Graves' disease is an immune system disorder that results in the overproduction of thyroid hormones (hyperthyroidism). Although a number of disorders may result in hyperthyroidism, Graves' disease is a common cause.
Because thyroid hormones affect a number of different body systems, signs and symptoms associated with Graves' disease can be wide ranging and significantly influence your overall well-being. Although Graves' disease may affect anyone, it is more common among women and before the age of 40.
The primary treatment goals are to inhibit the overproduction of thyroid hormones and lessen the severity of symptoms.
At our practice we treat graves’ disease after a detailed consultation and individual considerations that pertain to your preferences and lifestyle This includes Medications, consideration for Iodine treatment and if needed surgery
Graves Disease since it is a Autoimmune disease can go into a remission with time and careful observation, Dr Ahmad Has treated graves’ disease for over 16 years and develops treatment plans unique to each individual
How is Graves' disease diagnosed?
To diagnose Graves' disease, we will do a physical exam and may do some tests. Tests that can help you find out if you have Graves' disease include: Thyroid function tests. These tests check your blood for levels of the main thyroid hormone (T4) and thyroid-stimulating hormone (TSH). A high level of T4 plus a low level of TSH is a sign of an overactive thyroid gland. Sometimes, routine screening of thyroid function shows mild overactive thyroid in a person without symptoms. When this happens, your doctor may suggest treatment or watchful waiting to see if levels return to normal. Antibody tests. These blood tests look for antibodies that suggest Graves' disease.
Graves disease in Pregnancy
Undertreated or uncontrolled Graves' disease can lead to problems during pregnancy, including such dangerous conditions as Preeclampsia and Premature birth
Typically Antithyroid Medications were used to Manage thyroid hormone over production during pregnancy however a small subset of patients who take these drugs during pregnancy have shown a higher incidence of Birth defects We typically consider Definitive treatment before getting pregnant to avoid the use of Anti thyroid drugs if possible
Thyroid Nodules
Thyroid nodules are present in almost 10% of the adult population.so they are common. 95% of solitary thyroid nodules are benign, and therefore, only 5% of thyroid nodules are malignant.
Unfortunately around 15% of Biopsies come back as “Indeterminate “which do leave us in a Therapaeutic Quandery nodule isn’t cancerous but neither is it benign. For this reason, we usually reflex the test to the Cutting Edge Genetic tests developed to answer this Question. We utilize both AFIRMA and Thyroseq-V3 testing panels that are the most validated and reliable genetic tests for "indeterminate" thyroid Biopsies.
Common types of the benign thyroid nodules are adenomas (overgrowths of normal thyroid tissue), thyroid cysts, and Hashimoto's thyroiditis
What is a Cold or Hot Nodule/toxic?
Nodules detected by Iodine radioative scans are classified as cold or hot/toxic. Thyroid tissue absorb iodine to make thyroid hormone out of it. When radioactive iodine is given, a image will be obtained showing the outline of the thyroid. If a nodule is composed of cells that do not make thyroid hormone (don't absorb iodine), then it will appear "cold”. A nodule that is producing too much hormone will show up darker and is called "hot." 85% of thyroid nodules are cold, 10% are warm, and 5% are hot.
Most Endocrinologists Don’t Biopsy Hot/toxic Nodules as they feel that the risk of cancer is quite low, however recent studies from Europe cast significant doubt on this assumption. At our Clinic, we trust ultrasound findings and the American Thyroid Association guidelines to decide to biopsy any suspicious nodule, Hot or cold
Most Endocrinologists Don’t Biopsy Hot/toxic Nodules as they feel that the risk of cancer is quite low, however recent studies from Europe cast significant doubt on this assumption. At our Clinic, we trust ultrasound findings and the American Thyroid Association guidelines to decide to biopsy any suspicious nodule, Hot or cold
Can I shrink the Nodule by Taking Thyroid Hormone?
Taking thyroid hormone/ synthroid does not decrease the size of thyroid nodules. Therefore, unless a nodule is growing or becoming symptomatic, it is not necessary to suppress the nodule with thyroid hormone . in any event suppression of a thyroid nodule would require long-term medication usage , potentially increasing the risk of osteoporosis in these patients.
I have multiple nodules, am i at lower risk of cancer?
Recent studies indicate that there might be an equal chances for developing thyroid cancer in a multinodular goiter just as in a solitary thyroid nodule.