If you have Graves have you been checked for TED.

[shaws]

I came across the following and it may be helpful/informative to those who have Graves:-

"6 | THE ENDOCRINOLOGIST | AUTUMN 2017Figure 1.TEAMeD-5: five steps to improve outcomes in TED patients.3. ALERT ALL GRAVES’ PATIENTS TO THE RISK OF TED Give patients TEAMeD Early Warning Cards Increasing awareness of the early signs of TED in all patients with Graves’ disease aims to reduce delays in presentation and diagnosis. TEAMeD has developed TED ‘Early Warning Cards’, which can be given to all patients with an established diagnosis of Graves’ disease (but currently without TED), to raise awareness of TED and to facilitate earlier diagnosis (Figure 2; btf-thyroid.org/images/docu.... The Early Warning Card describes common symptoms of TED and has space for a local telephone number which can be contacted by individuals with concerns. In patients with Graves’ disease but without TED at baseline, the incidence of TED is expected to be approximately 15% per annum. In a pilot study of 160 patients who were issued with TEAMeD Early Warning Cards, 6% contacted their endocrine service about new eye symptoms.KEY RECOMMENDATIONTEAMeD recommends that all patients with Graves’ disease are informed about the risk of TED and given an Early Warning Card, as shown in Figure 2.4. PREVENT TEDEncourage smoking cessationAchieve and maintain euthyroidism rapidlyAvoid hypothyroidism after 131IAvoid 131I in active TED lCurrent smoking is the strongest risk factor for developing TED.4 Patients with Graves’ disease who smoke are approximately five times more likely to develop TED than non-smokers, and smokers tend to have more severe disease than non-smokers.4 There is evidence for a dose–response relationship between smoking and the severity of TED.5 Smoking cessation advice should be given to all Graves’ disease and TED patients who are current smokers and they should be referred to smoking cessation services for support with quitting. TEAMeD has developed a web-based smoking TEAMeD (Thyroid Eye Disease Amsterdam Declaration Implementation Group UK) was established in 2009 to implement the Amsterdam Declaration, which pledged to improve care for people with TED and prevent TED in those at risk. This autumn, TEAMeD is launching ‘TEAMeD-5’, a campaign to promote better care for patients with, or at risk of, TED. This campaign seeks to promote five recommendations in TED management (Figure 1).Thyroid eye disease (TED) is a distressing complication of Graves’ disease. TED can have a significant and negative impact upon the quality of patients’ lives and visual function. Delays in making a diagnosis of TED and initiating treatment are common. A recent study has shown that the median time from first symptoms to a diagnosis of TED is 7 months, and the median time from first visit to any doctor with symptoms to diagnosis is 2 months.11. DIAGNOSE GRAVES’ DISEASE ACCURATELYMeasure TSH (thyrotrophin) receptor antibody (TRab)Graves’ disease, the most common cause of hyperthyroidism in the UK, is caused by autoantibodies to the TSH receptor (TRab). Reliable, low cost TRab assays are available and can diagnose Graves’ disease with >95% sensitivity and specificity.2 A positive TRab test in the context of thyrotoxicosis identifies those at risk of TED, with higher TRab levels being associated with greater TED incidence and severity. TRab testing is still not routine in the diagnosis of thyrotoxicosis in many parts of the UK. However, using this test in all thyrotoxic patients is strongly recommended in order to target TRab-positive individuals with measures to increase awareness and reduce the risk of TED (see TEAMeD-5 points 2–4 below). Patients without circulating TRab are at very low risk of TED. KEY RECOMMENDATIONTEAMeD recommends that an accurate diagnosis of the cause is made in all cases of thyrotoxicosis to determine the risk of TED; TRab testing is a useful tool in the diagnosis of Graves’ disease.2. SCREEN ALL GRAVES’ PATIENTS FOR TEDUse the DiaGO clinical assessment toolIt can be challenging for endocrinologists to recognise TED and decide who should be referred for ophthalmic care. TEAMeD has developed DiaGO, a clinical assessment tool to screen all patients with Graves’ disease for signs and symptoms of TED, for use in general endocrinology clinics.3 DiaGO comprises 20 yes/no questions which aim to elicit signs and symptoms of TED. DiaGO has been tested and was found to be highly sensitive in picking up TED with a low false-positive rate (<8%). Half the individuals referred to the specialist clinic were offered ophthalmic treatment. This suggests that use of the tool is actively altering management in patients who might not otherwise have been referred and treated. DiaGO is easy to use (it can be completed in less than 5 minutes) and does not require specialist ophthalmic skills.KEY RECOMMENDATIONTEAMeD recommends a systematic assessment for early signs/symptoms of TED in all patients reviewed in endocrine clinics with an established diagnosis of Graves’ disease. This permits prompt and timely referral to appropriate ophthalmic care.

endocrinology.org/media/217...

[Valarian]

My endo runs through the symptoms of TED at every appointment (so far, luckily, I've had none).

Those with Graves' should also tell their optician when they have routine eye tests, so they can check for early symptoms which might otherwise get missed.

[shaldonkoolma]

So I'm a bit puzzled. I had a thyroidectomy for Graves in 2005. Do I still have Graves? Am I still at risk of TED, And do I still need trab testing? Thank you