Pick a sustain method to match your gear and bank. There are four established approaches.
1. Magic + freeze/safespot (the standard). Walk in, freeze thermy with the best ice spell you have, step back a tile so it can't reach you, and DPS it down from 9 tiles. With Tumeken's shadow this is the fastest clear and the closest thing to a no-damage kill. Re-freeze as the timer runs out. This is where the 60–100 kills/hour figure comes from.
2. Blood Barrage healing. If you have strong magic-attack and strength-bonus gear, Blood Barrage can out-heal thermy's damage, letting you chain very long trips. The Ancient sceptre's passive and bloodbark armour support this with little magic loss, and Augury plus a Forgotten brew or imbued heart raise effectiveness. The catch: the wiki notes it runs roughly 2–3x slower than using Tumeken's shadow, and it's only profitable if you hit uniques. Bring plenty of prayer/super restores and a little emergency food for unlucky splash streaks.
3. Redemption method (cheap sustain). With 49+ Prayer, run the Redemption prayer: when your HP drops below 10% it spends your remaining prayer to heal you for 25% of your Prayer level (rounded down). After each trigger, quickly sip a prayer-restoring dose and re-flick Redemption. Because thermy's max hit is 8, you must stay at 9 HP or more at all times so a hit can't kill you before Redemption fires — which is exactly why 90 Hitpoints is recommended. Zamorak/ancient/forgotten brews make this dramatically cheaper than prayer potions; a high-level player can sustain a full trip on zamorak brews alone.
4. Walk-under method (no-mage option). Your attack speed is slower than thermy's, so for each of your hits it gets 2–2.5. By stepping under thermy right after you attack, you hide from its shots until you step out again, cutting damage taken by 50–60%. There's an advanced refinement: NPCs stop moving when the player they're targeting is underneath them and the player clicks a ground item or interactive object (anything that produces a red 'X'). So you can click the ashes thermy drops every kill — or the room door — to lock it in place and settle into a clean 1:1 rhythm. A reliable setup is to stand on thermy's west side, then alternate: attack the boss, click the door, walk the two tiles back under it, and re-attack once you see the XP drop. This is the preferred method for players who don't want to (or can't) mage.
There is also a fast POH/Nardah special-attack method: bring max strength gear and a heavy spec weapon like dragon claws, dump specials to kill thermy almost instantly, then teleport home to a rejuvenation pool (or use a Desert amulet 4 if you've done the elite Desert Diary) to restore HP, prayer and special between kills. It's cheap and high-profit but slower than a clean magic rotation, because the boss has only a short respawn timer and the fight ends so fast that the teleport overhead dominates.
Two DPS extras stack onto any method: casting Resurrect Greater Zombie raises your damage output by around 5%, and because kills are so quick, Death Charge can be re-applied in rapid succession to keep your special-attack energy topped up.