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Graves’ Disease: An Overview

Graves’ disease is an autoimmune disorder that affects the thyroid gland. It is also known as a toxic diffuse goiter. When you have this condition, your immune system mistakenly invades your thyroid gland. As a result, your thyroid gland happens to produce more thyroid hormones than your body requires.

There could be many reasons behind an overactive thyroid or hyperthyroidism. However, Graves’ disease is one of the most common underlying causes for the same.

Graves’ disease – Some key facts

The thyroid is a small gland that resembles a butterfly and sits on the front side of your neck. Thyroid hormones help regulate the metabolism, body weight, and overall growth and development of your body. Therefore, these hormones involve almost every part of your body.

So, when your thyroid gland overproduces the hormones, it can lead to many serious health complications related to your bones, heart, muscles, fertility, and menstrual cycle. This autoimmune disorder also affects your skin and eyes.

Graves’ disease can happen to anyone. However, it is most prevalent in people who are below 40 and women.

What are the symptoms of Graves’ disease?

The symptoms of Graves’ disease include:

• increase in perspiration

• heat sensitivity

• unintentional weight loss

• anxiety and irritation

• goiter (enlargement in the size of the thyroid gland)

• fine tremor in hands and fingers

• frequent bowel movements

erectile dysfunction

• change in menstrual cycles

• palpitations (rapid heartbeat)

• fatigue

• irregularities in sleep

Manifestations of Graves’ disease

There are some characteristic manifestations of Graves’ disease- Graves’ ophthalmopathy and Graves’ dermopathy.

Graves’ ophthalmopathy

Nearly 30% of the patients experiencing Graves’ disease develop Graves’ ophthalmopathy. In this case, muscles and tissues around your eyes can get affected due to inflammation . Patients complain of bulging eyes, pressure and pain in the surrounding area, retracted eyelids, light sensitivity, double vision, and reddening of eyes. In some severe cases, Graves’ ophthalmopathy can also result in loss of sight.

Graves’ dermopathy

Graves’ dermopathy is another manifestation of Graves’ disease. Here, the skin on the feet’s upper surface and shin area becomes red and swollen. The texture of the skin mimics the orange peel. This condition develops due to the accumulation of specific carbohydrates on the epidermis.

When to see a doctor for Graves’ disease?

If you are experiencing any signs related to Graves’ disease, do not neglect it. Book an appointment with a doctor for early diagnosis of symptoms and commencement of the immediate treatment plan.

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What causes Graves’ disease?

Research has established that a malfunctioning immune system leads to the development of Graves’ disease. However, the exact cause behind this phenomenon is still elusive .

In healthy individuals, hormones secreted by a master gland present in the base of the brain regulates the thyroid gland functioning. This tiny master gland is known as the pituitary gland, and it secretes a hormone called- thyroid-stimulating hormone (TSH).

We know that antibodies generated by the immune system are responsible for fighting against specific foreign bodies like bacteria and viruses. However, in patients suffering from Graves’ disease, the immune system develops an antibody— thyrotropin receptor antibody (TRAb), which mimics the TSH secreted by the pituitary gland. It triggers the thyroid gland to generate an excess of thyroid hormones (thyroxine and triiodothyronine) and leads to hyperthyroidism.

In Graves’ ophthalmopathy, the same antibody responsible for hyperthyroidism (TRAb) induces the building up of some types of carbohydrates in the muscles and tissues surrounding the eyes. It ultimately leads to inflammation in the ocular region.

What are the risk factors for Graves’ disease?

Certain groups of the population have a higher risk of developing Graves’ disease. They include:

• Sex- Women are prone to Graves’ disease than men.

• Age- Individuals below 40 years are more likely to develop Graves’ disease.

• Family history- You should be careful about Graves’ disease’s if there is a family history .There is a high probability that genes play a crucial role in the manifestation of this disease.

• Emotional and physical well-being- If you are undergoing stressful life events or physical illnesses it may trigger Graves’ disease if they are genetically prone.

• Pregnancy- Women recently given birth to babies can develop Graves’ disease if they have susceptible genes.

• Smoking- Cigarette smoking adversely affects the immune system and can trigger the onset of Graves’ disease.

What are the complications of Graves’ disease?

Complications of Graves’ disease can include:

• Cardiac ailments- Graves’ disease can lead to complications in the heart’s functioning like irregular rhythms, disorders in the heart muscle , and inadequate pumping of blood to all the tissues and organs due to heart failure .

• Pregnancy-related complications- If expecting women to develop Graves’ disease, there is a high risk of miscarriage, preterm labor, preeclampsia (high blood pressure in pregnant women), and poor fetal growth.

• Thyroid storm- Thyroid storm is a fatal condition due to severe hyperthyroidism. It is also known as thyrotoxic crisis. This complication can occur due to untreated Graves’ disease.

• Complications in bones- Bones may also become weak and brittle if you neglect Graves’ disease for a prolonged period.

Treatment options for Graves’ disease

Medical science has shown considerable improvement in the last few decades. Now, it is possible to completely cure Graves’ disease. Detailed below are the treatment options for this medical condition.

Radioactive iodine therapy

Patients receive radioactive iodine orally. The thyroid gland accepts the radioiodine, as they require this element for the secretion of hormones. However, radioiodine acts on the overactive thyroid cells and eventually eliminates them. After the implementation of this therapy, the thyroid gland gets shrunk considerably. Patients also experience a decrease in symptoms within a few weeks to months.

Anti-thyroid medicines

Doctors may also prescribe anti-thyroid medications, such as propylthiouracil and methimazole for treating Graves’ disease. There is a chance of developing liver diseases by the administration of propylthiouracil-based compounds. So, methimazole is often the first choice of treatment. However, in the first trimester of pregnancy, doctors advise propylthiouracil-based medicines, as methimazole can cause birth disorders in the fetus.

Beta blockers

These medicines do not inhibit the production of thyroid hormones, but they do block the effect of hormones on the body. They may provide fairly rapid relief of irregular heartbeats,

tremors, anxiety or irritability, heat intolerance, sweating, diarrhea, and muscle weakness. Propranolol, Atenolol, Metoprolol are some examples of Beta blockers.

Surgery

If patients do not respond to medications, doctors may also conduct thyroidectomy- surgery for removing the thyroid gland. However, if you undergo this treatment option, then doctors would prescribe you supplements for thyroid hormones.

Prevention of Graves’ disease

Doctors are not sure about the causes of Graves’ disease. Hence, they cannot recommend any preventive measures against this disorder.

Frequently Asked Questions

1. What are the diagnostic tests for Graves’ disease?

Family history and physical examination would be the first steps . After this, blood tests for determining the level of thyroid-stimulating hormone (TSH) and a radioactive iodine test for assessing the rate of iodine intake by the thyroid gland will be done . Imaging tests like ultrasound examination, MRI (magnetic resonance imaging), and CT (computed tomography) are also helpful.

2. Are there any lifestyle measures that would help for Graves’ disease?

If you get detected with the early stages of Graves’ disease, then consumption of healthy meals, regular exercises, and relaxation techniques for easing out stress can help in limiting the symptoms. Doctors advocate wearing sunglasses, using cool compresses, administering lubricating eye drops, and quitting smoking to reduce the severity of Graves’ ophthalmopathy. In the case of Graves’ dermopathy, you can try wearing compression wraps around your legs.

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