Graves’ disease treatment options from the medical community

Doctors prescribe one or more of the three treatment options:  radioiodine therapy, antithyroid drugs, or thyroid surgery.  Radioiodine therapy is the most commonly used treatment for Graves’ disease in the United States.

Radioiodine Therapy

In radioiodine therapy, the patient takes radioactive iodine-131 by mouth.  Because the thyroid gland collects iodine to make thyroid hormone, it will collect the radioactive iodine from the bloodstream in the same way.  Iodine-131-stronger than the radioactive iodine used in diagnostic tests-will gradually destroy the cells that make up the thyroid gland but will not affect other tissues in the body.

Many doctors use a large enough dose of  iodine-131 to shut down the thyroid completely, but some prefer smaller doses to try to bring hormone production into the normal range.  More than one round of radioiodine therapy may be needed.  Results take time and a person undergoing this treatment may not notice improvement in symptoms for several weeks or months.

People with Graves’ ophthalmopathy should talk with their doctor about any risks associated with radioactive iodine treatments.  Several studies suggest that radioiodine therapy can worsen ophthalmopathy in some people.  Other treatments such as steroids may prevent this complication.

Although iodine-131 is knot known to cause birth defects or infertility, radioiodine therapy is not used in pregnant women or women who are breastfeeding.  Radioactive iodine can be harmful to the fetus’ thyroid, and it can be passed from mother to child in breast milk.

Almost everyone who receives radioactive iodine treatment eventually develops hypothyroidism, which occurs when the thyroid does not make enough thyroid hormone.  People with hypothyroidism must take synthetic thyroid hormone.

Medications

Doctors may prescribe a drug called a beta blocker to reduce symptoms until other treatments take effect.  Beta blockers act quickly to relieve symptoms such as hand tremors, rapid heart beat, and nervousness.  These drugs act by blocking the effects of thyroid hormone on the body, but they do not stop thyroid hormone production.

Two antithyroid drugs, methimazole and propylthiouracil (PTU), interfere with the way the thyroid gland uses iodine to make thyroid hormones.  Doctors sometimes use antithyroid drugs as the only treatment for Graves’ disease, but these drugs usually do not produce permanent results and their use requires frequent monitoring by a health care provider.  More often, antithyroid drugs are used to pretreat patients older than 60 of those who have other health problems before beginning radioiodine therapy, or as a supplemental treatment after radioiodine therapy.

Because pregnant and breastfeeding women cannot receive radioiodine therapy, they are usually treated with an antithyroid drug instead.  Pregnant women should not take methimazole and should be monitored if they take PTU.  Women who are breastfeeding should take the smallest dose necessary of either drug.

Antithyroid drugs can cause side effects in some people.  Allergic reactions such as rashes and itching are the most common side effects.  Rarely, antithyroid drugs cause liver failure or a decrease in the number of white blood cells, which can lower resistance to infection.

Thyroid Surgery

Surgery is the least-used option in treating Graves’ disease.  However, doctors sometimes choose surgery to treat pregnant women who cannot tolerate antithyroid drugs, people in whom thyroid cancer is suspected, or those who fail other forms of treatment.  Graves’ disease itself does not cause cancer.

When surgery is used, many doctors recommend the entire thyroid be removed, thus eliminating the chance that hyperthyroidism will return.  If the entire thyroid is removed, lifelong thyroid hormone replacement is necessary.

Although uncommon, certain problems can occur in thyroid surgery.  The parathyroid glands could be damaged because they are located very close to the thyroid gland.  These glands help control calcium levels in the body.  Damage to the laryngeal nerve, also located close to the thyroid gland, could lead to voice changes or breathing problems.  When surgery is performed by an experienced surgeon, less than 1 percent of patients have permanent complications.

