Conditions

Introduction๐Ÿ”—๏ธŽ click to copy

Mydex Data Services CIC provides an API known as the 'Master Reference Data Services' or MRD. This API provides access to a variety of non-personal, general purpose datasets that may be of use when integrating with the rest of the Mydex platform or simply a valuable managed API service for a range of datasets that can be subscribed to.

One of these services or datasets is Conditions, which itself is also offered to the public (see https://www.nhs.uk/conditions/) . Conditions is a service designed to help citizens find help and support for their medical conditions.

Mydex hosts its own copy of Conditions and also consumes the Conditions API from the upstream source to keep our instance of Conditions current with regular updates.

Mydex's MRD Service hosts the data and adds the ability to search for data using keywords and filters. Mydex's MRD API also allows filtering to remove any html tags and to replace any relevant links to links to Mydex MRD API.

Mydex's MRD Service hosts the data and adds the ability to search for data using keywords and filters. Mydex's MRD API also allows filtering to remove any html tags and to replace any relevant links with links to Mydex MRD API.

Subscribers to MRD use these managed lists, directories and look-ups to embed content into their own apps and services such as delivering personalised lists based on an individual's profile set in the subscribers application or service.

This guide explains:

If you encounter issues either getting authenticated to or using the MRD API, please contact support@mydex.org. Our team is ready and always happy to help you with any issues.

Authenticating with OAuth2.0๐Ÿ”—๏ธŽ click to copy

The Mydex MRD API requires authentication using the industry standard OAuth2.0 protocol. Please see our online documentation for more information on this: https://dev.mydex.org/mrd-api/mrd-authentication.html

Returning data via a specified Conditions route๐Ÿ”—๏ธŽ click to copy

The most basic request that can be made is to the root route: https://api-mrd.mydex.org/conditions

This will return a list of candidate routes that can be requested. Making a request to any of the routes listed will return the row of data linked to that route.

Some example requests for Conditions data are as follows:

A simple request like this can be made to any route and it will return that row of data. There are also options (flags) available for stripping html tags and replacing NHS links with links to our own MRD api which we will cover next.

[Example responses showing how the data is structured can be viewed under the heading Example responses at the end of this page. Referring to these will aid in understanding the structure of the data and the effect the flag settings have]

Flag settings๐Ÿ”—๏ธŽ click to copy

There are two possible flag settings which can be set independently of each other or together. These settings are:

These flags can be applied in the request as per the examples below:

Note: If both flags are set, the order in which they appear in the request does not matter.

What does no_html do?๐Ÿ”—๏ธŽ click to copy

Setting this flag removes all the html tags from the page content and stores any links in an array links[] at the end of the page content entity mainEntityOfPage.

What does mydex_mrd_links do?๐Ÿ”—๏ธŽ click to copy

The benefit of setting this flag is that it makes other Mydex MRD API endpoints available for use directly within the response. This means that links can be made across different services to build a dynamic range of data payloads.

Setting this flag replaces any links to the NHS api with our relative MRD api endpoint. This applies to any endpoints that we currently have available for use. Currently that includes:

If only mydex_mrd_links flag is set, i.e. no_html is not set, then these links are replaced in the page content text field with an index which relates to an array of these links which is added at the end of the page content entity mainEntityOfPage.

Returning data by filtering on one or more keywords๐Ÿ”—๏ธŽ click to copy

Returning Conditions data based on search filters can be done by passing a keyword along with a combination of operators and conditions in the request. An example of a request made using filters to search the data by keyword can be seen below:

https://api-mrd.mydex.org/conditions/search?filters[0][operator]=LIKE&filters[0][value]=treatment&filters[0][condition]=

[Example responses showing how the data is structured can be viewed under the heading Example responses at the end of this page. Referring to these will aid in understanding the structure of the data and the effect any flag settings have]

How to structure a request for returning filtered data๐Ÿ”—๏ธŽ click to copy

The filters are passed as an array filters[]. Each element in the array must contain at least 1 of both operator and value. A more complex search can be performed by also passing a condition parameter (AND or OR) plus a further keyword (stored in the value parameter).

The structure of the array is as follows:

filters[index][option]=value

Where index denotes the index in the array starting at 0 and incrementing by 1 for each additional filter.

option refers to the parameter that must be passed and determines how the results are to be filtered. There are three possible option parameters as described in the table below.

Parameter Description Example
[operator] The only valid operator here is LIKE. This will perform a search based on matches like the keyword passed in the value operator (see below) LIKE
[value] The keyword value used to filter the results. stress
sleep
medication
[condition] If we want to filter by more than one keyword we can include here AND or OR.

Note: these are the only valid conditions.

If we are only using one filter, then this still must be declared but left empty.
AND
OR

Some example filtered requests:

Here are two example requests. The first one shows an example of a request for the data filtered by only one keyword. The second example shows a request for data filtered by two keywords where both must be present to return a result.

Flag settings๐Ÿ”—๏ธŽ click to copy

The same flag settings can be passed here as per the section on getting the data from a specified Conditions route i.e. no_html=true and/or mydex_mrd_links=true (please refer to the section about returning data from a specific Conditions route for more information on this).

