Treatments for Graves Disease
Treatments for Graves Disease
The list of treatments mentioned in various sources
for Graves Disease
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
Graves Disease: Is the Diagnosis Correct?
The first step in getting correct treatment is
to get a correct diagnosis.
Differential diagnosis list for Graves Disease may include:
Hidden causes of Graves Disease may be incorrectly diagnosed:
- Graves's disease is autoimmune in etiology. The autoimmune process in Graves disease isinfluenced by a combination of environmental and genetic factors
- more causes...»
Graves Disease: Marketplace Products, Discounts & Offers
Products, offers and promotion categories available for Graves Disease:
Graves Disease: Research Doctors & Specialists
- Diabetes & Endocrinology Specialists:
- Pregnancy & Fertility Health Specialists:
- Womens Health Specialists:
- Immune-Related Disease Specialists (Immunology):
- more specialists...»
Research all specialists including ratings, affiliations, and sanctions.
Drugs and Medications used to treat Graves Disease:
Note:You must always seek professional medical advice about any prescription drug, OTC drug, medication, treatment
or change in treatment plans.
Some of the different medications used in the treatment of Graves Disease include:
- Levothyroxine
- Alti-Thyroxine
- Armour Thyroid
- Eltroxin
- Euthroid
- Euthyrox
- Levo-T
- Levotabs
- Levothroid
- Levoxine
- Levoxyl
- L-Thyroxine
- Proloid
- Synthroid
- Synthrox
- Syroxine
- Thyroid USP
- Thyrolar
Unlabeled Drugs and Medications to treat Graves Disease:
Unlabelled alternative drug treatments for Graves Disease include:
- Propranolol
- Apo-Propranolol
- Betachron
- Detensol
- Inderal
- Inderal-LA
- Inderide
- Inderide LA
- Ipran
- Novo-Pranol
- PMS Propranolol
Latest treatments for Graves Disease:
The following are some of the latest treatments for Graves Disease:
Hospitals & Medical Clinics: Graves Disease
Research quality ratings and patient incidents/safety measures
for hospitals and medical facilities in specialties related to Graves Disease:
Hospital & Clinic quality ratings » »
Choosing the Best Treatment Hospital:
More general information, not necessarily in relation to Graves Disease,
on hospital and medical facility performance and surgical care quality:
Medical news summaries about treatments for Graves Disease:
The following medical news items
are relevant to treatment of Graves Disease:
Discussion of treatments for Graves Disease:
There are many treatments for Graves' Disease.
-
Medications: There are some prescription medications that
can lower the amount of thyroid hormones produced by the body,
regulating them to normal levels.
-
Surgery: Part or all of the thyroid gland will be removed.
In most cases, people who have surgery for Graves' Disease will develop
an under-active thyroid (hypothyroidism),
and will have to take thyroid replacement hormones for the rest of their
lives.
-
Radioactive iodine: The iodine damages thyroid cells to
shrink the thyroid gland, to reduce hormone levels. Like surgery, this
condition usually leads to hypothyroidism, requiring medication for the
rest of the patient's life.
After a diagnosis is made and a treatment is selected, you should
return to your health care provider annually to make sure that your
thyroid levels are normal and do not need to be adjusted.
(Source: excerpt from Graves' Disease: NWHIC)
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Book Excerpts: Treatment of Graves Disease
Treatments of Graves Disease: Online Medical Books
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Review excerpts from medical books online, free, without registration,
for more information about the treatments of Graves Disease.
