Graves' Disease (cont.)

Most people with Graves' disease have symptoms that are bothersome. If you have symptoms of Graves' disease, your doctor will do an exam and order one or more tests. Tests used to help find out if you have Graves' disease include:

• Thyroid function tests. A blood sample is sent to a lab to see if your body has the right amount of thyroid hormone (T4) and TSH. A high level of thyroid hormone in the blood plus a low level of TSH is a sign of overactive thyroid. Sometimes, routine screening of thyroid function reveals mild overactive thyroid in a person without symptoms. In such cases, doctors might suggest treatment or watchful waiting to see if levels return to normal.
  
  
• Radioactive iodine uptake (RAIU). An RAIU tells how much iodine the thyroid takes up. The thyroid takes up iodine and uses it to make thyroid hormone. A high uptake suggests Graves' disease. This test can be helpful in ruling out other possible causes of overactive thyroid.
  
  
• Antibody tests. A blood sample is sent to a lab to look for antibodies that suggest Graves' disease.

Graves' disease can be hard to diagnose during pregnancy because it has many of the same symptoms as normal pregnancy, like fatigue and heat intolerance. Also, some lab tests can be harder to interpret. Plus, doctors cannot use RAIU during pregnancy to rule out other causes.

There are 3 main treatments for Graves' disease:

• Antithyroid medicine. Two drugs are used in the United States:
  
  
• Methimazole (meh-THEYE-muh-zohl), or MMI (brand name, Tapazole)
  
  
• Propylthiouracil (PROH-puhl-theye-oh-YUR-uh-sil), or PTU
  
  

These drugs keep the thyroid from making too much thyroid hormone. MMI is the preferred drug for most non-pregnant people. These drugs are generally not used for more than 1 or 2 years. For some people, thyroid function returns to normal when the drugs are stopped. But for most people, the overactive thyroid comes back.

• Radioactive iodine (RAI). The thyroid gland uses iodine to make thyroid hormone. With this treatment, you swallow a pill that contains RAI, which is a form of iodine that damages the thyroid by giving it radiation. The RAI destroys thyroid cells so that less thyroid hormone is made. This cures the overactive thyroid. But you will likely need to take thyroid hormone for the rest of your life to replace the needed thyroid hormone your body can no longer make. RAI has been used for a long time and does not harm other parts of the body or cause infertility or birth defects.
  
  
• Surgery. Most or all the thyroid is removed. As with RAI, surgery cures overactive thyroid. But you will need to take thyroid hormone to replace the needed thyroid hormone your body can no longer make.

Besides one of these 3 treatments, your doctor might also suggest you take a type of drug called a beta-blocker. Beta-blockers do not affect how much thyroid hormone is made. Rather, they block the action of thyroid hormone on your body. This slows down your heart rate and reduces symptoms such as shaking and nervousness. Beta-blockers work quickly and can help you feel better while waiting for the main treatment to take effect.

The treatment that is best for you will depend on many factors. Antithyroid drugs and RAI – or a mix of both – often are preferred. During and after treatment, your doctor will want to monitor your thyroid hormone levels. Ask how often you need to be seen for follow-up visits.

Source: MedicineNet.com
http://www.medicinenet.com/graves_disease/article.htm