• January 12, 2009 -- What are the symptoms of Grave’s disease?
  People with Graves' disease may have some of the common symptoms of  hyperthyroidism such as: nervousness or irritability fatigue or muscle weakness heat intolerance trouble sleeping hand tremors rapid and irregular heartbeat frequent bowel movements or diarrhea weight loss goiter, which is an enlarged thyroid that may cause the neck to look swollen In addition, the eyes of ...
• January 20, 2010 -- How Is Graves’s Disease Diagnosed?
  Graves' disease diagnosed Doctors can sometimes diagnose Graves' disease based only on a physical examination and a medical history.  Laboratory test confirm the diagnosis. The ultrasensitive TSH test is usually the first test a doctor performs.  This test detects even tiny amounts of TSH in the blood and is the most accurate measure of thyroid activity available.  Another blood test used to...

Graves’ disease diagnosed

Doctors can sometimes diagnose Graves’ disease based only on a physical examination and a medical history.  Laboratory test confirm the diagnosis.

The ultrasensitive TSH test is usually the first test a doctor performs.  This test detects even tiny amounts of TSH in the blood and is the most accurate measure of thyroid activity available.  Another blood test used to diagnose Graves’ disease measures T3 and T4.  In making a diagnosis, doctors look for below normal levels of TSH, normal to elevated levels of T4, and elevated levels of T3.

Because the combination of low TSH and high T3 and T4 can occur with other thyroid problems, doctors may order other test to finalize the diagnosis.  Two of these test are based on the fact that the thyroid gland uses iodine to make thyroid hormone.  Both test use small, safe doses of radioactive iodine.

• The radioactive iodine uptake test measures the amount of iodine the thyroid collects from the bloodstream.  High levels of iodine uptake can indicate Graves’ disease.

• A thyroid scan shows how and where iodine is distributed in the thyroid.  In Graves’ disease, the entire thyroid gland is involved so the iodine shows up throughout the gland.  Other causes of hyperthyroidism such as nodules-small lumps in the gland-will show a different pattern of iodine distribution.

Doctors may also consider the thyroid-stimulating immunoglobulin test, although this test usually isn’t necessary to diagnose Graves’ disease.  This test, also called a TSH antibody test, measures the level of TSI in the blood.  Most people with Graves’ disease have this antibody, but people whose hyperthyroidism is caused by other conditions do not.

• January 12, 2009 -- What are the symptoms of Grave’s disease?
  People with Graves' disease may have some of the common symptoms of  hyperthyroidism such as: nervousness or irritability fatigue or muscle weakness heat intolerance trouble sleeping hand tremors rapid and irregular heartbeat frequent bowel movements or diarrhea weight loss goiter, which is an enlarged thyroid that may cause the neck to look swollen In addition, the eyes of ...
• February 3, 2010 -- How Is Graves’ Disease Treated?
  Graves' disease treatment options from the medical community Doctors prescribe one or more of the three treatment options:  radioiodine therapy, antithyroid drugs, or thyroid surgery.  Radioiodine therapy is the most commonly used treatment for Graves' disease in the United States. Radioiodine Therapy In radioiodine therapy, the patient takes radioactive iodine-131 by mouth.  Because the ...

Are you likely to develop Graves’ Disease?

Scientists don’t know exactly why some people develop Graves’ disease, but they believe factors such as age, sex, heredity, and emotional and environmental stress are involved.

Graves’ disease usually occurs in people younger than age 40 and is five to 10 times more common in women than men.  An individual’s chance of developing Graves’ disease increases if other family members have it.

Researchers have not been able to find a specific gene that causes the disease to be passed from one generation to the next.  Scientists know that some people inherit an immune system that can make antibodies against healthy cells, but predicting who will be affected is difficult.

People with other autoimmune diseases have an increased chance of developing Graves’ disease.  Type 1 diabetes, rheumatoid arthritis, and vitiligo-a disorder in which some parts of the skin are pigmented-are among the conditions associated with Graves’ disease.