Proptosis/Exophthalmos:
Treatment
(In a Page: Signs and Symptoms)
-
Treat the underlying cause, although treatment of Graves’ disease does not always improve ophthalmopathy, and radioactive iodine may make it worse; systemic steroids for acute flareups only
-
Prevent eye injury and discomfort with artificial tears and sunglasses; may patch eye while sleeping
-
Surgical decompression (in TAO and retrobulbar hemorrhage with acute optic neuropathy by direct compression or by increased intraocular pressure)
-
If due to infectious causes, appropriate directed systemic intravenous antibiotic therapy and/or surgical debridement
-
If due to noninfectious inflammation, administer systemic steroids or immunomodulating therapy, particularly if there is acute optic neuropathy
-
Incisional or excisional biopsy of orbital tumors
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Proptosis/Exophthalmos:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Ophthalmology consultation is always warranted
-
Daily vision testing and optic nerve function evaluation
-
Lubrication for exposure
-
Cellulitis: Inpatient admission, drainage of abscess, IV antibiotics, close observation for visual detrioration
-
Systemic steroids for thyroid disease, capillary hemangioma
-
Orbital decompression if optic nerve compression
-
Surgical removal of tumors if appropriate
-
Irradiation (Graves disease, lymphoid tumors, lacrimal gland tumors)
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Exophthalmos:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Eye trauma may require cold compresses for the first 24 hours, followed by warm compresses, and prophylactic antibiotic therapy. After edema subsides, surgery may be necessary in a small percentage of cases. Eye infection requires treatment with broad-spectrum antibiotics during the 24 hours preceding positive identification of the organism, followed by specific antibiotics. A patient with exophthalmos resulting from an orbital tumor may initially benefit from antibiotic or corticosteroid therapy. Eventually, surgical exploration of the orbit and excision of the tumor, enucleation, or exenteration may be necessary. Radiation and chemotherapy may be used when primary orbital tumors can’t be fully excised as encapsulated lesions, such as in rhabdomyosarcoma lesions.
Treatment for Graves’ disease may include antithyroid drug therapy or partial or total thyroidectomy to control hyperthyroidism; initial high doses of systemic corticosteroids, such as prednisone, for optic neuropathy and, if lid retraction is severe, protective lubricants.
Surgery may include orbital decompression (removal of the superior and lateral orbital walls) if vision is threatened, followed by lid (blepharoplasty) and muscle surgery.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Simple goiter:
Treatment
(Professional Guide to Diseases (Eighth Edition))
The goal of treatment is to reduce thyroid hyperplasia. Exogenous thyroid hormone replacement with levothyroxine is the treatment of choice; it inhibits TSH secretion and allows the gland to rest. Small doses of iodide (Lugol’s or potassium iodide solution) commonly relieve goiter that’s due to iodine deficiency. Sporadic goiter requires avoidance of known goitrogenic drugs and foods. A large goiter that’s unresponsive to treatment may require subtotal thyroidectomy.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Hyperthyroidism:
Treatment
(Professional Guide to Diseases (Eighth Edition))
A number of approaches are used to treat hyperthyroidism, primarily antithyroid drugs, 131I, and surgery. Appropriate treatment depends on the size of the goiter, the causes, the patient’s age and parity, and how long surgery will be delayed (if the patient is an appropriate candidate for surgery).
Antithyroid drug therapy is used for children, young adults, pregnant females, and patients who refuse surgery or 131I treatment. Thyroid hormone antagonists are given to block thyroid hormone synthesis. Although hypermetabolic symptoms subside within 4 to 8 weeks after such therapy begins, the patient must continue the medication for 6 months to 2 years, depending on the clinical circumstances. Beta-adrenergic blockers may be given concomitantly to manage tachycardia and other peripheral effects of excessive hypersympathetic activity.
During pregnancy, antithyroid medication should be kept at the minimum dosage required to keep maternal thyroid function within the high-normal range until delivery and to minimize the risk of fetal hypothyroidism — even though most infants of hyperthyroid mothers are born with mild and transient hyperthyroidism. (Neonatal hyperthyroidism may even necessitate treatment with antithyroid medications and propranolol for 2 to 3 months.) Because hyperthyroidism is sometimes exacerbated in the puerperal period, continuous control of maternal thyroid function is essential. Approximately 3 to 6 months postpartum, antithyroid drug administration can be gradually tapered and thyroid function reassessed. The mother receiving low-dose antithyroid treatment may breast-feed as long as the infant’s thyroid function is checked periodically. Small amounts of the drug can be found in breast milk.
A single oral dose of 131I is the treatment of choice for patients not planning to have children. (Patients of reproductive age must not be pregnant and should give informed consent for this treatment because small amounts of 131I concentrate in the gonads. However, there have been no reports of damage to subsequently conceived children in more than 50 years of 131I use.) During treatment with 131I, the thyroid gland picks up the radioactive element as it would regular iodine. Subsequently, the radioactivity destroys some of the cells that normally concentrate iodine and produce T4, thus decreasing thyroid hormone production and normalizing thyroid size and function. In most patients, hypermetabolic symptoms diminish from 6 to 8 weeks after such treatment. However, some patients may require a second dose.
