“Congenital heart disease is a heart problem that a person is born with. It means that the heart’s structure — for example, its walls or valves — did not develop properly before birth. More than a million American adults live with congenital heart disease. Many were diagnosed as infants and had surgery or other treatment as a child. Others don’t know they have congenital heart disease until they develop symptoms as adults, like shortness of breath or an abnormal heartbeat.

No matter the cause or the age of diagnosis, people with congenital heart disease need continued care and treatment throughout their lives. It can be difficult for adults to find heart specialists familiar with their particular anatomy and problems–NewYork-Presbyterian has one of the few programs in the country with the depth and breadth of expertise to address the complexity of congenital heart disease in adults.

Our highly trained heart specialists understand congenital heart disease’s unique physiological, anatomical, and clinical features at all ages. Your care team includes physicians, surgeons, and genetic experts specializing in adult congenital heart disease. They’re experts in echocardiography, interventional cardiac catheterization, interventional electrophysiology, complex congenital heart surgery, and heart transplantation.

With this team approach, we address the complex needs of people with adult congenital heart disease at three centers where you can receive treatment in a hospital setting designed for adults without having to stay in a children’s hospital:

• Schneeweiss Adult Congenital Heart Center at New York-Presbyterian/Columbia University Irving Medical Center is one of the nation’s oldest, largest, and most experienced adult congenital heart disease programs.
• Cornell Center for Adult Congenital Heart Disease at New York-Presbyterian Weill Cornell Medical Center
• Ronald O. Perelman Heart Institute, NYP/Weill Cornell”

New York Presbyterian Hospital

(Congenital Heart Disease | NewYork-Presbyterian)

Though not all birth defects can be avoided, prenatal care and awareness of past or current conditions can help with prevention.

• Prenatal care. Taking a daily prenatal vitamin that includes at least 400 micrograms of folic acid can help prevent a variety of birth defects. You should be taking prenatal vitamins if you’re of reproductive age, when you’re actively trying to conceive and/or as soon as you find out you are pregnant. In addition to taking your prenatal vitamin, avoiding alcohol, tobacco and illegal drugs can significantly help prevent birth defects and pregnancy complications.
• Awareness of past or current conditions. If you previously had a pregnancy with a birth defect, it’s important to find out the most likely causes because it can help your physician plan preventive measures for your next pregnancy. For example, spina bifida is caused by a deficiency in folate, so if your previous pregnancy had spina bifida, you can take a high dose of folate to help prevent future spina bifida diagnoses.

Are all birth defects discovered before a baby is born?

It’s not always possible to detect all birth defects in utero. However, high-resolution ultrasounds done by certified prenatal ultrasound groups make it possible to diagnose defects that will cause a significant impact before birth.

Baschat says: “At the Center for Fetal Therapy, we recommend that pregnant women have the first-trimester nuchal translucency scan between 11 and 14 weeks and the anatomy scan between 18 and 20 weeks. These two ultrasounds provide us with the best opportunity for detecting birth defects.”

In recent years, some pregnant women have turned down the first-trimester ultrasound because a maternal screening blood test now exists for Down syndrome. The ultrasound is still strongly recommended, though, because there are many other serious birth defects that can be detected this early in pregnancy.

Is it possible to treat birth defects while a baby is in utero?

Absolutely. While there are many different types of birth defects, it’s extremely important to try to correct those that damage vital organs before the baby is born. The Center for Fetal Therapy specializes in treating several of these defects in utero, including:

• Congenital diaphragmatic hernia. This condition, in which a hole in the diaphragm allows abdominal content to enter the chest and restrict lung development, can be significantly helped in utero through fetoscopic endotracheal occlusion, a surgery that improves lung function and significantly increases survival rates.
• Lower urinary tract obstruction. This occurs when the flow of urine is blocked from exiting the fetus’ body, leading to permanent kidney damage. Relieving this obstruction before birth protects the kidneys.

