Graves' disease, the most common hyperthyroidism - The360 Healthy

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  • Thursday, December 26, 2019

    Graves' disease, the most common hyperthyroidism

    Graves disease, the most common hyperthyroidism

    This autoimmune thyroid disease mainly affects women. An 18-month treatment most often helps to cure it.

    Tremor, restlessness, rapid heart beat, irritability, sweating, weight loss ... Graves' disease, which accounts for three-quarters of hyperthyroidism, accelerates metabolism at all levels. Endocrinologist Dr. Pierre Nys compares the patient's condition to that of a "wrapped dragster".

    Goiter is not systematically present. This size, located at the base of the neck, corresponds to an abnormal increase in the volume of the thyroid. Likewise, some patients may have bulging eyes (exophthalmos), but not all. "There are fewer people affected than in the past because the disease is detected earlier today," said Dr. Nys.

    Stress, a trigger for the disease

    These symptoms are explained by an excess of thyroid hormone, hence the name hyperthyroidism. Another characteristic of Graves' disease is that it is “autoimmune”. Antibodies produced by the body abnormally stimulate the thyroid gland.

    Very often the disease is triggered by stress. It affects people genetically predisposed to thyroid pathologies.

    Symptoms appear on average around 43-44 years, mainly in women. Graves' disease is ten times less common in men, according to the French Society of Endocrinology.

    How is the diagnosis made?

    "The diagnosis is essentially clinical," says Dr. Nys, that is, based on the patient’s examination. The blood test for the hormone TSH (thyreostimulin) confirms this first impression. The analysis revealed that the TSH level was too low, that is to say less than 0.15 mIU / l (international micro-units per liter of blood). To complete, an assay for anti-thyroid antibodies is carried out. The result indicates whether or not the disease is autoimmune in origin.

    Medicines to calm the thyroid

    Graves' disease is treated first with drugs, synthetic anti-thyroid drugs (TTYs), such as thiamazole or carbimazole, prescribed for 18 months. "Quitting smoking is very important because smoking increases the risk of failure," said Dr. Nys. Ultimately, says the endocrinologist: "We can expect 60 to 70% recovery in patients, especially if they are young women."

    Important note: ATS are contraindicated during pregnancy. "ATS crosses the placental barrier, with the risk of blocking the thyroid function of the fetus," says Dr. Nys. It is therefore advisable to postpone a pregnancy plan, outside of the treatment phase.

    Surgery or radioactive iodine as an alternative

    If drug treatment fails, surgical removal of the thyroid may be offered. Another possibility is a treatment with radioactive iodine. But then again, caution is advised in women of childbearing age because of a potential risk of genetic mutation. "As a precaution, there should be a delay of several months between treatment and the start of a pregnancy," warns Dr. Nys.

    Graves' disease can recur. Relapse usually occurs within two years of stopping treatment. This is the reason why patients are monitored by a clinical examination, possibly supplemented by a blood test, every three months, then every six months, then once a year.

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