An additional flag setting, added in the same way, can be applied when filtering the data as follows: search_all=true

What does search_all do?๐Ÿ”—๏ธŽ click to copy

Itโ€™s worth noting here that without this flag set, the filter is applied only to the description field of the data. For a deeper search into the data, setting search_all=true will apply the filter also to the text field of the content entity for each row of data. The content entity is the mainEntityOfPage field which exists in each row of Conditions data.

Itโ€™s worth noting that some rows of data also contain a field mainEntity which is another type of content that is part of what NHS content system calls an โ€œExpander groupโ€. The search_all flag will also return results where a match is found in this field.

An example request using this flag setting:


Example Responses๐Ÿ”—๏ธŽ click to copy

What can be seen here are example responses for different requests with a range of different flag settings. We are showing only examples of data returned from a specified route here, however it is the same data that would be returned if a search and filter approach is taken. The only difference between the two approaches is that a specified route will only ever return 1 row of data whereas a filtered request can return multiple rows of data. Each following example is a single row of data.

No flags set๐Ÿ”—๏ธŽ click to copy

Example: https://api-mrd.mydex.org/conditions/acromegaly

{
   "data": {
      "@context": "http://schema.org",
      "@type": "MedicalWebPage",
      "name": "Acromegaly",
      "copyrightHolder": {
         "name": "Crown Copyright",
         "@type": "Organization"
      },
      "license": "https://developer.api.nhs.uk/terms",
      "author": {
         "url": "https://www.nhs.uk",
         "logo": "https://www.nhs.uk/nhscwebservices/documents/logo1.jpg",
         "email": "nhswebsite.servicedesk@nhs.net",
         "@type": "Organization",
         "name": "NHS website"
      },
      "about": {
         "@type": "WebPage",
         "name": "Acromegaly",
         "alternateName": [
            "Gigantism"
         ]
      },
      "description": "Find out about acromegaly, a rare condition where the body produces too much growth hormone causing tissue and bone to grow more quickly. Read about symptoms, causes, diagnosis and treatment.",
      "url": "https://api.nhs.uk/conditions/acromegaly/",
      "genre": [
         "Condition"
      ],
      "keywords": [],
      "lastReviewed": [
         "2020-10-12T00:00:00+00:00",
         "2023-10-12T00:00:00+00:00"
      ],
      "dateModified": "2023-04-14T11:46:25+00:00",
      "hasPart": [],
      "relatedLink": [
         {
            "@type": "LinkRole",
            "url": "https://api.nhs.uk/conditions/acromegaly/",
            "linkRelationship": "Navigation",
            "position": 0,
            "name": "Acromegaly"
         }
      ],
      "contentSubTypes": [],
      "mainEntityOfPage": [
         {
            "identifier": "0",
            "name": "section heading",
            "position": 0,
            "@type": "WebPageElement",
            "mainEntityOfPage": [
               {
                  "position": 0,
                  "identifier": "1",
                  "text": "<p><b>Acromegaly is a rare condition where the body produces too much growth hormone, causing body tissues and bones to grow more quickly.</b></p><p>Over time, this leads to abnormally large hands and feet, and a wide range of other symptoms.</p><p>Acromegaly is usually diagnosed in adults aged 30 to 50, but it can affect people of any age. When it develops before the end of puberty, it's known as "gigantism".</p>",
                  "@type": "WebPageElement",
                  "name": "markdown",
                  "headline": ""
               }
            ],
            "description": "",
            "hasPart": [
               {
                  "position": 0,
                  "identifier": "1",
                  "text": "<p><b>Acromegaly is a rare condition where the body produces too much growth hormone, causing body tissues and bones to grow more quickly.</b></p><p>Over time, this leads to abnormally large hands and feet, and a wide range of other symptoms.</p><p>Acromegaly is usually diagnosed in adults aged 30 to 50, but it can affect people of any age. When it develops before the end of puberty, it's known as "gigantism".</p>",
                  "@type": "WebPageElement",
                  "name": "markdown",
                  "headline": ""
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            ]
         },
         {
            "identifier": "0",
            "name": "section heading",
            "position": 1,
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               {
                  "position": 0,
                  "identifier": "1",
                  "text": "<p>Acromegaly can cause a wide range of symptoms, which tend to develop very slowly over time.</p><p>Early symptoms include:</p><ul><li>swollen hands and feet โ€“ you may notice a change in your ring or shoe size</li><li>tiredness and difficulty sleeping, and sometimes <a href="https://www.nhs.uk/conditions/obstructive-sleep-apnoea/">sleep apnoea</a></li><li>gradual changes in your facial features, such as your brow, lower jaw and nose getting larger, or your teeth becoming more widely spaced</li><li>numbness and weakness in your hands, caused by a compressed nerve (<a href="https://www.nhs.uk/conditions/carpal-tunnel-syndrome/">carpal tunnel syndrome</a>)</li></ul><p>Children and teenagers will be abnormally tall.