Hashimoto's disease is a disorder that affects your thyroid, a small gland located at the base of your neck, below

your Adam's apple. The thyroid

gland is part of your endocrine system, which produces hormones that coordinate many of your body's activities.

In Hashimoto's disease, also known as chronic lymphocytic thyroiditis, your immune system attacks your thyroid gland. The resulting
inflammation often leads to an underactive thyroid gland (hypothyroidism). Hashimoto's disease is the most common cause of hypothyroidism in
the United States.

Doctors test your thyroid function to help detect Hashimoto's disease. Treatment of Hashimoto's disease with thyroid hormone replacement
usually is simple and effective

Symptoms

By Mayo Clinic staff

Hashimoto's disease does not have unique signs and symptoms. The disease typically progresses slowly over a number of years and causes
chronic thyroid damage, leading to a drop in thyroid hormone levels in your blood. The signs and symptoms are mainly those of an underactive
thyroid gland (hypothyroidism).

The signs and symptoms of hypothyroidism vary widely, depending on the severity of hormone deficiency. At first, you may barely notice any
symptoms, such as fatigue and sluggishness, or you may simply attribute them to getting older. But as the disease progresses, you may develop
more obvious signs and symptoms. Signs and symptoms of hypothyroidism include:

• Fatigue and sluggishness

• Increased sensitivity to cold
• Constipation
• Pale, dry skin
• A puffy face
• Hoarse voice
• An elevated blood cholesterol level
• Unexplained weight gain - occurring infrequently and rarely more than 10 to 20 pounds, most of which is fluid
• Muscle aches, tenderness and stiffness, especially in your shoulders and hips
• Pain and stiffness in your joints and swelling in your knees or the small joints in your hands and feet
• Muscle weakness, especially in your lower extremities
• Excessive or prolonged menstrual bleeding (menorrhagia)
• Depression

Without treatment, signs and symptoms gradually become more severe and your thyroid gland may become enlarged (goiter). In addition, you
may become more forgetful, your thought processes may slow, or you may feel depressed.

When to see a doctor

See your doctor if you're feeling tired for no apparent reason or have any other signs and symptoms of hypothyroidism, such as dry skin, a pale,
puffy face, constipation or a hoarse voice.

You'll also need to see your doctor for periodic testing of your thyroid function if you've had previous thyroid surgery, treatment with radioactive
iodine or anti-thyroid medications, or radiation therapy to your head, neck or upper chest.

If you have high blood cholesterol, talk to your doctor about whether hypothyroidism may be a cause. And if you're receiving hormone therapy
for hypothyroidism caused by Hashimoto's disease, schedule follow-up visits as often as your doctor recommends. Initially, it's important to make
sure you're receiving the correct dose of medicine. And over time, the dose you need to adequately replace your thyroid function may change.

Causes

By Mayo Clinic staff

 Thyroid
gland

Your thyroid gland is part of your endocrine system, which produces hormones that coordinate many of your body's activities, from digestion to
metabolism to reproduction. Your thyroid gland produces two main hormones, thyroxine (T-4) and triiodothyronine (T-3). They maintain the rate
at which your body uses fats and carbohydrates, help control your body temperature, influence your heart rate and help regulate the production of
protein.

The rate at which thyroxine and triiodothyronine are released is controlled by your pituitary gland and your hypothalamus — an area at the base
of your brain that acts as a thermostat for your whole system. The hypothalamus signals your pituitary gland to make a hormone called thyroid-
stimulating hormone (TSH). Your pituitary gland then releases TSH — the amount depends on how much thyroxine and triiodothyronine are
detected in your blood. Finally, your thyroid gland regulates its production of hormones based on the amount of TSH it receives. Although this
process usually works well, the thyroid sometimes fails to produce enough hormones.

Your immune system's role

Normally, your immune system uses naturally occurring proteins (antibodies) and white blood cells (lymphocytes) to help protect against viruses,
bacteria and foreign substances (antigens) that invade your body. Hashimoto's disease is an autoimmune disorder in which your immune system
creates antibodies that damage your thyroid gland. The disease causes inflammation of your thyroid gland (thyroiditis), which may impair the
ability of your thyroid to produce hormones, leading to an underactive thyroid gland (hypothyroidism). Then, your pituitary gland attempts to
stimulate your thyroid gland to produce more thyroid hormones, thus causing your thyroid gland to enlarge (goiter).

