Graves’ Disease
Graves’ disease, also known as toxic diffuse goiter, is an autoimmune disease that affects the thyroid. It causes your thyroid to become hyperactive — work harder than it needs to. It is one of the most common thyroid problems and the leading cause of hyperthyroidism, a condition in which the thyroid gland produces too much hormones. It usually affects people between the ages of 30 and 50 and is more common in women.
Symptoms –
Common signs and symptoms of Graves’ disease include:
• Weight loss, despite normal eating habits
• Anxiety and irritability
• Rapid or irregular heartbeat (palpitations)
• A fine tremor of the hands or fingers
• Heat sensitivity and an increase in perspiration or warm, moist skin
• Enlargement of the thyroid gland (goiter)
• Change in menstrual cycles
• Erectile dysfunction or reduced libido
• Frequent bowel movements
• Sleep disturbance
• Fatigue
• Graves’ dermopathy, is the reddening and thickening of the skin, most often on your shins or the tops of your feet. It’s an uncommon condition.
• Graves’ ophthalmopathy – About 30% of people with Graves’ disease show some signs and symptoms of Graves’ ophthalmopathy. In Graves’ ophthalmopathy, inflammation and other immune system events affect muscles and other tissues around your eyes. Signs and symptoms may include:
▪︎ Bulging eyes
▪︎ Gritty sensation in the eyes
▪︎ Pressure or pain in the eyes
▪︎ Puffy or retracted eyelids
▪︎ Reddened or inflamed eyes
▪︎ Light sensitivity
▪︎ Double vision
▪︎ Vision loss
Causes –
In Graves’ disease, your immune system creates antibodies that cause your thyroid to grow and produce an excess of thyroid hormone. These antibodies are called thyroid-stimulating immunoglobulins (TSIs). The TSIs bind to your thyroid cell receptors, which are typically “docking stations” for thyroid-stimulating hormone (TSH). Invading TSIs then trick your thyroid into growing and releasing too much thyroid hormone, leading to hyperthyroidism.
Risk Factors –
The risk of developing Graves’ disease increases if you have –
• Family history. Because a family history of Graves’ disease is a known risk factor, there is likely a gene or genes that can make a person more susceptible to the disorder.
• Sex. Women are much more likely to develop Graves’ disease than are men.
• Age. Graves’ disease usually develops in people before age 40.
• Other autoimmune disorders. People with other disorders of the immune system, such as type 1 diabetes or rheumatoid arthritis, have an increased risk.
• Emotional or physical stress. Stressful life events or illness may act as a trigger for the onset of Graves’ disease among people who have genes that increase their risk.
• Pregnancy. Pregnancy or recent childbirth may increase the risk of the disorder, particularly among women who have genes that increase their risk.
• Smoking. Cigarette smoking, which can affect the immune system, increases the risk of Graves’ disease. Smokers who have Graves’ disease are also at increased risk of developing Graves’ ophthalmopathy.
Complications –
Complications of Graves’ disease can include –
• Pregnancy issues.
Possible complications of Graves’ disease during pregnancy include miscarriage, preterm birth, fetal thyroid dysfunction, poor fetal growth, maternal heart failure and preeclampsia.
• Heart disorders.
If left untreated, Graves’ disease can lead to heart rhythm disorders, changes in the structure and function of the heart muscles, and the inability of the heart to pump enough blood to the body (heart failure).
• Thyroid storm.
A rare but life-threatening complication of Graves’ disease is thyroid storm, also known as accelerated hyperthyroidism or thyrotoxic crisis. It’s more likely when severe hyperthyroidism is untreated or treated inadequately.
• Brittle bones.
Untreated hyperthyroidism also can lead to weak, brittle bones (osteoporosis). The strength of your bones depends, in part, on the amount of calcium and other minerals they contain. Too much thyroid hormone interferes with your body’s ability to incorporate calcium into your bones.
Diagnosis –
Your doctor may also request some of the following tests –
• blood test
• thyroid ultrasound
• radioactive iodine uptake test
• thyroid-stimulating hormone test
• thyroid-stimulating immunoglobulin test
Treatment –
There are two goals in the treatment for Graves’ disease. One is to stop your thyroid gland from overproducing thyroid hormone. The other is to stop the increased levels of thyroid hormone from causing problems in your body.
▪︎ Radioactive iodine therapy
With this treatment, you take another form of radioactive iodine by mouth than what is used in the test to diagnose Graves’ disease. The iodine gets into your thyroid and the radiation kills some of the cells in your thyroid that are overproducing thyroid hormones. It’s possible that this treatment could make any eye problems you have from Graves’ disease temporarily worse and it’s also likely it will lead to a lower production of thyroid hormone than is healthy. If that happens, your low thyroid can be treated.
▪︎ Medications
• Anti-thyroid medications make your thyroid produce less thyroid hormone. They aren’t permanent treatments but can be used for long periods of time and sometimes help even after you’ve stopped treatment.
• Beta blockers are medications typically used to reduce blood pressure, and they can help rapidly relieve some of the symptoms of hyperthyroidism including shaking, rapid heartbeat, and anxiety.
▪︎ Surgery
It is a less common treatment for Graves’ disease but may be a good choice if you have a goiter or you’re pregnant and can’t take anti-thyroid medications. During surgery, some or all of your thyroid gland is removed. After surgery, you may need to take a daily thyroid medication for the rest of your life.
For more informative articles on Thyroid Gland and other health related issues, please visit our website www.santripty.com and also feel free to consult with our experienced team of doctors.