Hyperthyroidism

Hyperthyroidism, also known as Graves disease, is most common in girls age 10-15 with an autoimmune disorder familial history. Graves disease most commonly presents with a goiter, as well as warm moist skin, restlessness, proximal muscle weakness, fine hand tremor with arm extension, growth acceleration and bone age, and potentially delayed puberty. Approximately one-third of children with hyperthyroidism develop Graves ophthalmology, yet most cases present as mild.

Diagnosis for pediatric hyperthyroidism typically begins with the screening of T3 and T4 levels, thyroid or thyrotropin receptor antibodies, and thyrotropin. T3 and T4 levels will be elevated in Graves disease, but physicians should note the level elevation may not positively correlate with symptom severity. Treatment of Graves disease typically begins with anti-thyroid drug therapy, such as methimazole. Propylthiouracil is not recommended because of liver toxicity. In severe cases, a cardioselective beta-blocker can be used temporarily. Because only an estimated 35% of children and adolescents achieve remission on drug-only treatment, definitive therapy can be considered in the form of a thyroidectomy or radioiodine ablation.

GO Terminology

Bilateral Symmetry – Both eyes are equally affected. Bulging of both eyes is the most commonly caused of by GO. Many have asymmetric involvement.
Blurred vision – a serious symptom in GO. Optic nerve problem is a major cause of blurring.
Congestive infiltration – increase in orbital volume and increased ocular pressure pseudo-glaucoma.
Diplopia – GO get binocular double vision due to muscle changes. It is corrected when one eye is covered.
Euthyroid – case without hyperthyroidism
External Beam Radiation – a form of therapy for severe congestive

Conclusion

Smoking behavior in a randomized study of the effect of radioiodine therapy on ophthalmopathy and in a case series of patients with Graves ophthalmopathy receiving orbital radiation therapy and glucocorticoids.

Design: Randomized, single-blind study of smoking and mild ophthalmopathy after radioiodine therapy (study 1) and a retrospective cohort study of the association between smoking and response of severe ophthalmopathy to treatment (study 2).

Setting: University medical center.

Patients: 300 patients with mild ophthalmopathy (study 1) and 150 patients with severe ophthalmopathy (study 2).

Intervention: In study 1, patients received radioiodine alone or radioiodine and a 3-month course of oral prednisone (initial dosage, 0.4 to 0.5 mg/kg of body weight per day). In study 2, patients received high-dose oral prednisone for 6 months (initial dosage, 80 to 100 mg/d) and underwent orbital radiation therapy by linear accelerator (cumulative dose, 20 Gy per eye over 2 weeks).

Measurements: Degree of ophthalmopathy was assessed by overall evaluation (inflammatory changes, proptosis, extraocular muscle dysfunction, corneal involvement, and optic neuropathy).

Results: In study 1, ophthalmopathy progressed in 4 of 68 nonsmokers (5.9% [95% CI, 3% to 9%]) and 19 of 82 smokers (23.2% [CI, 13% to 33%]) who received radioiodine alone (P = 0.007). Ophthalmopathy was alleviated in 37 of 58 nonsmokers (63.8% [CI, 51% to 78%]) and 13 of 87 smokers (14.9% [CI, 10% to 26%]) who received radioiodine plus prednisone (P < 0.001). In study 2, 61 of 65 nonsmokers (93.8% [CI, 90% to 98%]) and 58 of 85 smokers (68.2% [CI, 57% to 78%]) responded to treatment (P < 0.001).

Conclusions: Cigarette smoking increases the risk for progression of ophthalmopathy after radioiodine therapy and decreases the efficacy of orbital radiation therapy and glucocorticoid therapy.

Thyroid And The Continuing Saga With Biotin Interference: Avoid This Supplement

Thyroid And The Continuing Saga With Biotin Interference: Avoid This Supplement

Thyroid And The Continuing Saga With Biotin Interference: Avoid This Supplement for routine hair...

More info

Thyroid Radiofrequency Ablation RFA: Italian Experience

Thyroid Radiofrequency Ablation RFA: Italian Experience

Thyroid Radiofrequency Ablation RFA: Italian Experience Radiofrequency ablation for thyroid...