Fetal treatments also exist for conditions that make the baby unhealthy, even if they are not considered to be birth defects. For example, if a fetus has an irregular heartbeat, you can give the mother medication that will cross the placenta and treat the fetus.

How successful are in utero treatments for fetal conditions?

By treating fetal conditions in utero rather than waiting until after birth, fetuses are given significantly better chances of survival and a reduced need for major surgery after birth. For example, with a condition like twin-to-twin transfusion syndrome, in which identical twins develop a blood volume imbalance, both babies could die without any intervention. By performing laser surgery in utero, there is approximately a 95 percent chance that at least one baby will survive.

Explains Baschat, “Success rates vary depending on the condition, available treatments and the individual patient, but overall, where fetal interventions are available, we see a much higher rate of survival for affected fetuses.”

If a baby has fetal surgery, will he/she need different care after birth?

This will depend on the individual condition and type of surgery performed. For all fetal surgeries, your baby needs to be delivered at a hospital where pediatric subspecialties are in-house so the baby’s care can be managed after birth. Baschat says: “Many of the treatments we perform require patients to deliver at the highest-level multispecialty hospital, like The Johns Hopkins Hospital. This way, all prenatal and postnatal care is available to you in one location.”

If you have one child affected by a birth defect, will all of your future children have that same condition?

All future children will not definitively be affected by the same birth defect, but it will depend on what the cause was. If the birth defect was caused by a genetic mutation, there may be a higher likelihood of recurrence, but if you seek care from a specialized center, maternal-fetal medicine specialists and genetic counselors can work with you to assess future risk.

The risk of some conditions can be determined before you become pregnant through genetic testing. If that doesn’t exist for the condition in question, maternal-fetal medicine specialists and genetic counselors can genetically test your fetus during pregnancy to see if she or he exhibits the mutation that affected your previous child.

Are there communities in which you can speak with other families who have had children affected by birth defects?

There are many forums online, whether on the web or social media platforms, in which parents come together. “At our center, we reach out to previous patients to see if they are interested in communicating with new patients affected by the same condition,” Baschat explains. “They can empathize about the specific birth defect, but they can also provide guidance and advice about the experience of working with our center throughout the pregnancy and after the baby is born.”

In the future, what advances will take place in treating disease before birth?

Through prenatal diagnosis and understanding fetal disease better, physicians are learning more about what harms the fetus and what may be of benefit before birth. Additionally, new uses for minimally invasive surgical equipment are regularly being discovered.

There are also stem cell therapies, genomic medicine and a whole host of related treatments that are currently used for children and adults. One day, these may also apply to the fetus. “While it’s hard to predict the future, we’re currently doing things we couldn’t have foreseen 10 years ago, so we’re very hopeful for continued advancements in fetal care,” says Baschat.

“Vitiligo is a skin condition that has impacted millions of people worldwide. It affects people of all ages and genders. Vitiligo is a chronic skin condition that causes loss of natural pigment of the skin and results in the appearance of light-colored or white spots on arms, legs, and other parts of the body. Although it is not a life-threatening condition, vitiligo can significantly impact a person’s self-esteem, clothing choices, and quality of life.”

PERFECTFAQS (PerfectFaqs.com | Perfectly Curated, Fact-checked Blogs For You)

Vitiligo (vit-uh-lie-go) causes the skin to lose its natural color. Patches of lighter skin appear. Some people develop a few patches. Others lose much more skin color.

Vitiligo can also affect other parts of your body. A section of hair can turn white. Some people lose color inside their mouths. Even an eye can lose some of its color.

What causes this color loss is still a mystery. We do know that vitiligo is not contagious. It is not life-threatening.

But vitiligo can be life-altering. Some people develop low self-esteem. They may no longer want to hang out with friends. They can develop serious depression. Most people have vitiligo for life, so it’s important to develop coping strategies.