</p><p>As time goes on, common symptoms include:</p><ul><li>abnormally large hands and feet</li><li>large, prominent facial features (such as the nose and lips) and an enlarged tongue</li><li>skin changes โ€“ such as thick, coarse, oily skin, <a href="https://www.nhs.uk/conditions/skin-tags/">skin tags</a>, or <a href="https://www.nhs.uk/conditions/excessive-sweating-hyperhidrosis/">sweating too much</a></li><li>deepening of the voice as a result of enlarged sinuses and vocal cords</li><li><a href="https://www.nhs.uk/conditions/joint-pain/">joint pain</a></li><li>tiredness and weakness</li><li><a href="https://www.nhs.uk/conditions/headaches/">headaches</a></li><li>blurred or reduced vision</li><li><a href="https://www.nhs.uk/conditions/loss-of-libido/">loss of sex drive</a></li><li>abnormal periods (in women) and <a href="https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/">erection problems</a> (in men)</li></ul><p>Symptoms often become more noticeable as you get older.</p><p><b>See a GP straight away if you think you have acromegaly.</b></p><p>Acromegaly can usually be successfully treated, but early diagnosis and treatment is important to prevent the symptoms getting worse and reduce the chance of complications.</p>",
                  "@type": "WebPageElement",
                  "name": "markdown",
                  "headline": ""
               }
            ],
            "description": "",
            "hasPart": [
               {
                  "position": 0,
                  "identifier": "1",
                  "text": "<p>Acromegaly can cause a wide range of symptoms, which tend to develop very slowly over time.</p><p>Early symptoms include:</p><ul><li>swollen hands and feet โ€“ you may notice a change in your ring or shoe size</li><li>tiredness and difficulty sleeping, and sometimes <a href="https://www.nhs.uk/conditions/obstructive-sleep-apnoea/">sleep apnoea</a></li><li>gradual changes in your facial features, such as your brow, lower jaw and nose getting larger, or your teeth becoming more widely spaced</li><li>numbness and weakness in your hands, caused by a compressed nerve (<a href="https://www.nhs.uk/conditions/carpal-tunnel-syndrome/">carpal tunnel syndrome</a>)</li></ul><p>Children and teenagers will be abnormally tall.</p><p>As time goes on, common symptoms include:</p><ul><li>abnormally large hands and feet</li><li>large, prominent facial features (such as the nose and lips) and an enlarged tongue</li><li>skin changes โ€“ such as thick, coarse, oily skin, <a href="https://www.nhs.uk/conditions/skin-tags/">skin tags</a>, or <a href="https://www.nhs.uk/conditions/excessive-sweating-hyperhidrosis/">sweating too much</a></li><li>deepening of the voice as a result of enlarged sinuses and vocal cords</li><li><a href="https://www.nhs.uk/conditions/joint-pain/">joint pain</a></li><li>tiredness and weakness</li><li><a href="https://www.nhs.uk/conditions/headaches/">headaches</a></li><li>blurred or reduced vision</li><li><a href="https://www.nhs.uk/conditions/loss-of-libido/">loss of sex drive</a></li><li>abnormal periods (in women) and <a href="https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/">erection problems</a> (in men)</li></ul><p>Symptoms often become more noticeable as you get older.</p><p><b>See a GP straight away if you think you have acromegaly.</b></p><p>Acromegaly can usually be successfully treated, but early diagnosis and treatment is important to prevent the symptoms getting worse and reduce the chance of complications.</p>",
                  "@type": "WebPageElement",
                  "name": "markdown",
                  "headline": ""
               }
            ],
            "headline": "Symptoms of acromegaly"
         },
         {
            "identifier": "0",
            "name": "section heading",
            "position": 2,
            "@type": "WebPageElement",
            "mainEntityOfPage": [
               {
                  "position": 0,
                  "identifier": "1",
                  "text": "<p>If you do not get treatment, you may be at risk of developing:</p><ul><li><a href="https://www.nhs.uk/conditions/type-2-diabetes/">type 2 diabetes</a></li><li>high blood pressure (<a href="https://www.nhs.uk/conditions/high-blood-pressure-hypertension/">hypertension</a>)</li><li><a href="https://www.nhs.uk/conditions/cardiovascular-disease/">heart disease</a></li><li>disease of the heart muscle (<a href="https://www.nhs.uk/conditions/cardiomyopathy/">cardiomyopathy</a>)</li><li><a href="https://www.nhs.uk/conditions/arthritis/">arthritis</a></li><li><a href="https://www.nhs.uk/conditions/bowel-polyps/">bowel polyps</a>, which can potentially turn into bowel cancer if left untreated</li></ul><p>Because of the risk of bowel polyps, a procedure known as a <a href="https://www.nhs.uk/conditions/colonoscopy/">colonoscopy</a> might be recommended if you've been diagnosed with acromegaly. Regular colonoscopy screening may also be necessary.</p>",
                  "@type": "WebPageElement",
                  "name": "markdown",
                  "headline": ""
               }
            ],
            "description": "",
            "hasPart": [
               {
                  "position": 0,
                  "identifier": "1",
                  "text": "<p>If you do not get treatment, you may be at risk of developing:</p><ul><li><a href="https://www.nhs.uk/conditions/type-2-diabetes/">type 2 diabetes</a></li><li>high blood pressure (<a href="https://www.nhs.uk/conditions/high-blood-pressure-hypertension/">hypertension</a>)</li><li><a href="https://www.nhs.uk/conditions/cardiovascular-disease/">heart disease</a></li><li>disease of the heart muscle (<a href="https://www.nhs.uk/conditions/cardiomyopathy/">cardiomyopathy</a>)</li><li><a href="https://www.nhs.uk/conditions/arthritis/">arthritis</a></li><li><a href="https://www.nhs.uk/conditions/bowel-polyps/">bowel polyps</a>, which can potentially turn into bowel cancer if left untreated</li></ul><p>Because of the risk of bowel polyps, a procedure known as a <a href="https://www.nhs.uk/conditions/colonoscopy/">colonoscopy</a> might be recommended if you've been diagnosed with acromegaly. Regular colonoscopy screening may also be necessary.</p>",