• February 3, 2010 -- How Is Graves’ Disease Treated?
  Graves' disease treatment options from the medical community Doctors prescribe one or more of the three treatment options:  radioiodine therapy, antithyroid drugs, or thyroid surgery.  Radioiodine therapy is the most commonly used treatment for Graves' disease in the United States. Radioiodine Therapy In radioiodine therapy, the patient takes radioactive iodine-131 by mouth.  Because the ...
• January 20, 2010 -- How Is Graves’s Disease Diagnosed?
  Graves' disease diagnosed Doctors can sometimes diagnose Graves' disease based only on a physical examination and a medical history.  Laboratory test confirm the diagnosis. The ultrasensitive TSH test is usually the first test a doctor performs.  This test detects even tiny amounts of TSH in the blood and is the most accurate measure of thyroid activity available.  Another blood test used to...

Graves’ eye disease also know as Graves’ ophthalmopathy (GO) occurs when cells from the immune system attack the muscles and other tissues around the eyes.  The result is inflammation and a buildup in tissue and fat behind the eye socket, causing the eyeballs to bulge.  In rare cases, inflammation is severe enough to compress the optic nerve, causing vision loss.

Other symptoms of GO include:

1. dry, irritated eyes
2. puffy eyelids and under the eyes
3. double vision
4. light sensitivity
5. pressure or pain in the eyes
6. trouble moving the eyes

About 25 percent of people with Graves’ disease develop GO, which is usually of mild to moderate severity.  This eye disorder usually lasts 1 to 2 years and often improves on its own.  GO can occur before, at the same time as, or after other symptoms of hyperthyroidism develop and may even occur in people whose thyroid function is normal.  GO is severe in 3 to 5 percent of people who have the disorder, and smoking makes GO worse.

• February 3, 2010 -- How Is Graves’ Disease Treated?
  Graves' disease treatment options from the medical community Doctors prescribe one or more of the three treatment options:  radioiodine therapy, antithyroid drugs, or thyroid surgery.  Radioiodine therapy is the most commonly used treatment for Graves' disease in the United States. Radioiodine Therapy In radioiodine therapy, the patient takes radioactive iodine-131 by mouth.  Because the ...
• January 20, 2010 -- How Is Graves’s Disease Diagnosed?
  Graves' disease diagnosed Doctors can sometimes diagnose Graves' disease based only on a physical examination and a medical history.  Laboratory test confirm the diagnosis. The ultrasensitive TSH test is usually the first test a doctor performs.  This test detects even tiny amounts of TSH in the blood and is the most accurate measure of thyroid activity available.  Another blood test used to...

Graves’ disease is an autoimmune disorder, meaning the body’s immune system acts against its own healthy cells and tissues.

Graves’ disease, also known as toxic diffuse goiter, is the most common cause of hyperthyroidism in the United States.  Hyperthyroidism is a disorder that occurs when the thyroid gland makes more thyroid hormone than the body needs.

The thyroid is a small, butterfly-shaped gland in the from on the neck below the larynx or voice box.  The thyroid gland makes two thyroid hormones, triiodothyronine (T3) and thyroxine (T4).  Thyroid hormones affect metabolism, brain development, breathing, heart and nervous system functions, body temperature, muscle strength, skin dryness, menstrual cycles, weight, and cholesterol levels.

Thyroid hormone production is regulated by another hormone called thyroid-stimulating hormone (TSH), which is made by the pituitary gland located in the brain.

Graves’ disease is an autoimmune disorder, meaning the body’s immune system acts against its own healthy cells and tissues.  In Graves’ disease the immune system makes antibodies called thyroid-stimulating immunoglobulin (TSI) that attach to thyroid cells.  TSI mimics the action of TSH and stimulates the thyroid to make too much thyroid hormone.  Sometimes the antibodies can instead block thyroid hormone production, leading to a confusing clinical picture.  The diagnosis and treatment of Graves’ disease is often performed by an endocrinologist-a doctor who specializes in the body’s hormone-secreting glands.

