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  • Q&A with Australian Health Practitioners

    Can you help with Graves' disease?

    I have Graves' disease but went into remission about four months ago. However, I am currently getting tests done as I feel it has returned. I constantly feel run down and often get ill. Is there anything I can do or someone I can see to help control how this disease affects my immune system? Was seeing an Endroconologist before I was told I was in remission. However, I didn't feel my visits to be very helpful as far as management, control and prevention were concerned. My visits were more about results and drugs being prescribed. Not too sure if you can help but a lady I met over the Internet with GD suggested possibly an immunologist would be the way to go.
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  • 4

    Thanks

    Serene Johnson

    Registered Nurse

    I am a Registered Nurse.I have a particular interest in patient advocacy, as well as ethics. Ethical treatment of those who cannot made their own … View Profile

    Unfortunately the best you can do is to find a practitioner that fits with you. If you feel your vists are impersonal and no help to you, it might be worth finding a different endocrinologist - one you click with better. I have known people to have an endocrinologist but also see a homeopath, and herbalist. For them, it works. You need to find the regime that works for YOU. All the doctors in the world could prescribe the same medication for you, but in the end, you would want to be with the one that you mesh with best, right? Speak to your GP about this. It may be a costly move, as public health endocrinologists are not so easy to come by. Your health is not just about medications and lab results. Its also about YOU as a person. If they are not treating YOU, they are treating a lab result, and you are less likely to want to continue their treatment. 

    Bottom line, find a clinician that works for you :)

  • 8

    Thanks

    Dr Nicolas Oddone Baridon MBBS, MS, MD, FRACS is an accomplished and passionate General Surgeon whose main interest is thyroid surgery (endocrine surgeon). He has … View Profile

    Graves disease is an autoinmune disease in which your own formed antibodies stimulate the thyroid gland into producing more thyroid hormone. This is not like an alergy that can be treated by an inmunologist.

    You must find an endocrinologist that can give you the right combination of medication, antithyroid medication to balance the overproduction of thyroid hormone. 

    The treatment for Graves disease follows 3 different pathways:

    1. medication, some patients do very well and some not so well

    2. Radioactive iodine therapy. This is very well tolerated and basically the thyroid gland is ablated medically. It does however have recurrences, meaning it comes back(not a sure cure) and lastly

    3. Surgery, total thyroidectomy, this is the pathway that always achieves control and cure of the disease. In patients who are responding well to medication it is probably not necessary, however in patients who are not responding to medication it is a very valid option. The down side of surgery is the fact that you wil have to take thyroxine (thyroid hormone replacement) for life. This is however, easy to adjust and once you find your right dose it is only one tablet in the morning with your breakfast and vitamins.

    It is always good to remember that when considering thyroid surgery, you should seek thyroid specialist surgeons, who have minimal complications, smaller scars and best outcomes.

    I suppose the first thing for you to do would be to find an endocrinologist. I would be happy to point you in the right direction if your GP is not able to.

    All the best,

  • 2

    Thanks

    Dr Kevin Lee

    Endocrinologist, Nuclear Medicine Physician

    Consultant Physician in Endocrinology, Diabetes & Nuclear Medicine. I am on Twitter @dr_kevinlee. I am on Facebook https://www.facebook.com/kevinleefracp/ I help patients with obesity, diabetes, thyroid, … View Profile

    It would be highly unusual for an immunologist to be referred a patient with Graves' Disease, in Australia. 

    There is no established immunotherapy for Graves' Disease.
    Dr Oddone-Baridon has already summarised very nicely the treatment options.

    Unfortunately Graves' Disease is a relapsing condition for many people, so not staying in remission is part of the disease process with treating with medications.

    It is prudent to continue to see your GP, even if you don't get on well with a specialist.

    Regards,

    Dr Kevin Lee

    Endocrinologist
    https://www.facebook.com/kevinleeFRACP

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