                  "@type": "WebPageElement",
                  "name": "markdown",
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            ],
            "headline": "Risks of acromegaly"
         },
         {
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            "position": 3,
            "@type": "WebPageElement",
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                  "text": "<p>Acromegaly happens because your pituitary gland (a pea-sized gland just below the brain) produces too much growth hormone.</p><p>This is usually caused by a <a href="https://www.nhs.uk/conditions/benign-brain-tumour/">non-cancerous tumour</a> in the pituitary gland called an adenoma.</p><p>Most of the symptoms of acromegaly are due to the excess of growth hormone itself, but some come from the tumour pressing on nearby tissues. For example, you may get headaches and vision problems if a tumour pushes against the nearby nerves.</p><p>Acromegaly sometimes runs in families, but most of the time it's not inherited. Adenomas usually spontaneously develop because of a genetic change in a cell of the pituitary gland. This change causes uncontrolled growth of the affected cells, creating the tumour.</p><p>Rarely, acromegaly is caused by a tumour in another part of the body, such as the lungs, pancreas or another part of the brain. It may also be linked to some genetic conditions.</p>",
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            "description": "",
            "hasPart": [
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                  "position": 0,
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                  "text": "<p>Acromegaly happens because your pituitary gland (a pea-sized gland just below the brain) produces too much growth hormone.</p><p>This is usually caused by a <a href="https://www.nhs.uk/conditions/benign-brain-tumour/">non-cancerous tumour</a> in the pituitary gland called an adenoma.</p><p>Most of the symptoms of acromegaly are due to the excess of growth hormone itself, but some come from the tumour pressing on nearby tissues. For example, you may get headaches and vision problems if a tumour pushes against the nearby nerves.</p><p>Acromegaly sometimes runs in families, but most of the time it's not inherited. Adenomas usually spontaneously develop because of a genetic change in a cell of the pituitary gland. This change causes uncontrolled growth of the affected cells, creating the tumour.</p><p>Rarely, acromegaly is caused by a tumour in another part of the body, such as the lungs, pancreas or another part of the brain. It may also be linked to some genetic conditions.</p>",
                  "@type": "WebPageElement",
                  "name": "markdown",
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            ],
            "headline": "Causes of acromegaly"
         },
         {
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                  "text": "<p>Treatment for acromegaly depends on your symptoms. Usually the goal is to:</p><ul><li>reduce growth hormone production to normal levels</li><li>relieve the pressure a tumour may be putting on surrounding tissues</li><li>treat any hormone deficiencies</li><li>improve your symptoms</li></ul><p>Most people with acromegaly have surgery to remove a pituitary tumour. Medicine or radiotherapy may sometimes be needed after, or instead of, surgery.</p><h3>Surgery</h3><p>Surgery is usually effective and can completely cure acromegaly. But sometimes the tumour is too large to be removed entirely, and you may need another operation or further treatment with medicine or radiotherapy.</p><p>Under <a href="https://www.nhs.uk/conditions/general-anaesthesia/">general anaesthetic</a>, the surgeon will make a small cut inside your nose or behind your upper lip to access the pituitary gland.</p><p>A long, thin, flexible tube with a light and video camera at one end, called an <a href="https://www.nhs.uk/conditions/endoscopy/">endoscope</a>, is fed into the opening so your doctor can see the tumour. Surgical instruments are passed through the same opening and used to remove the tumour.</p><p>Removing the tumour should instantly lower your levels of growth hormone and relieve pressure on the surrounding tissue. Facial features often start to return to normal and swelling improves within a few days.</p><p>With surgery, there's risk of:</p><ul><li>damaging the healthy parts of your pituitary gland</li><li>leakage of the fluid that surrounds and protects your brain</li><li><a href="https://www.nhs.uk/conditions/meningitis/">meningitis</a> โ€“ although this is rare</li></ul><p>Your surgeon will discuss these risks with you and answer any questions you have.</p><h3>Medicine</h3><p>Medicine may be prescribed if your growth hormone levels are still higher than normal after surgery, or if surgery was not possible.</p><p>3 different types of medicine are used:</p><ul><li><b>a monthly injection of either octreotide, lanreotide or pasireotide</b> โ€“ this slows down the release of growth hormone and can sometimes also shrink tumours</li><li><b>a daily pegvisomant injection</b> โ€“ this blocks the effects of growth hormone and can significantly improve symptoms</li><li><b>bromocriptine or cabergoline tablets</b> โ€“ these can stop growth hormone being produced, but they only work in a small proportion of people</li></ul><p>Each of these medicines has different advantages and disadvantages. Speak to your doctor about the options available to you, and the benefits and risks of each.