurgical expertise required
thyroidectomy)Removes an unsightly goitreAnaesthetic risk
Surgical complications
Specific complications: hypoparathyroidism laryngeal nerve palsy visible scar (+/− keloid)
Risk of thyroid “crisis”
Thyroxine replacement required
RadioiodineUsually definitiveInitial inconvenience after RI administration
CheapShort term side effects, e.g. neck discomfort, transient hypoparathyroidism
Non-invasiveMay precipitate thyroid crisis
Second dose may be needed
Ophthalmopathy may deteriorate
Thyroxine replacement required
Relative lack of long term safety data in the young