Treatment
Means to interrupt the autoimmune processes of Graves' disease are unknown, so treatment must be indirect. The thyroid gland is the target, via three different methods (which have not changed fundamentally since the 1940s): Antithyroid drugs (which reduce the production of thyroid hormone), partial or complete destruction of the thyroid gland by ingestion of radioactive iodine (radioiodine), and partial or complete surgical removal of the thyroid gland (thyroidectomy).
No treatment for Graves' hyperthyroidism is preferred; it is not straightforward and often involves complex decision-making. The physician must weigh the advantages and disadvantages of the different treatment options and help the patient arrive at an individualized, appropriate and cost-effective therapeutic strategy. Kaplan summarizes, "the choice of therapy varies according to nonbiological factors - physicians' training and personal experience; local and national practice patterns; patient, physician, and societal attitudes toward radiation exposure; and biological factors including age, reproductive status, and severity of the disease".
Therapy with radioiodine is the most common treatment in the United States, while antithyroid drugs and/or thyroidectomy are used more often in Europe, Japan, and most of the rest of the world. However, due to the varying success of every treatment option, patients are often subjected to more than one when the first attempted treatment does not prove entirely successful; the risk of relapse or subsequent hypothyroidism is substantial.
In the short term, treatment of hyperthyroidism usually produces a parallel decrease in endocrine and psychiatric symptoms. When prolonged treatment normalizes thyroid function, some psychiatric symptoms and somatic complaints may persist. In spite of modern therapeutic modalities, Graves' disease is accompanied by seriously impaired quality of life. Several recent studies stress the importance of early prevention, speedy rehabilitation, and thorough follow-up of hyperthyroid patients. Patients who do not have a spontaneous remission with the use of antithyroid drugs become lifelong thyroid patients.
Read more about this topic: Graves' Disease
Famous quotes containing the word treatment:
“[17th-century] Puritans were the first modern parents. Like many of us, they looked on their treatment of children as a test of their own self-control. Their goal was not to simply to ensure the child’s duty to the family, but to help him or her make personal, individual commitments. They were the first authors to state that children must obey God rather than parents, in case of a clear conflict.”
—C. John Sommerville (20th century)
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—Henry David Thoreau (1817–1862)
“Our treatment of both older people and children reflects the value we place on independence and autonomy. We do our best to make our children independent from birth. We leave them all alone in rooms with the lights out and tell them, “Go to sleep by yourselves.” And the old people we respect most are the ones who will fight for their independence, who would sooner starve to death than ask for help.”
—Margaret Mead (1901–1978)