</p><h3>Radiotherapy</h3><p>If surgery is not possible, or not all of the tumour could be removed, or if medicine has not worked, you may be offered <a href="https://www.nhs.uk/conditions/radiotherapy/">radiotherapy</a>.</p><p>This can eventually reduce your growth hormone levels, but it may not have a noticeable effect for several years and you may need to take medicine in the meantime.</p><p>2 main types of radiotherapy are used to treat acromegaly:</p><ul><li><b>stereotactic radiotherapy</b> โ€“ a high-dose beam of radiation is aimed very precisely at your adenoma; you'll need to wear a rigid head frame or a plastic mask to hold your head still during the treatment, which can usually be done in one session</li><li><b>conventional radiotherapy</b> โ€“ this also uses a beam of radiation to target the adenoma, but it's wider and less precise than the one used in stereotactic radiotherapy; this means this treatment can damage the surrounding pituitary gland and brain tissue, so it's given in small doses over 4 to 6 weeks to give your tissues time to heal between treatments</li></ul><p>Stereotactic radiotherapy is more commonly used to treat adenomas because it minimises the risk of damage to nearby healthy tissue.</p><p>Radiotherapy can have a number of side effects. It will often cause a gradual drop in the levels of other hormones produced by your pituitary gland, so you'll usually need <a href="https://www.nhs.uk/conditions/hormone-replacement-therapy-hrt/">hormone replacement therapy</a> for the rest of your life. It may also have an effect on your fertility.</p><p>Your doctor will be able to talk to you about these risks and other possible side effects.</p><h3>Follow-up</h3><p>Treatment is often effective at stopping the excessive production of growth hormone and improving the symptoms of acromegaly.</p><p>After treatment, you'll need regular follow-up appointments with your specialist for the rest of your life. These will be used to monitor how well your pituitary gland is working, check you're on the correct hormone replacement treatment and make sure the condition does not return.</p>",
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                  "text": "<p>Treatment for acromegaly depends on your symptoms. Usually the goal is to:</p><ul><li>reduce growth hormone production to normal levels</li><li>relieve the pressure a tumour may be putting on surrounding tissues</li><li>treat any hormone deficiencies</li><li>improve your symptoms</li></ul><p>Most people with acromegaly have surgery to remove a pituitary tumour. Medicine or radiotherapy may sometimes be needed after, or instead of, surgery.</p><h3>Surgery</h3><p>Surgery is usually effective and can completely cure acromegaly. But sometimes the tumour is too large to be removed entirely, and you may need another operation or further treatment with medicine or radiotherapy.</p><p>Under <a href="https://www.nhs.uk/conditions/general-anaesthesia/">general anaesthetic</a>, the surgeon will make a small cut inside your nose or behind your upper lip to access the pituitary gland.</p><p>A long, thin, flexible tube with a light and video camera at one end, called an <a href="https://www.nhs.uk/conditions/endoscopy/">endoscope</a>, is fed into the opening so your doctor can see the tumour. Surgical instruments are passed through the same opening and used to remove the tumour.</p><p>Removing the tumour should instantly lower your levels of growth hormone and relieve pressure on the surrounding tissue. Facial features often start to return to normal and swelling improves within a few days.</p><p>With surgery, there's risk of:</p><ul><li>damaging the healthy parts of your pituitary gland</li><li>leakage of the fluid that surrounds and protects your brain</li><li><a href="https://www.nhs.uk/conditions/meningitis/">meningitis</a> โ€“ although this is rare</li></ul><p>Your surgeon will discuss these risks with you and answer any questions you have.</p><h3>Medicine</h3><p>Medicine may be prescribed if your growth hormone levels are still higher than normal after surgery, or if surgery was not possible.</p><p>3 different types of medicine are used:</p><ul><li><b>a monthly injection of either octreotide, lanreotide or pasireotide</b> โ€“ this slows down the release of growth hormone and can sometimes also shrink tumours</li><li><b>a daily pegvisomant injection</b> โ€“ this blocks the effects of growth hormone and can significantly improve symptoms</li><li><b>bromocriptine or cabergoline tablets</b> โ€“ these can stop growth hormone being produced, but they only work in a small proportion of people</li></ul><p>Each of these medicines has different advantages and disadvantages. Speak to your doctor about the options available to you, and the benefits and risks of each.</p><h3>Radiotherapy</h3><p>If surgery is not possible, or not all of the tumour could be removed, or if medicine has not worked, you may be offered <a href="https://www.nhs.uk/conditions/radiotherapy/">radiotherapy</a>.</p><p>This can eventually reduce your growth hormone levels, but it may not have a noticeable effect for several years and you may need to take medicine in the meantime.