Doctors don't know what causes your immune system to attack your thyroid gland. Some scientists think a virus or bacterium might trigger the
response, while others believe a genetic flaw may be involved. A combination of factors, including heredity, sex and age, may determine your
likelihood of developing the disorder. Hashimoto's disease is most common in middle-aged women and tends to run in families.

Complications

By Mayo Clinic staff

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Enlarged thyroid

Left untreated, an underactive thyroid gland (hypothyroidism) caused by Hashimoto's disease can lead to a number of health problems:

• Goiter. Constant stimulation of your thyroid to release more hormones may cause the gland to become enlarged, a condition known as
goiter. Hypothyroidism is one of the most common causes of goiter. Although generally not uncomfortable, a large goiter can affect
your appearance and may interfere with swallowing or breathing.
• Heart problems. Hashimoto's disease also may be associated with an increased risk of heart disease, primarily because high levels of
low-density lipoprotein (LDL) cholesterol — the "bad" cholesterol — can occur in people with an underactive thyroid gland
(hypothyroidism). Hypothyroidism caused by Hashimoto's disease also can lead to an enlarged heart and, in rare cases, heart failure.
• Mental health issues. Depression may occur early in Hashimoto's disease and may become more severe over time. Hashimoto's
disease can also cause sexual desire (libido) to decrease in both men and women and can lead to slowed mental functioning.
• Myxedema. This rare, life-threatening condition can develop due to long-term hypothyroidism as a result of untreated Hashimoto's
disease. Its signs and symptoms include intense cold intolerance and drowsiness followed by profound lethargy and unconsciousness.
A myxedema coma may be triggered by sedatives, infection or other stress on your body. Myxedema requires immediate emergency
medical treatment.
• Birth defects. Babies born to women with untreated hypothyroidism due to Hashimoto's disease may have a higher risk of birth
defects than babies born to healthy mothers. Doctors have long known that these children are more prone to intellectual and
developmental problems. There may be a link between hypothyroid pregnancies and birth defects, such as cleft palate. A connection
also exists between hypothyroid pregnancies and heart, brain and kidney problems in infants. However, if any of these conditions are
diagnosed within the first few months of a baby's life, chances of normal development are excellent.
Preparing for your appointment

By Mayo Clinic staff

You're likely to start by first seeing your family doctor or a general practitioner. However, in some cases when you call to set up an appointment
you may be referred immediately to a specialist called an endocrinologist.

Here's some information to help you prepare for your appointment and what to expect from your doctor.

What you can do

• Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to
do in advance to prepare for common diagnostic tests.
• Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the
appointment. For example, if you've been feeling more forgetful than usual, this is important information to share with your doctor.
Also tell your doctor about changes you've noticed in your physical appearance, such as unexplained weight gain or a difference in
your skin.
• Write down key personal information, including any changes in your menstrual cycle and in your sex life. Let your doctor know if
your libido has noticeably changed.
• Make a list of all medications, as well as any vitamins or supplements, that you are currently taking or have used in the past. Include
on your list the specific name and dose of these medications, and how long you've been taking them.
• Take a family member or friend along, if possible. Sometimes it can be difficult to soak up all the information provided to you
during an appointment. Someone who accompanies you may remember something that you missed or forgot.
• Write down questions to ask your doctor.

Create a list of questions ahead of your appointment so that you can make the most of your time with your doctor. For Hashimoto's disease, some
basic questions to ask your doctor include:

• What is likely causing my symptoms or condition?

• Other than the most likely cause, what are possible causes for my symptoms or condition?
• What kinds of tests do I need now?
• Is my condition likely temporary or chronic?
• What treatment approach do you recommend?
• How long will I need to take medications?
• What side effects could I experience from the medications you're recommending?
• How will you monitor whether my treatment is working?
• Under what circumstances might my medications need to be adjusted?
• Will I experience long-term complications from this condition?
• Do I need to make any changes to my diet?
• Will exercise benefit my condition?
• Are there any restrictions that I need to follow?
• I have these other health conditions. How can I best manage them together?
• Should I see a specialist? What will that cost, and will my insurance cover seeing a specialist?
• Is there a generic alternative to the medicine you're prescribing me?
• Are there any brochures or other printed material that I can take home with me? What Web sites do you recommend visiting?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you
don't understand something.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend
more time on. Your doctor may ask:

