DEAR MAYO CLINIC: What can you acquaint me about Graves’ disease? I’m a 33-year-old woman and was diagnosed aftermost week, but had never heard of this action before. How is it treated?
ANSWER: Graves’ ache — a ataxia in which the thyroid gland makes added thyroid hormone than the anatomy needs — is the best accepted anatomy of hyperthyroidism in the U.S. Although it can affect both women and men and action at any age, the action is bristles to 10 times added accepted in women and about starts afore age 40. Graves’ ache is rarely life-threatening. However, afterwards treatment, it can advance to affection problems and anemic and breakable bones.
Graves’ ache is accepted as an autoimmune disorder. That’s because with the disease, your allowed arrangement attacks your thyroid, a small, erfly-shaped gland at the abject of your neck. Antibodies alleged thyroid-stimulating immunoglobulins (TSI) afresh account your thyroid to accomplish boundless amounts of two thyroid hormones: triiodothyronine (T3) and thyroxine (T4).
These hormones advice adapt your metaism (how your anatomy uses energy). However, back your anatomy makes too abundant of them, abounding actual functions can be kicked into overdrive — causing aggregate from afraid and a accelerated baby to abrupt weight accident and fatigue.
Added signs and affection may accommodate all-overs or nervousness, beddy-bye difficulties, changes in menstrual cycles, accepted bowel movements and an continued thyroid gland (goiter). Some bodies additionally may advance Graves’ ophthalmopathy, a action that causes bloom and abscess about the eyes and billowing of the eyeballs aural the eye sockets. Accession potential, but uncommon, assurance of Graves’ ache is agglomeration and bloom of the skin, about on the shins.
It’s cryptic why some bodies advance Graves’ disease. But actuality a woman in your changeable years increases the risk. So does accepting a ancestors history of the ache or accepting accession autoimmune ataxia — such as blazon 1 diabetes or rheumatoid arthritis.
To analyze Graves’ disease, doctors frequently booty a medical history, accomplish a concrete exam, and adjustment one or added lab tests. These tests may accommodate thyroid action tests, a radioactive iodine uptake analysis or an antibiotic test.
The analysis goals for Graves’ ache are to arrest assembly of thyroid hormones and abate the severity of symptoms. There are several analysis options, including:
•Anti-thyroid medications: These drugs, such as methimazole (Tapazole), accumulate the thyroid from authoritative too abundant thyroid hormone. Afterwards one or two years of treatment, thyroid action may adapt in some bodies and aftereffect in a abiding absolution of Graves’ disease. However, it’s accepted for the thyroid to become overactive already afresh afterwards the biologic is stopped. Therefore, these drugs may be acclimated with, or followed by, accession blazon of treatment.
•Radioactive iodine therapy: This analysis uses radioactive iodine to abort the thyroid’s adeptness to accomplish thyroid hormones. Almost anybody who receives this treatment, which is swallowed as a liquid, develops an underactive thyroid (hypothyroidism), which is advised by demography constructed thyroid hormone for activity to alter what the thyroid can no best accomplish on its own. The radioactive iodine acclimated for this analysis is advised a low-risk analysis for best adults. However, this analysis isn’t acclimated in abundant women or in women who are -feeding. This analysis may additionally not be recommended in some patients with Graves’ ophthalmopathy because studies accept appropriate that it could aggravate this eye condition.
•Surgery: With surgery, best or all of the thyroid gland is removed, and constructed thyroid hormone about charge be taken for life. Anaplasty is a safe and able analysis for Graves’ ache if performed by a surgeon who is actual accomplished in the procedure. It may be recommended if you can’t abide anti-thyroid drugs, accept Graves’ ophthalmopathy or don’t accept success with radioactive iodine treatment. Anaplasty is the best advantage if there’s any adumbration that you additionally accept thyroid cancer. Graves’ ache doesn’t account thyroid cancer, but this blight can be present at the aforementioned time as the disorder.
In accession to one or added of these treatments, your doctor may acclaim that you booty a beta acquaintance until your added analysis becomes effective. This blazon of biologic blocks some of the accomplishments of thyroid hormone on your body. As a result, it can apathetic bottomward your affection amount and finer abate some added affection of Graves’ disease, such as nervousness.
Because there are abundant analysis options, be abiding to assignment carefully with your doctor to actuate which analysis will advice you best administer the condition. — Rebecca Bahn, M.D., Endocrinology, Mayo Clinic, Roer, Minn.
(Medical Edge from Mayo Clinic is an educational ability and doesn’t alter approved medical care. E-mail a catechism to [email protected], or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite 114, Buffalo, N.Y., 14207. For added information, appointment http://www.mayoclinic.org.)
(c) 2011 Mayo Foundation for Medical Education and Research. Distributed by Tribune Media Services Inc. All Rights Reserved.
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