A coping strategy that helps many people is to learn about vitiligo. Another helpful strategy is to connect with others who have vitiligo.

Up to 2% of the population and an estimated 2 to 5 million Americans have the condition. It doesn’t matter if you’re a man or a woman.

In most cases, it develops early in life, between ages 10 and 30. It will almost always show up before age 40.

“National Blood Donor Month is a time to recognize the selfless contributions of the roughly 7 million people across the country who give blood each year. Their simple yet profound decision has saved countless lives. We encourage all eligible individuals to join the ranks of America’s blood donors and make a lifesaving impact in someone’s time of need,” said Kate Fry, CEO of America’s Blood Centers.

This National Blood Donor Month, the blood community says thank you to the millions of blood donors throughout the United States. Your gift provides essential medicine for patients in need,” said Debra BenAvram, chief executive officer of AABB. “Blood is an essential part of health care and is needed every day. We encourage eligible Americans to start the new year off by making an appointment to donate blood today.”

“We are grateful to those who generously roll up a sleeve for patients in need,” said Chris Hrouda, president of American Red Cross Biomedical Services. “Even as we see the donor base decline, the American Red Cross recognizes and celebrates our dedicated blood and platelet donors who are giving more often today than past decades. This National Blood Donor Month, please join us in our mission that truly helps save lives.”

President Richard Nixon proclaimed January 1970 as the first National Blood Donor Month on December 31, 1969, as requested by Senate Joint Resolution 154, to pay tribute to voluntary blood donors and encourage new donors to join. This month continues to be celebrated each year to thank America’s blood donors and encourage more people to donate blood.

Blood transfusion remains one of the most common hospital procedures, with patients requiring a blood transfusion every two seconds. More than 42,000 units of red blood cells, platelets, and plasma are used by patients every day.”

American Red Cross (Blood Community Unites to Recognize Donors Ahead of National Blood Donor Month in January)

January is National Blood Donor Month, a time to celebrate generous volunteer donors and raise awareness for the need for blood donations.  The purpose is to raise awareness about the vital importance of blood donation. Every drop counts and every donor is a hero.

It began in 1970 when President Richard Nixon made an historic proclamation. During this special month, we encourage all those impacted by the lifesaving power of blood donation to come together to honor and celebrate the incredible generosity of America’s voluntary blood donors.

According to the American Red Cross, winter is “one of the most difficult times of year to collect enough blood products to meet patient needs.” That’s because of, among other things, busy holiday schedules and bad weather often resulting in canceled blood drives. Furthermore, seasonal illnesses such as the flu force potential donors to forgo their blood donations.

That’s just one of the reasons that National Blood Donor Month, which has taken place each January since 1970, is such an important observance. Donating blood saves many lives and improves health for many people. According to the World Health Organization, “blood is the most precious gift that anyone can give to another person — the gift of life. A decision to donate your blood can save a life.”

Did you know these facts? Seek below:

Give blood. Don’t wait for a disaster. Someone needs blood now! Contact the American Red Cross or your local blood bank for more information.

“The golden (Rh null) blood is the rarest blood group, lacking Rh antigens in the red blood cells (RBCs). Learn more about the golden blood type, other rare blood types, and blood charts.

Proteins known as Rhesus (Rh) factors or antigens are completely absent in the red cells of people with the golden blood type or Rh null blood group. This is the rarest blood group in the world, with less than 50 individuals having this blood group. Golden blood type was first discovered in an Australian Aboriginal woman in 1961.

Our red blood cells have sugars and proteins called antigens on their surface membranes. Depending on the mix of antigens present, blood is categorized into different blood types, and we have A, B, O, or AB blood types. The ABO system has a further distinction as Rh-positive or Rh-negative depending on the presence or absence of the “Rh-D” factor in the cells.

A person with the golden blood type, or the Rh null blood type lacks all the Rh antigens whereas a person with the Rh-negative blood group lacks only Rh-D antigen.

