How should Graves' disease be monitored and treated?

This is an automatically translated article.

The article was written by MSc Trinh Ngoc Anh - Endocrinologist - Department of General Internal Medicine - Vinmec Times City International Hospital.
Graves' disease (also known as Graves' disease) is an autoimmune disease of the thyroid gland. If the disease is not treated, it will affect the patient's life and physical activity and may lead to a number of complications such as heart failure, exhaustion, severe protrusion or most dangerously, a thyroid storm that can lead to severe illness. to death.

1. How should Graves' disease be treated?

Basedow is a non-communicable disease and the disease can be controlled by 1 of 3 methods: Using drugs, taking radioactive iodine or surgery. In addition, the patient also needs to know the notes about diet, exercise, and rest to help support the treatment of the disease.
1.1 Notes on nutrition and exercise for Graves' patients Graves' patients need to rest (especially when the disease is progressing severely), avoid strenuous physical activity, and do not engage in stressful mental activities. Patients should live in a quiet room, avoid noise, limit the number of passers-by and visitors. The patient's body with Graves is often thin and exhausted, so it is necessary to encourage eating a high-protein, rich diet. calories, drink more water. Because iodine is a raw material for the thyroid gland to synthesize hormones, Graves' patients should limit eating foods containing a lot of iodine such as seafood, seaweed... The use of white salt without iodine is necessary during the period. In advanced stages of the disease Should stay in a well-ventilated room, need to clean the body daily to avoid skin infections Eyes are vulnerable organs in Graves need to be protected: Wear protective glasses, wash eyes daily with water physiological salt, avoid dust when going out.
1.2 Treatment of Basedow with drugs 1.2.1 Antithyroid drugs Antithyroid drugs include 2 groups: Thiouracil (PTU, Basedene) and Methimazole (Thyrozol, Neomecarzole...). These drugs work by reducing thyroid hormone production. The duration of drug treatment with patients must last at least 1 year, the disease can be cured for a long time but it can also recur, the shorter the treatment time, the easier it is to relapse.
One thing to note is that antithyroid drugs can cause dangerous complications such as: Agranulocytosis (a cell in the blood that plays a protective role in the body) and liver toxicity. Therefore, patients who take anti-thyroid drugs must be monitored monthly at a health facility and must see a doctor immediately after taking the drug and have symptoms such as fatigue, high fever, sore throat. , yellow eyes...
1.2.2 Using supportive drugs Doctors can also give patients some more drugs to help relieve symptoms such as:
Beta-blockers: To reduce heart rate Tachycardia, hand tremors Sedatives help the patient to be less irritable and easier to sleep Vitamins and minerals (such as potassium). 1.3 Basedow treatment with oral radioactive iodine This is a method that has been applied in Vietnam since 1978 and is applied in many central and provincial hospitals today.

When patients drink radioactive iodine, this substance into the body will destroy thyroid cells, reducing the ability to synthesize hormones to help improve the disease
This simple and effective method helps patients avoid the effects Side effects of antithyroid drugs and surgery, however, the use of radioactive iodine can cause hypothyroidism in patients later on, can cause teratogenicity and tumors (should not be used in children and women). pregnant women) and may aggravate ocular manifestations (eg, worsening protrusion). Therefore, doctors often choose radioactive iodine treatment only for severe cases that cannot be treated with antithyroid drugs.
1.4 Treatment of Graves with surgery The purpose of surgery is to remove a part of the thyroid gland, leaving only a small part to maintain hormone production. Surgery is an effective treatment to help solve these problems. The goiter is too large, restoring the patient's aesthetics, but this measure can also cause some side effects such as: Hypothyroidism and parathyroid gland (an endocrine gland that helps the body maintain calcium). normal blood) causes a decrease in blood calcium, affecting the patient's pronunciation. Therefore, we often appoint Basedow surgery for patients with too large goiter, suspected thyroid cancer or severe patients who cannot be treated with drugs and radioactive iodine.

2. How to prevent Basedow's disease?

Basedow is a disease of unknown etiology, so there are no effective measures to prevent the occurrence of the disease. For those who have had Graves' disease, in order to avoid recurrence or aggravation of the disease, the following measures should be taken:
Avoid prolonged heavy physical activity Avoid nervous tension, stress Do not smoke, avoid inhalation cigarette smoke Always wear protective eyewear from dust, eye drops with physiological saline daily Do not touch the neck area much, limit eating foods containing a lot of iodine Maternity can make the disease worse, so it is necessary to treat completely treat the disease before pregnancy. Follow the treatment and have regular check-ups according to the doctor's appointment. Currently, Vinmec Times City International Hospital uses the SPECT/CT Discovery NM/CT 670 Pro system, with the most modern 16-strip CT technology of the world's leading medical equipment company GE Healthcare (USA). , for high-quality images, helping to diagnose thyroid diseases early.

Vinmec International General Hospital is one of the hospitals that not only ensures professional quality with a team of leading medical doctors, modern equipment and technology, but also stands out for its examination and consultation services. comprehensive and professional medical consultation and treatment; civilized, polite, safe and sterile medical examination and treatment space. Customers when choosing to perform tests here can be completely assured of the accuracy of test results.
For detailed information, please contact the hospitals and clinics of Vinmec health system nationwide.

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