Subtotal (partial) thyroidectomy, which decreases the thyroid gland’s capacity for hormone production, is indicated for patients with a large goiter whose hyperthyroidism has repeatedly relapsed after drug therapy or patients who refuse or aren’t candidates for 131I treatment. Preoperatively, the patient may receive iodides (Lugol’s solution or saturated solution of potassium iodide), antithyroid drugs, or high doses of propranolol, to help prevent thyroid storm. If euthyroidism isn’t achieved, surgery should be delayed and propranolol administered to decrease the systemic effects (cardiac arrhythmias) caused by hyperthyroidism. After ablative treatment with 131I or surgery, patients require regular medical supervision for the rest of their lives because they usually develop hypothyroidism, sometimes as long as several years after treatment.
Therapy for hyperthyroid ophthalmopathy includes local applications of topical medications but may require high doses of corticosteroids. A patient with severe exophthalmos that causes pressure on the optic nerve may require external beam radiation therapy or surgical decompression to lessen pressure on the orbital contents.
Treatment of thyroid storm includes administration of an antithyroid drug, propranolol I.V. to block sympathetic effects, a corticosteroid to inhibit the conversion of T4 to T3 and to replace depleted cortisol levels, and an iodide to block the release of thyroid hormone. Supportive measures include administration of nutrients, vitamins, fluids, and sedatives.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Thyroid enlargement:
Patient counseling
(Professional Guide to Signs & Symptoms (Fifth Edition))
Instruct the patient to watch for signs and symptoms of hypothyroidism, such as lethargy, restlessness, dry skin, and sensitivity to cold. Advise the patient with Graves’disease to use artificial tears frequently if proptosis causes his eyes to become dry. If the hyperthyroid patient is receiving therapy with radioactive iodine, tell him not to expectorate or cough freely after treatment because his saliva is radioactive for 24 hours.
Inform the patient that lifelong thyroid hormone replacement therapy is necessary after thyroidectomy or radioactive destruction of the thyroid gland. Tell him to watch for signs of an overdose, such as nervousness and palpitations.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Thyrotoxicosis:
Treatment
(Handbook of Diseases)
A number of approaches are utilized for the treatment of thyrotoxicosis. The primary forms of therapy include antithyroid drugs, 131I, and surgery. Appropriate treatment depends on the size of the goiter, the causes, the patient’s age and parity, and how long surgery will be delayed (if the patient is an appropriate candidate for surgery).
Antithyroid therapy
Therapy with antithyroid drugs is used for children, young adults, pregnant women, and patients who refuse surgery or 131I treatment. Antithyroid drugs are also used to correct the thyrotoxic state in preparation for 131I treatment or surgery. Treatment options include the following:
❑ Thyroid hormone antagonists include propylthiouracil and methimazole, which block thyroid hormone synthesis. Although hypermetabolic symptoms subside within 4 to 8 weeks after such therapy begins, the patient must continue the medication for 6 months to 2 years, in an attempt to achieve remission in Graves’disease.
❑ Propranolol may be given concomitantly to manage tachycardia and other peripheral effects of excessive hypersympathetic activity. Propranolol blocks the conversion of T4 to the active T3 hormone.
❑ During pregnancy, antithyroid medication should be kept at the minimum dosage required to keep maternal thyroid function within the high-normal range until delivery and to minimize the risk of fetal hypothyroidism. Propylthiouracil is the preferred agent for the pregnant patient. (See Congenital thyrotoxicosis).
131I
The treatment of choice for patients not planning to have children is a single oral dose of 131I. (Patients of reproductive age must give informed consent for this treatment, since small amounts of 131I concentrate in the gonads.)
During treatment with 131I, the thyroid gland picks up the radioactive element as it would regular iodine. Subsequently, the radioactivity destroys some of the cells that normally concentrate iodine and produce T4, thus decreasing thyroid hormone production and normalizing thyroid size and function.
In most patients, hypermetabolic symptoms diminish from 6 to 8 weeks after such treatment. However, some patients may require a second dose of 131I.
CLINICAL TIP: Patients commonly become permanently hypothyroid after 131I ablation.
Surgery
Near-total thyroidectomy, which decreases the thyroid gland’s capacity for hormone production, is indicated for patients whose thyrotoxicosis has repeatedly relapsed after drug therapy or patients who refuse or aren’t candidates for 131I treatment.