The worry with the golden blood type is that donations of the Rh null blood type are incredibly scarce and difficult to obtain. An Rh null person has to rely on the cooperation of a small network of regular Rh null donors around the world if they need blood. Across the globe, there are only nine active donors for this blood group. This makes it the world’s most precious blood type, hence the name “golden” blood.

Golden blood type can be donated. Because of the absence of antigens on RBCs, a person with Rh null blood is considered to be a universal donor, and this blood can be donated to anyone with rare blood types within the Rh systems.”

Medicine Net (Golden Blood Type: Understanding the Rarest Blood Group)

Blood type (also called blood group) is genetically determined. Blood is primarily categorised based on the presence and/or absence of antigens on the surface of our red blood cells (RBCs). Antigens are distinct molecules or substances capable of coaxing an immune response. Our immune system sends out mini soldiers called antibodies (also known as immunoglobulins), which are special proteins that recognise and bind to these antigens.

If our antibodies recognise these antigens as allies or naturally part of our body, our immune system happily leaves it alone.  But if they detect enemy or foreign antigens, our immune system will go on an all-out war to destroy them. This is the reason you need give the blood type and Rh factor (positive or negative) that a patient is if they need blood transfusions to prevent this destructive action to take place unless your the universal donor type O with no antibodies.  Unfortunately, our immune system isn’t perfect. In rare cases, it does attack ‘self’ antigens, as seen in some cases of autoimmune blood disorders.

You might be familiar with the ABO blood group system. When you ask someone what blood type they are, they might respond with “AB”. They are referring to this most important blood group system in human-blood transfusion. It comprises of only two antigens (antigen A and antigen B), but it can produce these four ABO blood types: A, B, AB or O.  At present, the International Society of Blood Transfusion recognises 36 human blood group systems and more than 300 different antigens.  The most common are type ABO and AB blood types.

Why does Rh positive or negative matter in knowing for your blood type?

The Rh blood group system has a colourful history. It consists of 61 blood group antigens (Rh antigens), which are expressed as part of a protein complex found only in RBC membranes. Rh antigens are believed to be essential for maintaining the integrity of RBCs.

Briefly going back to ABO blood group system, some people might tell you that they’re “O negative” or “A positive”. The negative/positive part refers to the absence or presence of one Rh antigen: the Rh(D) antigen. It’s the main Rh antigen considered for human-blood transfusion.

So what is Rh Null?

People who have the ‘golden blood’ type lack these Rh antigens. Their DNA lacks the genes responsible for building those RBC protein complexes. These people don’t just lack one, two or three of these 61 Rh antigens, they actually lack all of them. Yes, you read that right: all of them. As you might have guessed, people with Rh Null blood type have abnormal RBCs. They have deformed shapes, leaky membranes and shorter lifespans, which sometimes result in mild anaemia for the individual. Still, the absence of all Rh antigens makes Rh null the ‘golden blood’, which is highly admired for its rarity and medical purposes.

Rare blood types within the Rh blood type system can make it difficult or even impossible to get a blood transfusion. This makes Rh Null blood as the ‘universal’ life-saving blood for the Rh blood type system (especially if the donor has an ABO blood type O too).

But rarity comes at a price. If people with Rh Null blood type requires a blood transfusion, they can only receive Rh_null blood themselves. Even if they receive an O-negative blood, the presence of other Rh antigens on the RBCs may trigger a severe immune response. Therefore, these ‘golden blood’ carriers are solely dependent on other Rh Null donors, but only a few of them regularly donate and they are all spread out across the world.

This is why Rh Null blood is considered as the ‘golden blood’, but it’s not all sunshine and rainbows for those people who carry it. Still, we can’t deny the life-saving properties of this rare blood type and we can deeply appreciate the generosity of those selfless donors.

