What is the first-line treatment for Graves disease?

Graves' disease, an autoimmune condition that leads to hyperthyroidism, typically presents with symptoms such as weight loss, heat intolerance, palpitations, and goiter. The primary goal in treating this condition is to achieve a euthyroid state by reducing the production of thyroid hormones.

The first-line treatment for Graves' disease is the use of antithyroid medications, namely propylthiouracil (PTU) or methimazole. These medications work by inhibiting the synthesis of thyroid hormones. PTU has the added advantage of blocking the conversion of thyroxine (T4) to triiodothyronine (T3), which is particularly beneficial in acute settings, such as in the case of a thyroid storm. Methimazole is often preferred due to its longer half-life and once-daily dosing, making it more convenient for patients.

While other treatment options exist, including radioactive iodine ablation and surgical thyroidectomy, these are typically considered in specific situations, such as when patients are intolerant to antithyroid medications, have large goiters, or wish to be free of medications. The choice of treatment will depend on various factors, including the patient's age, severity of the disease, and personal