• What are your symptoms, and when did you first notice them?
• How have your symptoms changed over time?
• Have you noticed any changes in your energy level or your mood?
 • Has your appearance changed, including weight gain or skin dryness?
• Has your voice changed?
• Have your bowel habits changed? How?
• Do you have muscle or joint pain? Where?
• Have you noticed a change in your sensitivity to cold?
• Have you felt more forgetful than usual?
• Has your interest in sex decreased? If you're a woman, has your menstrual cycle changed?
• Are you currently being treated or have you recently been treated for any other medical conditions?
• Do any of your family members have thyroid disease?

Tests and diagnosis

By Mayo Clinic staff

In general, your doctor may test for Hashimoto's disease if you're feeling increasingly tired or sluggish, have dry skin, constipation and a hoarse
voice, or have had previous thyroid problems or goiter.

Diagnosis of Hashimoto's disease is based on your signs and symptoms and the results of blood tests that measure levels of thyroid hormone and
thyroid-stimulating hormone (TSH). These may include:

• A hormone test. Blood tests can determine the amount of hormones produced by your thyroid and pituitary glands. If your thyroid is
underactive, the level of thyroid hormone is low. At the same time, the level of TSH is elevated because your pituitary gland tries to
stimulate your thyroid gland to produce more thyroid hormone.
• An antibody test. Because Hashimoto's disease is an autoimmune disorder, the cause involves production of abnormal antibodies. A
blood test may confirm the presence of antibodies against thyroid peroxidase (TPO), an enzyme normally found in the thyroid gland
that plays an important role in the production of thyroid hormones.

In the past, doctors weren't able to detect underactive thyroid (hypothyroidism), the main indicator of Hashimoto's disease, until symptoms were
fairly advanced. But by using the sensitive TSH test, doctors can diagnose thyroid disorders much earlier, often before you experience symptoms.
Because the TSH test is the best screening test, your doctor will likely check TSH first and follow with a thyroid hormone test if needed. TSH
tests also play an important role in managing hypothyroidism. These tests also help your doctor determine the right dosage of medication, both
initially and over time.

Treatments and drugs

By Mayo Clinic staff

Treatment for Hashimoto's disease may include observation and use of medications. If there's no evidence of hormone deficiency and your
thyroid is functioning normally, your doctor may suggest a wait-and-see approach.

Synthetic hormones
If Hashimoto's disease causes thyroid hormone deficiency, you may need replacement therapy with thyroid hormone. This usually involves daily
use of the synthetic thyroid hormone levothyroxine (Levothroid, Levoxyl, Synthroid). Synthetic levothyroxine is identical to thyroxine, the
natural version of this hormone made by your thyroid gland. The oral medication restores adequate hormone levels and reverses all the symptoms
of hypothyroidism.

Soon after starting treatment, you'll notice that you're feeling less fatigued. The medication also gradually lowers cholesterol levels elevated by
the disease and may reverse any weight gain. Treatment with levothyroxine is usually lifelong, but because the dosage you need may change,
your doctor is likely to check your TSH level every six to 12 months.

Monitoring the dosage

To determine the right dosage of levothyroxine initially, your doctor generally checks your level of TSH after a few weeks of treatment.
Excessive amounts of the hormone can accelerate bone loss, which may make osteoporosis worse or add to your risk of this disease.
Overtreatment with levothyroxine also can cause heart rhythm disorders (arrhythmias).

If you have coronary artery disease or severe hypothyroidism, your doctor may start treatment with a smaller amount of medication and gradually
increase the dosage. Progressive hormone replacement allows your heart to adjust to the increase in metabolism.
Levothyroxine causes virtually no side effects when used in the appropriate dose and is relatively inexpensive. If you change brands, let your
doctor know to ensure you're still receiving the right dosage. Also, don't skip doses or stop taking the drug because you're feeling better. If you
do, signs and symptoms will gradually return.