“Undiagnosed thyroid issues can increase the risk for other serious conditions, such as cardiovascular disease, obesity, osteoporosis, and infertility. However, most thyroid diseases are lifelong conditions that can be managed with medical attention once diagnosed. Learn about the different types of tests used to determine if you have a thyroid condition.

Treatment for thyroid disease varies depending on the specific condition. Learn about common treatment options for hyperthyroidism, Graves’ disease, thyroid eye disease, hypothyroidism, Hashimoto’s disease, goiters, nodules, and thyroid cancer.”

American Association of Clinical Endocrinology / AACE

(Patient Journey Thyroid | American Association of Clinical Endocrinology)

Diagnostic Tools for Hypothyroidism:

History: The doctor will take a detailed history, evaluating both past and present medical problems. If the patient is younger than 20 or older than 70 years, there is increased likelihood that a nodule is cancerous. Similarly, the nodule is more likely to be cancerous if there is any history of radiation exposure, difficulty swallowing, or a change in the voice. It was actually customary to apply radiation to the head and neck in the 1950s to treat acne! Significant radiation exposures include the Chernobyl and Fukushima disasters. Although women tend to have more thyroid nodules than men, the nodules found in men are more likely to be cancerous. Despite its value, the history cannot differentiate benign from malignant nodules. Thus, many patients with risk factors uncovered in the history will have benign lesions. Others without risk factors for malignant nodules may still have thyroid cancer.

Physical examination: The physician should determine if there is one nodule or many nodules, and what the remainder of the gland feels like. The probability of cancer is higher if the nodule is fixed to the surrounding tissue (unmovable). In addition, the physical exam should search for any abnormal lymph nodes nearby that may suggest the spread of cancer. In addition to evaluating the thyroid, the physician should identify any signs of gland malfunction, such as thyroid hormone overproduction (hyperthyroidism) or underproduction (hypothyroidism).

Blood tests: Initially, blood tests should be done to assess thyroid function. These tests include:

• The free T4 and thyroid stimulating hormone (TSH) levels. Elevated levels of the thyroid hormones T4 or T3 in the context of suppressed TSH suggests hyperthyroidism
• Reduced T4 or T3 in the context of high TSH suggests hypothyroidism
• Antibody titers to thyroperoxidase or thyroglobulin may be useful to diagnose autoimmune thyroiditis
• (for example, Hashimoto’s thyroiditis).
• If surgery is likely to be considered for treatment, it is strongly recommended that the physician als determine the level of thyroglobin. Produced only in the thyroid hormone in the blood. Thyroglobulin carries thyroid hormone in the blood. Thyroglobulin levels should fall quickly within 48 hours in the thyroid gland is completely remobed. If thyroglobulin levels start to climb.

Ultrasonography: A physician may order an ultrasound examination of the thyroid to:

• Detect nodules that are not easily felt
• Determine the number of nodules and their sizes
• Determine if a nodule is solid or cystic
• Assist obtaining tissue for diagnosis from the thyroid with a fine needle aspirate (FNA)

Despite its value, the ultrasound cannot determine whether a nodule is benign or cancerous.

Radionuclide scanning: Radionuclide scanning with radioactive chemicals is another imaging technique a physician may use to evaluate a thyroid nodule. The normal thyroid gland accumulates iodine from the blood and uses it to make thyroid hormones. Thus, when radioactive iodine (123-iodine) is administered orally or intravenously to an individual, it accumulates in the thyroid and causes the gland to “light up” when imaged by a nuclear camera (a type of Geiger counter). The rate of accumulation gives an indication of how the thyroid gland and any nodules are functioning. A “hot spot” appears if a part of the gland or a nodule is producing too much hormone. Non-functioning or hypo-functioning nodules appear as “cold spots” on scanning. A cold or non-functioning nodule carries a higher risk of cancer than a normal or hyper-functioning nodule. Cancerous nodules are more likely to be cold, because cancer cells are immature and don’t accumulate the iodine as well as normal thyroid tissue. However, cold spots can also be caused by cysts. This makes the ultrasound a much better tool for determining the need to do an FNA.