Preoperatively, the patient may receive iodides (Lugol’s solution or saturated solution of potassium iodide), antithyroid drugs, and propranolol to help prevent thyroid storm. If euthyroidism isn’t achieved, surgery should be delayed, and antithyroid drugs and propranolol should be administered to decrease the systemic effects (such as cardiac arrhythmias) caused by thyrotoxicosis.
After surgery, patients require regular medical supervision for the rest of their lives because they usually develop hypothyroidism, sometimes as long as several years after treatment.
Treatment for ophthalmopathy
Therapy includes local application of topical medications but may require high doses of corticosteroids. A patient with severe exophthalmos that causes pressure on the optic nerve may require external-beam radiation therapy or surgical decompression to lessen pressure on the orbital contents.
Treatment for thyroid storm
This includes administration of an antithyroid drug, propranolol I.V. or by mouth, to block sympathetic effects and conversion of T4 to T3. Corticosteroids also inhibit the conversion of T4 to T3, and an iodide is used to block release of thyroid hormone.
Supportive measures include administration of nutrients, vitamins, fluids, and sedatives.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Goiter:
Treatment
(Handbook of Diseases)
The goal of treatment is to reduce thyroid hyperplasia. The following measures are used:
❑ Exogenous thyroid hormone replacement with levothyroxine is the treatment of choice; it decreases TSH secretion and allows the gland to rest. (See Patient instructions in goiter.)
❑ Small doses of iodine (Lugol’s or potassium iodide solution) commonly relieve goiter caused by iodine deficiency. Sporadic goiter requires avoidance of known goitrogenic drugs and foods.
❑ A large goiter that’s unresponsive to treatment may require subtotal thyroidectomy.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Exophthalmos:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Teach the patient to protect his eyes from trauma and to avoid exposure to wind and dust. Demonstrate how to apply lubricants to prevent corneal drying. Encourage the patient to verbalize his feelings about changes in body image.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Thyroid enlargement:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Instruct the patient to watch for signs and symptoms of hypothyroidism, such as lethargy, restlessness, dry skin, and sensitivity to cold. If the patient has Graves’disease, proptosis may cause his eyes to become dry, so advise him to use artificial tears frequently. If the hyperthyroid patient is receiving therapy with radioactive iodine, tell him not to expectorate or cough freely after treatment because his saliva is radioactive for 24 hours. If the patient has a goiter, support him as he expresses his feelings related to his appearance.
After thyroidectomy or radioactive destruction of the thyroid gland, explain to the patient that lifelong thyroid hormone replacement therapy is necessary. Tell him to watch for signs of overdose, such as nervousness and palpitations.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Thyroid enlargement:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Prepare the patient for diagnostic tests, which may include needle aspiration, ultrasound, and radioactive thyroid scanning.
▪ Prepare the patient for surgery or radiation therapy, if necessary.
▪ Provide specific interventions, depending on whether the patient is hypothyroid or has thyroiditis.
▪ Provide postoperative care for the patient who has undergone thyroidectomy.
Patient teaching
▪ Explain the underlying disorder and treatment plan.
▪ Explain the signs and symptoms of hypothyroidism to report.
▪ Explain posttreatment precautions to the patient undergoing radioactive iodine therapy.
▪ Teach thyroid hormone replacement therapy and signs of thyroid hormone overdose to report.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Exophthalmos [Proptosis]:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Because exophthalmos usually makes the patient self-conscious, provide privacy and emotional support.
▪ Protect the affected eye from trauma, especially drying of the cornea.
▪ Don't place a gauze eye pad or other object over the affected eye; removal could damage the corneal epithelium.
▪ If necessary, refer him to an ophthalmologist for a complete examination.
▪ Prepare the patient for blood tests, such as a thyroid panel and a white blood cell count.
Patient teaching
▪ Teach ways to protect the eye from trauma, wind, and dust.
▪ Discuss the proper application of lubricants to the eye.
▪ Explain the underlying cause of the patient's exophthalmos and its treatment.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Goiter:
Goiter - TREATMENT
(The 5-Minute Pediatric Consult)
Possible conflicts: In manic-depressive patients on lithium and cardiac patients on amiodarone, medication-induced thyroid abnormalities can be a significant problem that should be addressed by the endocrinologist and appropriate subspecialist.
» READ BOOK EXCERPT ONLINE »
Source: The 5-Minute Pediatric Consult, 2008
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