Symptoms of this condition includes goiter (an enlarged thyroid gland that can lead to the swelling of the neck), trouble sleeping, irritability, nervousness, hand tremors, rapid or irregular heartbeats, diarrhea, heat intolerance, apparent weight loss, and fatigue or muscle weakness.

Others refer to these symptoms as a resemblance to an overdose of epinephrine (or adrenaline).

Factors like heredity, age, sex, and stress are believed to be involved in determining who are affected, but those who often experience this disease are individuals around the age of 40 or younger and is more common among women.

Doctors can diagnosis Grave’s disease  based only on a physical examination and medical history.  Laboratory test confirm the diagnosis.

Treatments for Graves Disease include Radioiodine Therapy, thyroid surgery, or antithyroid drugs.

Radioiodine Therapy is often the choice of treatment for hyperthyroidism since this is given in a single dose – those some prefer taking it in small doses. The radioactive iodine (RAI) disrupts the function of some thyroid cells that causes those to stop functioning. A higher dose of RAI would cause more thyroid cells to stop producing hormones.

Antithyroid drugs are medications that blocks formation of thyroid hormones in the gland. Some use it only as a short-term treatment since it has certain side effects. People with Graves Disease who uses these drugs are often monitored by their doctors or health care providers.

Others who has Graves Disease may exhibit bulging eyes, or what is medically considered as Graves’ ophthalmopathy, and may require additional treatment.

• January 12, 2009 -- What are the symptoms of Grave’s disease?
  People with Graves' disease may have some of the common symptoms of  hyperthyroidism such as: nervousness or irritability fatigue or muscle weakness heat intolerance trouble sleeping hand tremors rapid and irregular heartbeat frequent bowel movements or diarrhea weight loss goiter, which is an enlarged thyroid that may cause the neck to look swollen In addition, the eyes of ...
• November 7, 2009 -- Depression Tips
  There are many causes of depression.  Thyroid disorders like hypothyroidism (low thyroid) and hyperthyroidism (high thyroid, graves disease), hormone changes like menopause and adrenal problems.  Also prolonged stress, nutritional deficiencies, and imbalances of brain chemicals like seratonin, dopamine, and epinephrine. If you suffer from depression and are not getting good results from any med...

As many as 13 million adults could have an undiagnosed hypothyroid condition.  If you have a chronic illness that does not respond well to medical therapy including high cholesterol, high blood pressure, chronic infections, chronic fatigue, depression and more. It could be your thyroid.

Every single muscle, organ and cell in the body depends on adequate thyroid hormone levels for optimal functioning.

Physicians are taught to rely primarily on the TSH (thyroid stimulation hormone) blood test, if the TSH blood test is normal then, you most likely will not be diagnosed with a thyroid problem.  But perhaps the blood tests did not tell the whole story in evaluating thyroid problems.

Symptoms of low thyroid (hypothyroidism) can produce a huge amount of symptoms:

brittle nails, cold hands and feet, cold intolerance, constipation, depression, difficulty swallowing, dry skin, elevated cholesterol, high blood pressure, eyelid swelling, fatigue, hair loss, hoarseness, low blood pressure, inability to concentrate, infertility, irritability, menstrual irregularities, muscle cramps, muscle weakness, nervousness, poor memory, puffy eyes, slower heartbeat, throat pain and weight gain

Blood test for thyroid disorders should include:

• TSH  (normal range 0.5-4.5mU/l)
• T4    (normal 80-180ug/dl)
• T3    (normal 55-120ng/dl)

Most physicians rely solely on laboratory testing for diagnosing, and don’t take into account the patient’s signs and symptoms, family history and all other aspects of their health.