Fine needle aspiration: Fine needle aspiration (FNA) of a nodule is a type of biopsy and the most common, direct way to determine what types of cells are present. The needle used is very thin. The procedure is simple and can be done in an outpatient office, and anesthetic is injected into tissues traversed by the needle. FNA is possible if the nodule is easily felt. If the nodule is more difficult to feel, fine needle aspiration can be performed with ultrasound guidance. The needle is inserted into the thyroid or nodule to withdraw cells. Usually, several samples are taken to maximize the chance of detecting abnormal cells. These cells are examined microscopically by a pathologist to determine if cancer cells are present. The value of FNA depends upon the experience of the physician performing the FNA and the pathologist reading the specimen. Diagnoses that can be made from FNA include:

• Benign thyroid tissue (non-cancerous) can be consistent with Hashimoto’s thyroiditis, a colloid nodule, or a thyroid cyst. This result is reported from approximately 60% of biopsies.
• Cancerous tissue (malignant) can be consistent with diagnosis of papillary, follicular, or medullary cancer. This result is reported from approximately 5% of biopsies. The majority of these are papillary cancers.
• Suspicious biopsy can show a follicular adenoma. Though usually benign, up to 20% of these nodules are found ultimately to be cancerous.
• Non-diagnostic results usually arise because insufficient cells were obtained. Upon repeat biopsy, up to 50% of these cases can be distinguished as benign, cancerous, or suspicious.

One of the most difficult problems for the pathologist is to be confident that a follicular adenoma – usually a benign nodule – is not a follicular cell carcinoma or cancer. In these cases, it is up to the physician and the patient to weigh the option of surgery on a case-by-case basis, with less reliance on the pathologist’s interpretation of the biopsy. It is also important to remember that there is a small risk (3%) that a benign nodule diagnosed by FNA may still be cancerous. Thus, even benign nodules should be followed closely by the patient and physician. Another biopsy may be necessary, especially if the nodule is growing. Most thyroid cancers are not very aggressive; that is, they do not spread rapidly. The exception is poorly differentiated (anaplastic) carcinoma, which spreads rapidly and is difficult to treat.

Treatment  for Hypothyroidism:

Hypothyroidism happens when the thyroid gland doesn’t make enough hormones. Conditions or problems that can lead to hypothyroidism include:

• Autoimmune disease. The most common cause of hypothyroidism is an autoimmune disease called Hashimoto’s disease. Autoimmune diseases happen when the immune system makes antibodies that attack healthy tissues. Sometimes that process involves the thyroid gland and affects its ability to make hormones.
• Thyroid surgery. Surgery to remove all or part of the thyroid gland can lower the gland’s ability to make thyroid hormones or stop it completely.
• Radiation therapy. Radiation used to treat cancers of the head and neck can affect the thyroid gland and lead to hypothyroidism.
• Thyroiditis. Thyroiditis happens when the thyroid gland becomes inflamed. This may be due to an infection. Or it can result from an autoimmune disorder or another medical condition affecting the thyroid. Thyroiditis can trigger the thyroid to release all of its stored thyroid hormone at once. That causes a spike in thyroid activity, a condition called hyperthyroidism. Afterward, the thyroid becomes underactive.
• Medicine. A number of medicines may lead to hypothyroidism. One such medicine is lithium, which is used to treat some psychiatric disorders. If you’re taking medicine, ask your heath care provider about its effect on the thyroid gland.