</p><p>2 main types of radiotherapy are used to treat acromegaly:</p><ul><li><b>stereotactic radiotherapy</b> โ€“ a high-dose beam of radiation is aimed very precisely at your adenoma; you'll need to wear a rigid head frame or a plastic mask to hold your head still during the treatment, which can usually be done in one session</li><li><b>conventional radiotherapy</b> โ€“ this also uses a beam of radiation to target the adenoma, but it's wider and less precise than the one used in stereotactic radiotherapy; this means this treatment can damage the surrounding pituitary gland and brain tissue, so it's given in small doses over 4 to 6 weeks to give your tissues time to heal between treatments</li></ul><p>Stereotactic radiotherapy is more commonly used to treat adenomas because it minimises the risk of damage to nearby healthy tissue.</p><p>Radiotherapy can have a number of side effects. It will often cause a gradual drop in the levels of other hormones produced by your pituitary gland, so you'll usually need <a href="https://www.nhs.uk/conditions/hormone-replacement-therapy-hrt/">hormone replacement therapy</a> for the rest of your life. It may also have an effect on your fertility.</p><p>Your doctor will be able to talk to you about these risks and other possible side effects.</p><h3>Follow-up</h3><p>Treatment is often effective at stopping the excessive production of growth hormone and improving the symptoms of acromegaly.</p><p>After treatment, you'll need regular follow-up appointments with your specialist for the rest of your life. These will be used to monitor how well your pituitary gland is working, check you're on the correct hormone replacement treatment and make sure the condition does not return.</p>",
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                  "text": "<p>Because the symptoms of acromegaly often develop gradually over several years, you may not get a diagnosis straight away. Your doctor may ask you to bring in photographs of yourself that span the past few years to look for the tell-tale gradual changes.</p><h3>Blood tests</h3><p>If your doctor suspects you have acromegaly, you'll need to have a blood test to measure your growth hormone levels.</p><p>To make sure the blood test gives an accurate result, you may be asked to drink a sugary solution before having a series of blood samples taken. For people without acromegaly, drinking the solution should stop growth hormone being released. In people with acromegaly, the level of growth hormone in the blood will remain high. This is called a glucose tolerance test.</p><p>Your doctor will also measure the level of another hormone, called insulin-like growth factor 1 (IGF-1). A higher level of IGF-1 is a very accurate indication that you may have acromegaly.</p><h3>Brain scans</h3><p>If your blood tests show a high level of growth hormone and IGF-1, you might have an <a href="https://www.nhs.uk/conditions/mri-scan/">MRI scan</a> of your brain. This will show where the adenoma is in your pituitary gland and how big it is. If you cannot have an MRI scan, a <a href="https://www.nhs.uk/conditions/ct-scan/">CT scan</a> can be carried out, but this is less accurate.</p>",
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                  "text": "<p>Because the symptoms of acromegaly often develop gradually over several years, you may not get a diagnosis straight away. Your doctor may ask you to bring in photographs of yourself that span the past few years to look for the tell-tale gradual changes.</p><h3>Blood tests</h3><p>If your doctor suspects you have acromegaly, you'll need to have a blood test to measure your growth hormone levels.</p><p>To make sure the blood test gives an accurate result, you may be asked to drink a sugary solution before having a series of blood samples taken. For people without acromegaly, drinking the solution should stop growth hormone being released. In people with acromegaly, the level of growth hormone in the blood will remain high. This is called a glucose tolerance test.</p><p>Your doctor will also measure the level of another hormone, called insulin-like growth factor 1 (IGF-1). A higher level of IGF-1 is a very accurate indication that you may have acromegaly.</p><h3>Brain scans</h3><p>If your blood tests show a high level of growth hormone and IGF-1, you might have an <a href="https://www.nhs.uk/conditions/mri-scan/">MRI scan</a> of your brain. This will show where the adenoma is in your pituitary gland and how big it is. If you cannot have an MRI scan, a <a href="https://www.nhs.uk/conditions/ct-scan/">CT scan</a> can be carried out, but this is less accurate.</p>",
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                  "text": "<p>If you have acromegaly, your clinical team will pass information about you on to the <a href="https://www.ndrs.nhs.uk/">National Congenital Anomaly and Rare Disease Registration Service (NCARDRS)</a>.</p><p>The NCARDRS helps scientists look for better ways to treat and prevent acromegaly. You can opt out of the register at any time.</p>",
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                  "text": "<p><b>Acromegaly is a rare condition where the body produces too much growth hormone, causing body tissues and bones to grow more quickly.</b></p><p>Over time, this leads to abnormally large hands and feet, and a wide range of other symptoms.</p><p>Acromegaly is usually diagnosed in adults aged 30 to 50, but it can affect people of any age. When it develops before the end of puberty, it's known as "gigantism".</p>",
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                  "text": "<p><b>Acromegaly is a rare condition where the body produces too much growth hormone, causing body tissues and bones to grow more quickly.</b></p><p>Over time, this leads to abnormally large hands and feet, and a wide range of other symptoms.</p><p>Acromegaly is usually diagnosed in adults aged 30 to 50, but it can affect people of any age. When it develops before the end of puberty, it's known as "gigantism".</p>",
