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DIAGNOSIS continued...

In some cases of Graves' disease, a whispering sound can be heard through a stethoscope placed over the thyroid gland. This is called a "bruit" and is caused by blood rushing rapidly through the gland.

A blood test, called the TSH test, determines the level of the hormone (TSH) most directly affected by the disease process. Once Graves' is diagnosed, other tests may be given. These may include additional blood tests to check for an autoimmune disorder and radioactive iodine uptake tests. The patient is given a dose of radioactive iodine; the next day, a conical, camera-like instrument is placed against the patient's neck area to see how the thyroid handled the iodine.

TREATMENT

"Suppressive therapy" uses medicine to lower the TSH level in the blood, causing less stimulation of the thyroid gland. It often requires several months to work and is not always effective. Also, radioactive iodine may be used to destroy the overactive parts of the thyroid gland.

Initial treatment for thyroid eye disease involves treating the active eye disease, which usually lasts two or more years and requires careful monitoring until stable. Treatment during the active phase of the disease focuses on preserving sight. Prescriptions of artificial tears and ointments, high doses of cortisone (steroids), surgery, and possible additional treatments may be required. Afterward, treatment of permanent changes may require surgical correction of double vision, staring appearance, or eye protrusion.

PREVENTION

Physicians can't always pinpoint the cause of thyroid enlargement, so prevention is tricky at best. The American Thyroid Association recently recommended that people over age 35 be screened with TSH tests every five years.

RECOVERY

Since, with hyperthyroidism, proteins and fats are not broken down normally, patients need to increase their calories to maintain their weight. Because diarrhea drains needed vitamins and minerals, including calcium, patients need to ensure that they are getting all the important nutrients. Once the thyroid is back to normal, they will need to back off these extra calories, or they will gain unwanted pounds.

In a released statement, Ann Brown, MD, an endocrinologist at Duke University, where Overbeck is an assistant women's soccer coach, said "I'm impressed with how few symptoms she showed, except when she was at peak performance. Since she has so few symptoms at rest, I'm optimistic for a very rapid recovery. Her physical performance will not suffer in any way when this is fully treated."

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