Effects of other substances

Certain medications, supplements and even some foods may affect your ability to absorb levothyroxine. Talk to your doctor if you eat large
amounts of soy products or a high-fiber diet, or if you take any of the following:

• Iron supplements including multivitamins that contain iron

• Cholestyramine (Questran), a medication used to lower blood cholesterol levels
• Aluminum hydroxide, which is found in some antacids
• Sodium polystyrene sulfonate (Kayexalate), used to prevent high blood potassium levels
• Sucralfate, an ulcer medication
• Calcium supplements

Alternative medicine

By Mayo Clinic staff

Most doctors recommend levothyroxine, the synthetic form of thyroxine (T-4). However, natural extracts are available that contain thyroid
hormone derived from the thyroid glands of pigs. These products — Armour Thyroid, for example — contain both levothyroxine and
triiodothyronine (T-3).

Doctors have a number of concerns about natural thyroid hormone extracts such as Armour Thyroid, including:

• The balance of T-4 and T-3 in animals isn't the same as in humans.
• The exact amount of T-4 and T-3 in each batch of a natural extract product can vary, leading to unpredictable levels of these hormones
in your blood.

Still, researchers have investigated whether adjusting standard hypothyroidism treatment to replace some T-4 with T-3 may offer benefit. The
majority of studies have determined that the addition of T-3 does not offer any advantage over treatment with T-4 alone.

However, there is some evidence that T-3 may offer benefit to certain subsets of people, such as people who have had their thyroid surgically
removed (thyroidectomy). Research is ongoing.

AiDS

The symptoms of HIV and AIDS vary, depending on the phase of infection.

Within the first few weeks

When first infected with HIV, you may have no signs or symptoms at all, although you're still able to transmit the virus to others. Many people
develop a brief flu-like illness two to four weeks after becoming infected. Signs and symptoms may include:

• Fever
• Headache
• Sore throat
• Swollen lymph glands
• Rash

Years later
You may remain symptom-free for years. But as the virus continues to multiply and destroy immune cells, you may develop mild infections or
chronic symptoms such as:

• Swollen lymph nodes — often one of the first signs of HIV infection
• Diarrhea
• Weight loss
 • Fever
• Cough and shortness of breath

Progression to AIDS
If you receive no treatment for your HIV infection, the disease typically progresses to AIDS in about 10 years. By the time AIDS develops, your
immune system has been severely damaged, making you susceptible to opportunistic infections — diseases that wouldn't trouble a person with a
healthy immune system. The signs and symptoms of some of these infections may include:

• Soaking night sweats

• Shaking chills or fever higher than 100 F (38 C) for several weeks
• Cough and shortness of breath
• Chronic diarrhea
• Persistent white spots or unusual lesions on your tongue or in your mouth
• Headaches
• Persistent, unexplained fatigue
• Blurred and distorted vision
• Weight loss
• Skin rashes or bumps

Complications

By Mayo Clinic staff

HIV infection weakens your immune system, making you highly susceptible to all sorts of infections and certain types of cancers.

Infections common to HIV/AIDS:

• Tuberculosis (TB). In resource-poor nations, TB is the most common opportunistic infection associated with HIV and a leading cause
of death among people living with AIDS. Millions of people are currently infected with both HIV and tuberculosis, and many experts
consider the two diseases twin epidemics.
• Salmonellosis. You contract this bacterial infection from contaminated food or water. Symptoms include severe diarrhea, fever, chills,
abdominal pain and, occasionally, vomiting. Although anyone exposed to salmonella bacteria can become sick, salmonellosis is far
more common in people who are HIV-positive.
• Cytomegalovirus (CMV). This common herpes virus is transmitted in body fluids such as saliva, blood, urine, semen and breast
milk. A healthy immune system inactivates the virus, and it remains dormant in your body. If your immune system weakens, the virus
resurfaces — causing damage to your eyes, digestive tract, lungs or other organs.
• Candidiasis. Candidiasis is a common HIV-related infection. It causes inflammation and a thick white coating on the mucous
membranes of your mouth, tongue, esophagus or vagina. Children may have especially severe symptoms in the mouth or esophagus,
which can make eating painful and difficult.
• Cryptococcal meningitis. Meningitis is an inflammation of the membranes and fluid surrounding your brain and spinal cord
(meninges). Cryptococcal meningitis is a common central nervous system infection associated with HIV, caused by a fungus that is
present in soil. It may also be associated with bird or bat droppings.
• Toxoplasmosis. This potentially deadly infection is caused by Toxoplasma gondii, a parasite spread primarily by cats. Infected cats
pass the parasites in their stools, and the parasites may then spread to other animals.
• Cryptosporidiosis. This infection is caused by an intestinal parasite that's commonly found in animals. You contract cryptosporidiosis
when you ingest contaminated food or water. The parasite grows in your intestines and bile ducts, leading to severe, chronic diarrhea
in people with AIDS.