• Take your medication as prescribed, thyroid medication should be taken on an empty stomach
• Consider the addition of nutritional supplements
• Get the junk food out of your diet
• Don’t look to caffeine for energy
• Increase protein intake this helps with metabolism
• For hair loss Nioxin products work well

• December 9, 2009 -- Is Your Hashimoto Treatment Missing This?
  Hashimotos thyroiditis is treated with medication but there is more that you need to know about autoimmune thyroid disorders.  To find the root cause of your thyroid disorder there are other factors to consider.  For example do you have an underlying infection or heavy metals in your system. Dr. Andrew Lange: How Thyroid Medications Can Destroy Your Thyroid As an autoimmune disease Hashimoto...
• November 7, 2009 -- Depression Tips
  There are many causes of depression.  Thyroid disorders like hypothyroidism (low thyroid) and hyperthyroidism (high thyroid, graves disease), hormone changes like menopause and adrenal problems.  Also prolonged stress, nutritional deficiencies, and imbalances of brain chemicals like seratonin, dopamine, and epinephrine. If you suffer from depression and are not getting good results from any med...

There are many causes of depression.  Thyroid disorders like hypothyroidism (low thyroid) and hyperthyroidism (high thyroid, graves disease), hormone changes like menopause and adrenal problems.  Also prolonged stress, nutritional deficiencies, and imbalances of brain chemicals like seratonin, dopamine, and epinephrine.

If you suffer from depression and are not getting good results from any medication you are taking here are a few guidelines to help you.

• Blood work to rule out any thyroid disorder
• B vitamin supplement
• Stress management
• Urine test for brain chemical levels
• Exercise of some sort is a must, walking, etc. force yourself get out and move.  Exercise releases the feel good chemicals and can really do wonders to help.

• December 9, 2009 -- Is Your Hashimoto Treatment Missing This?
  Hashimotos thyroiditis is treated with medication but there is more that you need to know about autoimmune thyroid disorders.  To find the root cause of your thyroid disorder there are other factors to consider.  For example do you have an underlying infection or heavy metals in your system. Dr. Andrew Lange: How Thyroid Medications Can Destroy Your Thyroid As an autoimmune disease Hashimoto...
• November 8, 2009 -- Hypothyroid Symptoms
  As many as 13 million adults could have an undiagnosed hypothyroid condition.  If you have a chronic illness that does not respond well to medical therapy including high cholesterol, high blood pressure, chronic infections, chronic fatigue, depression and more. It could be your thyroid. Every single muscle, organ and cell in the body depends on adequate thyroid hormone levels for optimal functi...

People with Graves’ disease may have some of the common symptoms of  hyperthyroidism such as:

• nervousness or irritability
• fatigue or muscle weakness
• heat intolerance
• trouble sleeping
• hand tremors
• rapid and irregular heartbeat
• frequent bowel movements or diarrhea
• weight loss
• goiter, which is an enlarged thyroid that may cause the neck to look swollen

In addition, the eyes of people with Graves’ disease may appear enlarged because their eyelids are retracted and their eyes bulge out from the eye socket.  This condition is called Graves’ ophthalmopathy.

A small number of people with Graves’ disease also experience thickening and reddening of the skin on their shins.  This usually painless problem is called pretibial myxedema or Graves’ dermopathy.

• November 8, 2009 -- Hypothyroid Symptoms
  As many as 13 million adults could have an undiagnosed hypothyroid condition.  If you have a chronic illness that does not respond well to medical therapy including high cholesterol, high blood pressure, chronic infections, chronic fatigue, depression and more. It could be your thyroid. Every single muscle, organ and cell in the body depends on adequate thyroid hormone levels for optimal functi...
• January 11, 2010 -- What Is Graves’ Disease?
  Graves' disease is an autoimmune disorder, meaning the body's immune system acts against its own healthy cells and tissues. Graves' disease, also known as toxic diffuse goiter, is the most common cause of hyperthyroidism in the United States.  Hyperthyroidism is a disorder that occurs when the thyroid gland makes more thyroid hormone than the body needs. The thyroid is a small, butterfly-sha...