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                  "text": "<p>Acromegaly can cause a wide range of symptoms, which tend to develop very slowly over time.</p><p>Early symptoms include:</p><ul><li>swollen hands and feet โ€“ you may notice a change in your ring or shoe size</li><li>tiredness and difficulty sleeping, and sometimes <a index-link=[0]>sleep apnoea</a></li><li>gradual changes in your facial features, such as your brow, lower jaw and nose getting larger, or your teeth becoming more widely spaced</li><li>numbness and weakness in your hands, caused by a compressed nerve (<a index-link=[1]>carpal tunnel syndrome</a>)</li></ul><p>Children and teenagers will be abnormally tall.</p><p>As time goes on, common symptoms include:</p><ul><li>abnormally large hands and feet</li><li>large, prominent facial features (such as the nose and lips) and an enlarged tongue</li><li>skin changes โ€“ such as thick, coarse, oily skin, <a index-link=[2]>skin tags</a>, or <a index-link=[3]>sweating too much</a></li><li>deepening of the voice as a result of enlarged sinuses and vocal cords</li><li><a index-link=[4]>joint pain</a></li><li>tiredness and weakness</li><li><a index-link=[5]>headaches</a></li><li>blurred or reduced vision</li><li><a index-link=[6]>loss of sex drive</a></li><li>abnormal periods (in women) and <a index-link=[7]>erection problems</a> (in men)</li></ul><p>Symptoms often become more noticeable as you get older.</p><p><b>See a GP straight away if you think you have acromegaly.</b></p><p>Acromegaly can usually be successfully treated, but early diagnosis and treatment is important to prevent the symptoms getting worse and reduce the chance of complications.</p>",
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                  "text": "<p>Acromegaly can cause a wide range of symptoms, which tend to develop very slowly over time.</p><p>Early symptoms include:</p><ul><li>swollen hands and feet โ€“ you may notice a change in your ring or shoe size</li><li>tiredness and difficulty sleeping, and sometimes <a index-link=[0]>sleep apnoea</a></li><li>gradual changes in your facial features, such as your brow, lower jaw and nose getting larger, or your teeth becoming more widely spaced</li><li>numbness and weakness in your hands, caused by a compressed nerve (<a index-link=[1]>carpal tunnel syndrome</a>)</li></ul><p>Children and teenagers will be abnormally tall.</p><p>As time goes on, common symptoms include:</p><ul><li>abnormally large hands and feet</li><li>large, prominent facial features (such as the nose and lips) and an enlarged tongue</li><li>skin changes โ€“ such as thick, coarse, oily skin, <a index-link=[2]>skin tags</a>, or <a index-link=[3]>sweating too much</a></li><li>deepening of the voice as a result of enlarged sinuses and vocal cords</li><li><a index-link=[4]>joint pain</a></li><li>tiredness and weakness</li><li><a index-link=[5]>headaches</a></li><li>blurred or reduced vision</li><li><a index-link=[6]>loss of sex drive</a></li><li>abnormal periods (in women) and <a index-link=[7]>erection problems</a> (in men)</li></ul><p>Symptoms often become more noticeable as you get older.</p><p><b>See a GP straight away if you think you have acromegaly.</b></p><p>Acromegaly can usually be successfully treated, but early diagnosis and treatment is important to prevent the symptoms getting worse and reduce the chance of complications.</p>",
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                  "text": "<p>If you do not get treatment, you may be at risk of developing:</p><ul><li><a index-link=[0]>type 2 diabetes</a></li><li>high blood pressure (<a index-link=[1]>hypertension</a>)</li><li><a index-link=[2]>heart disease</a></li><li>disease of the heart muscle (<a index-link=[3]>cardiomyopathy</a>)</li><li><a index-link=[4]>arthritis</a></li><li><a index-link=[5]>bowel polyps</a>, which can potentially turn into bowel cancer if left untreated</li></ul><p>Because of the risk of bowel polyps, a procedure known as a <a index-link=[6]>colonoscopy</a> might be recommended if you've been diagnosed with acromegaly. Regular colonoscopy screening may also be necessary.</p>",
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                  "text": "<p>Acromegaly happens because your pituitary gland (a pea-sized gland just below the brain) produces too much growth hormone.</p><p>This is usually caused by a <a index-link=[0]>non-cancerous tumour</a> in the pituitary gland called an adenoma.</p><p>Most of the symptoms of acromegaly are due to the excess of growth hormone itself, but some come from the tumour pressing on nearby tissues. For example, you may get headaches and vision problems if a tumour pushes against the nearby nerves.</p><p>Acromegaly sometimes runs in families, but most of the time it's not inherited. Adenomas usually spontaneously develop because of a genetic change in a cell of the pituitary gland. This change causes uncontrolled growth of the affected cells, creating the tumour.</p><p>Rarely, acromegaly is caused by a tumour in another part of the body, such as the lungs, pancreas or another part of the brain. It may also be linked to some genetic conditions.</p>",
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                  "text": "<p>Acromegaly happens because your pituitary gland (a pea-sized gland just below the brain) produces too much growth hormone.</p><p>This is usually caused by a <a index-link=[0]>non-cancerous tumour</a> in the pituitary gland called an adenoma.</p><p>Most of the symptoms of acromegaly are due to the excess of growth hormone itself, but some come from the tumour pressing on nearby tissues. For example, you may get headaches and vision problems if a tumour pushes against the nearby nerves.</p><p>Acromegaly sometimes runs in families, but most of the time it's not inherited. Adenomas usually spontaneously develop because of a genetic change in a cell of the pituitary gland. This change causes uncontrolled growth of the affected cells, creating the tumour.</p><p>Rarely, acromegaly is caused by a tumour in another part of the body, such as the lungs, pancreas or another part of the brain. It may also be linked to some genetic conditions.</p>",