Cancers common to HIV/AIDS

• Kaposi's sarcoma. Kaposi's sarcoma is a tumor of the blood vessel walls. Although rare in people not infected with HIV, it's common
in HIV-positive people. Kaposi's sarcoma usually appears as pink, red or purple lesions on the skin and mouth. In people with darker
skin, the lesions may look dark brown or black. Kaposi's sarcoma can also affect the internal organs, including the digestive tract and
lungs.
• Lymphomas. This type of cancer originates in your white blood cells. Lymphomas usually begin in your lymph nodes. The most
common early sign is painless swelling of the lymph nodes in your neck, armpit or groin.

Other complications
 • Wasting syndrome. Aggressive treatment regimens have reduced the number of cases of wasting syndrome, but it does still affect
many people with AIDS. It is defined as a loss of at least 10 percent of body weight and is often accompanied by diarrhea, chronic
weakness and fever.
• Neurological complications. Although AIDS doesn't appear to infect the nerve cells, it can still cause neurological symptoms such as
confusion, forgetfulness, depression, anxiety and trouble walking. One of the most common neurological complications is AIDS
dementia complex, which leads to behavioral changes and diminished mental functioning.

Tests and diagnosis

By Mayo Clinic staff

HIV is most commonly diagnosed by testing your blood or saliva for the presence of antibodies to the virus. Unfortunately, these types of HIV
tests aren't accurate immediately after infection because it takes time for your body to develop these antibodies — usually up to 12 weeks. In rare
cases, it can take up to six months for an HIV antibody test to become positive.

A newer type of test checks for HIV antigen, a protein produced by the virus immediately after infection. This test can confirm a diagnosis within
days of infection. An earlier diagnosis may prompt people to take extra precautions to prevent transmission of the virus to others.

Tests to tailor treatment

If you receive a diagnosis of HIV/AIDS, several types of tests can help your doctor determine what stage of the disease you have. These tests
include:

• CD4 count. CD4 cells are a type of white blood cell that's specifically targeted and destroyed by HIV. A healthy person's CD4 count
can vary from 500 to more than 1,000. Even if a person has no symptoms, HIV infection progresses to AIDS when his or her CD4
count becomes less than 200.
• Viral load. This test measures the amount of virus in your blood. Studies have shown that people with higher viral loads generally
fare more poorly than do those with a lower viral load.
• Drug resistance. This type of test determines if your strain of HIV is resistant to any anti-HIV medications.

Treatments and drugs

By Mayo Clinic staff

There is no cure for HIV/AIDS, but a variety of drugs can be used in combination to control the virus. Each of the classes of anti-HIV drugs
blocks the virus in different ways. It's best to combine at least three drugs from two different classes to avoid creating strains of HIV that are
immune to single drugs. The classes of anti-HIV drugs include:

• Non-nucleoside reverse transcriptase inhibitors (NNRTIs). NNRTIs disable a protein needed by HIV to make copies of itself.
Examples include efavirenz (Sustiva), etravirine (Intelence) and nevirapine (Viramune).
• Nucleoside reverse transcriptase inhibitors (NRTIs). NRTIs are faulty versions of building blocks that HIV needs to make copies
of itself. Examples include Abacavir (Ziagen), and the combination drugs emtricitabine and tenofovir (Truvada), and lamivudine and
zidovudine (Combivir).
• Protease inhibitors (PIs). PIs disable protease, another protein that HIV needs to make copies of itself. Examples include atazanavir
(Reyataz), darunavir (Prezista), fosamprenavir (Lexiva) and ritonavir (Norvir).
• Entry or fusion inhibitors. These drugs block HIV's entry into CD4 cells. Examples include enfuvirtide (Fuzeon) and maraviroc
(Selzentry).
• Integrase inhibitors. Raltegravir (Isentress) works by disabling integrase, a protein that HIV uses to insert its genetic material into
CD4 cells.