More info

Thyroid History 101: After Several Centuries We Still Did Not Learn That Thyroid Extract is Not a Good Treatment for Thyroid Disease in 2017

Thyroid History 101: After Several Centuries We Still Did Not Learn That Thyroid Extract is Not a Good Treatment for Thyroid Disease in 2017

Thyroid History 101: After Several Centuries We Still Did Not Learn That Thyroid Extract is Not...

More info

Thyroid Radiofrequency Ablation RFA of Thyroid Nodules 101:

Thyroid Radiofrequency Ablation RFA of Thyroid Nodules 101:

Radiofrequency ablation for treatment of benign thyroid nodules. Comments on this article by...

More info

Thyroidectomy 101: Where You Live Puts You at Risk for Too Much Surgery and Associated Complications

Thyroidectomy 101: Where You Live Puts You at Risk for Too Much Surgery and Associated Complications

Thyroidectomy 101: Where You Live Puts You at Risk for Too Much Surgery and Associated...

More info

Thyroid Checkup: Signs you may have a thyroid condition

Thyroid Checkup: Signs you may have a thyroid condition

Thyroid Checkup: Signs you may have a thyroid condition. Comments on article by Dr.G.   1...

More info

Iodine OTC Supplements 101: No Benefit But Harmful to Thyroid Patients

Iodine OTC Supplements 101: No Benefit But Harmful to Thyroid Patients

Iodine OTC Supplements 101: No Benefit But Harmful to Thyroid Patients Hoang TD1, Endocr...

More info

Thyroid Goiter 101: The Good, Bad and Ugly of Iodine Ingestion.

Thyroid Goiter 101: The Good, Bad and Ugly of Iodine Ingestion.

Thyroid Goiter 101: The Good, Bad and Ugly of Iodine Ingestion. Iodine deficiency causes goiter...

More info

Thyroid Goiter 101: Thyroid Injections for Goiter 1890

Thyroid Goiter 101: Thyroid Injections for Goiter 1890

Thyroid Goiter 101: Thyroid Injections for Goiter: 1890 Injection Treatments used in 1890 are...

More info

Family Case Finding in Children with Family History of Autoimmune Disease.

Family Case Finding in Children with Family History of Autoimmune Disease.

Family Case Finding in Children with Family History of Autoimmune Disease. Here is another...

More info

TV Dr is a Present Day “Thyroid” Snake Oil Salesman: Avoid is Show For Your Health.

TV Dr is a Present Day “Thyroid” Snake Oil Salesman: Avoid is Show For Your Health.

TV Dr is a Present Day “Thyroid” Snake Oil Salesman: Avoid His Show For Your Own...

More info

Thyroid No Surgery’s Own Dr.Guttler featured in this Article in VoyageLA. LA’s Most Inspiring Stories

Thyroid No Surgery’s Own Dr.Guttler featured in this Article in VoyageLA. LA’s Most Inspiring Stories

September 25, 2017 Meet Richard Guttler of Santa Monica Thyroid Ablation Center VoyageLA Staff...

More info

Santa Monica Thyroid Center’s Dr.Richard Guttler uses Dr.Carole Spencer’s USC Thyroid Laboratory Exclusively

Santa Monica Thyroid Center’s Dr.Richard Guttler uses Dr.Carole Spencer’s USC Thyroid Laboratory Exclusively

Santa Monica Thyroid Center’s Dr.Richard Guttler uses Dr.Carole Spencer’s USC...

More info

Thyroid Ultrasound? You don’t have an indication? Just say No.

Thyroid Ultrasound?  You don’t have an indication? Just say No.

 Thyroid Ultrasound?  You don’t have an indication?            Just say No. What are the...

More info

Santa Monica Thyroid Center Richard Guttler MD,FACE,ECNU, Thyroid Tumor Ablation Thyroidologist

Santa Monica Thyroid Center Richard Guttler MD,FACE,ECNU, Thyroid Tumor Ablation Thyroidologist

Santa Monica Thyroid Center Richard Guttler MD,FACE,ECNU, Thyroid Tumor Ablation Thyroidologist...