Less often, hypothyroidism may be caused by:

• Problems present at birth. Some babies are born with a thyroid gland that doesn’t work correctly. Others are born with no thyroid gland. In most cases, the reason the thyroid gland didn’t develop properly is not clear. But some children have an inherited form of a thyroid disorder. Often, infants born with hypothyroidism don’t have noticeable symptoms at first. That’s one reason why most states require newborn thyroid screening.
• Pituitary disorder. A relatively rare cause of hypothyroidism is the failure of the pituitary gland to make enough thyroid-stimulating hormone (TSH). This is usually because of a noncancerous tumor of the pituitary gland.
• Pregnancy. Some people develop hypothyroidism during or after pregnancy. If hypothyroidism happens during pregnancy and isn’t treated, it raises the risk of pregnancy loss, premature delivery and preeclampsia. Preeclampsia causes a significant rise in blood pressure during the last three months of pregnancy. Hypothyroidism also can seriously affect the developing fetus.
• Not enough iodine. The thyroid gland needs the mineral iodine to make thyroid hormones. Iodine is found mainly in seafood, seaweed, plants grown in iodine-rich soil and iodized salt. Too little iodine can lead to hypothyroidism. Too much iodine can make hypothyroidism worse in people who already have the condition. In some parts of the world, it’s common for people not to get enough iodine in their diets. The addition of iodine to table salt has almost eliminated this problem in the United States.

• If you have had radiation therapy and have hypothyroidism, or if your thyroid gland has been removed, you will most likely need treatment from now on. If your hypothyroidism is caused by Hashimoto’s thyroiditis, you might also need treatment from now on. Sometimes, thyroid gland function returns on its own in Hashimoto’s thyroiditis.
• If a serious illness or infection triggered your hypothyroidism, your thyroid function most likely will return to normal when you recover.
• Some medicines may cause hypothyroidism. Your thyroid function may return to normal when you stop the medicines.
• If you have mild (subclinical) hypothyroidism, you may not need treatment but should be watched for signs of hypothyroidism getting worse. You and your doctor will talk about the pros and cons of taking medicine to treat your mild hypothyroidism. The dose of thyroid medicine must be watched carefully in people who also have heart disease, because too much medicine increases the risk of chest pain (angina) and irregular heartbeats (atrial fibrillation).

*****1.)If you have severe hypothyroidism by the time you are diagnosed, you will need immediate treatment. Severe, untreated hypothyroidism can cause myxedema coma, a rare, life-threatening condition.

            2.)Treatment during pregnancy is especially important, because hypothyroidism can harm the developing fetus.

• If you develop hypothyroidism during pregnancy, treatment should be started immediately. If you have hypothyroidism before you become pregnant, your thyroid hormone levels need to be checked to make sure that you have the right dose of thyroid medicine. During pregnancy, your dose of medicine may need to be increased by 25% to 50%.

• You are likely to need treatment for hypothyroidism from now on. As a result, you need to take your medicine as directed. For some people, hypothyroidism gets worse as they age and the dosage of thyroid medicine may have to be increased gradually as the thyroid continues to slow down.
• Most people treated with thyroid hormone develop symptoms again if their medicine is stopped. If this occurs, medicine needs to be restarted.

Treatment for Hyperthyroidism:

If your symptoms bother you, your doctor may give you pills called beta-blockers. These can help you feel better while you and your doctor decide what your treatment should be. Hyperthyroidism can lead to more serious problems. So even if your symptoms do not bother you, you still need treatment.

The diagnostic workup for hyperthyroidism includes measuring thyroid-stimulating hormone, free thyroxine (T₄), and total triiodothyronine (T₃) levels to determine the presence and severity of the condition, as well as radioactive iodine uptake and scan of the thyroid gland to determine the cause.

