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Hashimoto’s thyroiditis common symptoms include:
Graves’ disease common symptoms include:
Serological testing can help diagnose an AITD and to distinguish it from other forms of thyroid dysfunction. International guidelines classification criteria recommend laboratory testing for autoantibodies against:4
The measurement of anti-TPO antibodies is the most common test for AITDs; these antibodies can be detected in Graves’ disease or Hashimoto’s thyroiditis.
Patients suffering from AITDs might only have one positive autoantibody test result. For example, 6 percent of patients with Hashimoto’s thyroiditis have isolated anti-TG positivity,9 therefore measurement of all three autoantibodies is recommended. Anti-TSH-R has the highest prevalence in untreated Graves’ disease.10 Besides AITDs, anti-TG antibodies are a critical biomarker in patients with thyroid cancer—these antibodies may interfere with the measurement of TG protein levels.11
Adding diagnostic testing to aid in a differential diagnosis has been shown to increase confidence in diagnosis to 90 percent.i,ii Conventionally, a diagnosis of allergic or autoimmune disease relies on the case history and a physical examination. However, adding diagnostic testing to aid in a differential diagnosis has been shown to increase confidence in diagnosis.i,ii Diagnostic testing can also help to improve the patient’s quality of life and productivity, reduce costs associated with absenteeism, and optimize use of medication, in addition to decreasing unscheduled healthcare visits.iii,iv
i. Duran-Tauleria E, Vignati G, Guedan MJ, et al. The utility of specific immunoglobulin E measurements in primary care. Allergy. 2004;59 (Suppl78):35-41.
ii. NiggemannB, Nilsson M, Friedrichs F. Paediatric allergy diagnosis in primary care is improved by in vitro allergen specific IgE testing. Pediatr Allergy Immunol. 2008;19:325-331
iii. Welsh N, et al. The Benefits of Specific Immunoglobulin E Testing in the Primary Care Setting. J Am Pharm Assoc. 2006;46:627.
iv. Szeinbach SL, Williams B, Muntendam P, et al. Identification of allergic disease among users of antihistamines. J Manag Care Pharm. 2004; 10 (3): 234-238
Prompt treatment of thyroid disease is important for patient quality of life. Untreated hyperthyroid diseases, such as Graves’ disease, not only reduces quality of life, but also poses the serious risks of psychiatric illness, cardiac disease, arrhythmia, and sudden cardiac death.12 Patients with hypothyroidism, such as in Hashimoto’s disease, have worse quality of life. They experience predominantly fatigue but also weight gain, dry skin, cold intolerance, muscle weakness, constipation, eye puffiness, hoarse voice, and poor memory.13 The three treatment modalities for hyperthyroidism include:14
1. Medical therapy
2. Radioactive iodine therapy
Supportive therapy is sometimes additionally required to control symptoms.14 Treatment of patients with hypothyroidism consists of replacement with thyroid hormones.14
Clinical guidelines have been designed to assist healthcare providers in the treatment of thyroid conditions and to improve patient care.