More info

ENT Surgeon Scare Tactics: Tells Mother Anything But Surgery is Malpractice in Treating Her Daughter

ENT Surgeon Scare Tactics: Tells Mother Anything But Surgery is Malpractice in Treating Her Daughter

ENT Surgeon Scare Tactics: Tells Mother Anything But Surgery is Malpractice in Treating Her...

More info

Thyroid Tumor Ablation 101: My goal from 1972 was to decrease unnecessary thyroid surgery when a first line alternative was available.

Thyroid Tumor Ablation 101: My goal  from 1972 was to decrease unnecessary thyroid surgery when a first line alternative was available.

Thyroid Tumor Ablation 101: My goal from 1972 was to decrease unnecessary thyroid surgery when a...

More info

Thyroid No Surgery or Radioiodine 101: RFA for Autonomous Functioning Thyroid Nodule AFTN: A case study

Thyroid No Surgery or Radioiodine 101: RFA for Autonomous Functioning Thyroid Nodule AFTN: A case study

Thyroid No Surgery or Radioiodine 101: RFA for Autonomous Functioning Thyroid Nodule AFTN: A...

More info

Childhood Atom Bomb Survivors had no effect radiation effects on thyroid function or autoimmunity 60-70 years later.

Childhood Atom Bomb Survivors had no effect radiation effects on thyroid function or autoimmunity 60-70 years later.

Childhood Atom Bomb Survivors had no effect radiation effects on thyroid function or...

More info

Higher Free T3 in Males

Higher Free T3 in Males

Higher Free T3 in Males Strich D et al Endo.  Practice (23) July 7 2017  803-807 Major findings...

More info

Thyroid RFA 101: Autonomous or Toxic Thyroid Nodule

Thyroid RFA 101: Autonomous or Toxic Thyroid Nodule

Thyroid RFA 101: Autonomous or Toxic Thyroid Nodule RFA treatment of an autonomous functioning...

More info

The 250 Patients Treated with Pig Thyroid in Digby Nova Scotia Are Better off Without Desiccated Animal Thyroid

The 250 Patients Treated with Pig Thyroid in Digby Nova Scotia Are Better off Without Desiccated Animal Thyroid

The 250 Patients Treated with Pig Thyroid in Digby Nova Scotia Are Better off Without Desiccated...

More info

Graves’ Disease after Ethanol Treatment of a Thyroid Cyst : Rare Complication

Graves’ Disease after Ethanol Treatment of a Thyroid Cyst : Rare Complication

Graves’ Disease after Ethanol Treatment of a Thyroid Cyst : Rare Complication  Severe...

More info

Toxic Nodule Post Ethanol Ablation of a Large Thyroid Cyst.

Toxic Nodule Post Ethanol Ablation of a Large Thyroid Cyst.

A Rare Complication following Thyroid Percutaneous Ethanol Injection: Plummer Adenoma. Cesareo...

More info

Survey of Thyroid Specialists by American Thyroid Association: Adverse Outcomes with Thyroid Hormone Extract THE

Survey of Thyroid Specialists by American Thyroid Association: Adverse Outcomes with Thyroid Hormone Extract THE

Survey of Thyroid Specialists by American Thyroid Association: Adverse Outcomes with Thyroid...

More info

Thyroid Specialists Comments on Patient’s Use of Thyroid Extract

Thyroid Specialists Comments on Patient’s Use of Thyroid Extract

Thyroid Specialists Comments on Patient’s Use of Thyroid Extract  THE Sample of Comments...

More info

Thyroid Disease 101: Seaweed soup ia an Iodine Bomb

Thyroid Disease 101: Seaweed soup ia an Iodine Bomb

Thyroid Disease 101: Seaweed soup is an Iodine Bomb On birthdays, many South Koreans eat seaweed...

More info
Contact Info
1328 16th Street, Santa Monica, CA 90404
Monday – Friday
9:00 AM to 5:00 PM
(310) 393-8860