Lifestyle and home remedies

By Mayo Clinic staff

Although it's important to receive medical treatment for HIV/AIDS, it's also essential to take an active role in your own care. The following
suggestions may help you stay healthy longer:

• Eat healthy foods. Emphasize fresh fruits and vegetables, whole grains and lean protein. Healthy foods help keep you strong, give
you more energy and support your immune system.
 • Avoid certain foods. Food-borne illnesses can be especially severe in people who are infected with HIV. Avoid unpasteurized dairy
products, raw eggs and raw seafood such as oysters, sushi or sashimi. Cook meat until it's well-done or until there's no trace of pink
color.
• Get immunizations. These may prevent infections such as pneumonia and the flu. Make sure the vaccines don't contain live viruses,
which can be dangerous for people with weakened immune systems.
• Take care with companion animals. Some animals may carry parasites that can cause infections in people who are HIV-positive. Cat
feces can cause toxoplasmosis, while pet reptiles can carry salmonella.

Alternative medicine

By Mayo Clinic staff

People who are infected with HIV sometimes try dietary supplements that claim to boost the immune system or counteract side effects of anti-
HIV drugs.

Supplements that may be helpful

• Fish oil. Some anti-HIV drugs can cause increases in cholesterol levels. Studies indicate that fish oil supplements can help bring those
numbers down.
• Whey protein. Preliminary evidence indicates that whey protein, a cheese by-product, can help some people with HIV gain weight.
Whey protein also appears to reduce diarrhea and increase CD4 counts.
• Coenzyme Q10. This supplement appears to increase levels of CD4 cells, which could make your immune system stronger. More
research is needed, however.

Supplements that may be dangerous

• St. John's wort. Commonly used to combat depression, St. John's wort can reduce the effectiveness of several types of anti-HIV
drugs by more than 50 percent.
• Garlic supplements. Although garlic may help strengthen the immune system, it also interacts with several anti-HIV drugs —
reducing their effectiveness by 50 percent. Occasionally eating garlic in food appears to be safe.
• Coping and support
• By Mayo Clinic staff
• Receiving a diagnosis of any life-threatening illness is devastating. But the emotional, social and financial consequences of HIV/AIDS
can make coping with this illness especially difficult — not only for you but also for those closest to you.
• Fortunately, a wide range of services and resources are available to people with HIV. Most HIV/AIDS clinics have social workers,
counselors or nurses who can help you with problems directly or put you in touch with people who can. They can arrange for
transportation to and from doctor appointments, help with housing and child care, deal with employment and legal issues, and see you
through financial emergencies.
• Coming to terms with your illness may be the hardest thing you've ever done. For some people, having a strong faith or a sense of
something greater than themselves makes this process easier. Others seek counseling from someone who understands HIV/AIDS. Still
others make a conscious decision to experience their lives as fully and intensely as they can or to help other people who have the
disease.

Prevention

By Mayo Clinic staff

There's no vaccine to prevent HIV infection and no cure for AIDS. But it's possible to protect yourself and others from infection. That means
educating yourself about HIV and avoiding any behavior that allows HIV-infected fluids — blood, semen, vaginal secretions and breast milk —
into your body.

To help prevent the spread of HIV, you should:

• Use a new condom every time you have sex. If you don't know the HIV status of your partner, use a new condom every time you
have anal or vaginal sex. Women can use a female condom. Use only water-based lubricants. Oil-based lubricants can weaken
condoms and cause them to break. During oral sex use a condom, dental dam &madsh; a piece of medical-grade latex — or plastic
wrap.
• Use a clean needle. If you use a needle to inject drugs, make sure it's sterile and don't share it. Take advantage of needle-exchange
programs in your community and consider seeking help for your drug use.
 • Tell your sexual partners if you have HIV. It's important to tell anyone with whom you've had sex that you're HIV-positive. Your
partners need to be tested and to receive medical care if they have the virus. They also need to know their HIV status so that they don't
infect others.
• If you're pregnant, get medical care right away. If you're HIV-positive, you may pass the infection to your baby. But if you receive
treatment during pregnancy, you can cut your baby's risk by as much as two-thirds.

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