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                  "text": "<p>Treatment for acromegaly depends on your symptoms. Usually the goal is to:</p><ul><li>reduce growth hormone production to normal levels</li><li>relieve the pressure a tumour may be putting on surrounding tissues</li><li>treat any hormone deficiencies</li><li>improve your symptoms</li></ul><p>Most people with acromegaly have surgery to remove a pituitary tumour. Medicine or radiotherapy may sometimes be needed after, or instead of, surgery.</p><h3>Surgery</h3><p>Surgery is usually effective and can completely cure acromegaly. But sometimes the tumour is too large to be removed entirely, and you may need another operation or further treatment with medicine or radiotherapy.</p><p>Under <a index-link=[0]>general anaesthetic</a>, the surgeon will make a small cut inside your nose or behind your upper lip to access the pituitary gland.</p><p>A long, thin, flexible tube with a light and video camera at one end, called an <a index-link=[1]>endoscope</a>, is fed into the opening so your doctor can see the tumour. Surgical instruments are passed through the same opening and used to remove the tumour.</p><p>Removing the tumour should instantly lower your levels of growth hormone and relieve pressure on the surrounding tissue. Facial features often start to return to normal and swelling improves within a few days.</p><p>With surgery, there's risk of:</p><ul><li>damaging the healthy parts of your pituitary gland</li><li>leakage of the fluid that surrounds and protects your brain</li><li><a index-link=[2]>meningitis</a> โ€“ although this is rare</li></ul><p>Your surgeon will discuss these risks with you and answer any questions you have.</p><h3>Medicine</h3><p>Medicine may be prescribed if your growth hormone levels are still higher than normal after surgery, or if surgery was not possible.</p><p>3 different types of medicine are used:</p><ul><li><b>a monthly injection of either octreotide, lanreotide or pasireotide</b> โ€“ this slows down the release of growth hormone and can sometimes also shrink tumours</li><li><b>a daily pegvisomant injection</b> โ€“ this blocks the effects of growth hormone and can significantly improve symptoms</li><li><b>bromocriptine or cabergoline tablets</b> โ€“ these can stop growth hormone being produced, but they only work in a small proportion of people</li></ul><p>Each of these medicines has different advantages and disadvantages. Speak to your doctor about the options available to you, and the benefits and risks of each.</p><h3>Radiotherapy</h3><p>If surgery is not possible, or not all of the tumour could be removed, or if medicine has not worked, you may be offered <a index-link=[3]>radiotherapy</a>.</p><p>This can eventually reduce your growth hormone levels, but it may not have a noticeable effect for several years and you may need to take medicine in the meantime.</p><p>2 main types of radiotherapy are used to treat acromegaly:</p><ul><li><b>stereotactic radiotherapy</b> โ€“ a high-dose beam of radiation is aimed very precisely at your adenoma; you'll need to wear a rigid head frame or a plastic mask to hold your head still during the treatment, which can usually be done in one session</li><li><b>conventional radiotherapy</b> โ€“ this also uses a beam of radiation to target the adenoma, but it's wider and less precise than the one used in stereotactic radiotherapy; this means this treatment can damage the surrounding pituitary gland and brain tissue, so it's given in small doses over 4 to 6 weeks to give your tissues time to heal between treatments</li></ul><p>Stereotactic radiotherapy is more commonly used to treat adenomas because it minimises the risk of damage to nearby healthy tissue.</p><p>Radiotherapy can have a number of side effects. It will often cause a gradual drop in the levels of other hormones produced by your pituitary gland, so you'll usually need <a index-link=[4]>hormone replacement therapy</a> for the rest of your life. It may also have an effect on your fertility.</p><p>Your doctor will be able to talk to you about these risks and other possible side effects.</p><h3>Follow-up</h3><p>Treatment is often effective at stopping the excessive production of growth hormone and improving the symptoms of acromegaly.</p><p>After treatment, you'll need regular follow-up appointments with your specialist for the rest of your life. These will be used to monitor how well your pituitary gland is working, check you're on the correct hormone replacement treatment and make sure the condition does not return.</p>",
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Both no_html and mydex_mrd_links flags set ๐Ÿ”—๏ธŽ click to copy

Example: https://api-mrd.mydex.org/conditions/baby/support-and-services/your-6-week-postnatal-check?mydex_mrd_links=true&no_html=true

As above, here you can see that all the html tags have been stripped out. Highlighted in yellow, you can see where links have been updated to use our MRD api endpoint and an array has been added to contain any links that were stripped out with the html.

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   "data": {
      "@context": "http://schema.org",
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      "name": "Your 6-week postnatal check",
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