There are several treatments available for hyperthyroidism. The best approach for you depends on your age and health. The underlying cause of hyperthyroidism and how severe it is make a difference too. Your personal preference also should be considered as you and your health care provider decide on a treatment plan. Treatment may include:

• Anti-thyroid medicine. These medications slowly ease symptoms of hyperthyroidism by preventing the thyroid gland from making too many hormones. Anti-thyroid medications include methimazole and propylthiouracil. Symptoms usually begin to improve within several weeks to months.Treatment with anti-thyroid medicine typically lasts 12 to 18 months. After that, the dose may be slowly decreased or stopped if symptoms go away and if blood test results show that thyroid hormone levels have returned to the standard range. For some people, anti-thyroid medicine puts hyperthyroidism into long-term remission. But other people may find that hyperthyroidism comes back after this treatment.Although rare, serious liver damage can happen with both anti-thyroid medications. But because propylthiouracil has caused many more cases of liver damage, it’s generally used only when people can’t take methimazole. A small number of people who are allergic to these medicines may develop skin rashes, hives, fever or joint pain. They also can raise the risk of infection.
• Beta blockers. These medicines don’t affect thyroid hormone levels. But they can lessen symptoms of hyperthyroidism, such as a tremor, rapid heart rate and heart palpitations. Sometimes, health care providers prescribe them to ease symptoms until thyroid hormones are closer to a standard level. These medicines generally aren’t recommended for people who have asthma. Side effects may include fatigue and sexual problems.Regardless of the cause of hyperthyroidism, the adrenergic symptoms are controlled by beta blockers Propranolol has the theoretical advantage of also inhibiting 5′-monodeiodinase, thus blocking peripheral conversion of T₄ to T₃.
• Radioiodine therapy. The thyroid gland takes up radioiodine. This treatment causes the gland to shrink. This medicine is taken by mouth. With this treatment, symptoms typically lessen within several months. This treatment usually causes thyroid activity to slow enough to make the thyroid gland underactive. That condition is hypothyroidism. Because of that, over time, you may need to take medicine to replace thyroid hormones.
• Radioactive iodine and antithyroid medicine are the treatments doctors use most often. The best treatment for you will depend on a number of things, including your age. Some people need more than one kind of treatment.
• Thyroidectomy. This is surgery to remove part of or all of the thyroid gland. It is not used often to treat hyperthyroidism. But it may be an option for people who are pregnant. It also may be a choice for those who can’t take anti-thyroid medicine and don’t want to or can’t take radioiodine therapy.Risks of this surgery include damage to the vocal cords and parathyroid glands. The parathyroid glands are four tiny glands on the back of the thyroid. They help control the level of calcium in the blood.People who have a thyroidectomy or radioiodine therapy need lifelong treatment with the medicine levothyroxine (Levoxyl, Synthroid, others). It supplies the body with thyroid hormones. If the parathyroid glands are removed during surgery, medicine also is needed to keep blood calcium in a healthy range.

Thyroid eye disease

If you have thyroid eye disease, you may be able to manage mild symptoms with self-care steps, such as artificial tear drops and lubricating eye gels. Avoiding wind and bright lights can help too.

More-severe symptoms may need treatment with medicine called corticosteroids, such as methylprednisolone or prednisone. They can lessen swelling behind the eyeballs. The medicine teprotumumab (Tepezza) also may be used to control moderate to severe symptoms. If those medicines don’t ease symptoms, other medicines are sometimes used to treat thyroid eye disease. They include, tocilizumab (Actemra), rituximab (Rituxan) and mycophenolate mofetil (Cellcept).

In some cases, surgery may be needed to treat thyroid eye disease, including:

• Orbital decompression surgery. In this surgery, the bone between the eye socket and the sinuses is removed. This surgery can improve vision. It also gives the eyes more room, so they can go back to their usual position. There is a risk of complications with this surgery. If you have double vision before the surgery, it may not go away afterward. Some people develop double vision after the surgery.
• Eye muscle surgery. Sometimes scar tissue from thyroid eye disease can cause one or more eye muscles to be too short. This pulls the eyes out of alignment, causing double vision. Eye muscle surgery may correct double vision by cutting the muscle from the eyeball and attaching it again farther back.

The choice of treatment modality for hyperthyroidism caused by overproduction of thyroid hormones depends on the patient’s age, symptoms, comorbidities, and preference but also including what is the CAUSE of the hyperthyroidism determined by diagnostic tooling tests.