Graves’ Disease or also known as diffuse thyrotoxic goiter is the most common type of hyperthyroidism. Hyperthyroidism is a disorder that causes the thyroid glands to be overactive, thus producing too much hormones which causes metabolic imbalance. Famous pop star Missy Elliott talked about Graves Disease recently; she admitted that she was victim to this rare disease.
Graves’ Disease was named after Robert J. Graves, MD, an Irish physician, who was the first to discover about the said disease during the 1830’s. He had described Graves’ Disease as an autoimmune type of illness that leads to over production of thyroxine hormones which can also affect other functions of the body like speeding up of heart rate, metabolism, brain development, body temperature, menstrual cycle, muscle strength, skin dryness, and cholesterol level.
Causes of Graves’ Disease
The thyroid gland is one of the largest organs in the endocrine system. It is found in the neck right below the thyroid cartilage. The thyroid gland produces many hormones but the two major hormones are triiodothyronine (T3) and thyroxine (T4). These hormones help regulate metabolism and other growth and rate functions of other systems in the body. When the immune system mistakenly releases thyrotropin receptor antibodies (TRAb), it causes the thyroid gland to produce too much of the thyroid hormones.
Graves’ Disease can affect both men and women but is most commonly found on women with ages over 20. Though trigger points for over production of auto antibodies is still unknown, most physicians believe that severe stress can help trigger the development of such disease. However this is not the case for other victims, as some other factors that can be considered are:
• Genes
• Gender – women are most likely to be affected compared to men
• Pregnancy
• Infection
Risk Factors for Graves’ Disease
Though the root cause of the disease is still unknown, physicians believe that a combination of 2 or more of these factors can trigger the development of such disease:
• Family History
• Sex
• Age – people whose age is above 20 are at higher risk of developing the disease.
• Stress
• Pregnancy
• Smoking
Symptoms of Graves Disease
The following symptoms can be found on people with Graves’ Disease:
• Anxiety
• Difficulty in concentrating
• The possibility of enlargement of breasts in men
• Double vision
• Sticking out of eyeballs
• Irritation and tearing of the eyes
• Fatigue
• Heat intolerance
• Possible formation of goiter
• Increased sweating
• Increased appetite
• Insomnia
• Menstrual irregularities
• Nervousness
• Muscle weakness
• Irregular heartbeat
• Difficulty in sleeping or restlessness
• Weight loss
• Thinning of skin
• Brittle hair
• Irregular bowel movements
• Hand tremors
• Difficulties in getting pregnant
These symptoms may sometimes slowly occur or at times could be very sudden that most physicians might get confused, especially when it manifests with symptoms of other health conditions. Meanwhile, other cases may not show any symptoms at all.
Complications brought by Graves’ Disease
When the body produces too much thyroid hormones this can lead to more severe complications such as:
• Heart problems – Graves’ Disease causes the heart to beat rapidly which may lead to abnormal blood circulation in the heart. This imposes great risk but is completely reversible. Appropriate treatment must be done to keep the heart at its normal rate.
• Brittle Bones – When hyperthyroidism is not treated right away, it could lead to the weakening of the bones thus making it brittle.High levels of thyroid hormones interfere with the absorption of calcium and other minerals in the bones.
• Thyrotoxic crisis – This complication is an intensified Graves’ Disease symptom that leads to rapid pulse rate, delirium and fever. Though such complication rarely occurs, but when it happens it is best to seek medical help immediately.
Complications caused by surgeries done for Graves’ Disease include:
• Hoarseness of the voice caused by a damage in the nerve connecting to the voice box
• Scarring in the neck
• Low levels of calcium caused by a damage in the parathyroid gland
Diagnosis of Graves’ Disease
Graves’ Disease can sometimes be diagnosed through physical examination and study of the patient’s medical history, while laboratory tests may help confirm such diagnosis. Tests used to diagnose Graves’ Disease include:
• Thyroid Function Test – This test collects blood sample that can help determine the T4 and TSH level in the body. A high level of T4 plus a low level of TSH indicates a sign of an overactive thyroid.
• Radioactive Iodine Uptake Test (RAIU) – This test measures the amount of iodine collected by the thyroid from the bloodstreams. High levels of iodine indicate the presence of Graves’ Disease.
• Antibody Test – Blood samples taken will be examined for high levels of antibodies which may help ultimately confirm the presence of Graves’ Disease. Though this test is not that necessary, it helps identify the disease from other types of thyroid diseases.
Treatment for Graves’ Disease
Though there is no exact treatment for this type of disease, it is important to control the over-activity in the thyroid gland. Medications like Methimazole (MMI) and Propylthiouracil (PTU) are Antithyroid drugs used to stop the thyroid from producing too much hormones. Other treatments may include radioactive iodine therapy or at times may need thyroid surgery.
In radioactive iodine therapy, patients are advised to take radioactive iodine-131 pills that destroy thyroid cells to help control the thyroid hormones. Surgery, on the other hand, should be done when patients do not respond to other types of treatments. This is usually the last option since the removal of the thyroid gland may need a lifelong replacement of thyroid hormones.
No matter how controlled your hyperthyroidism is, it still has a tendency to come back even after a radioactive iodine treatment or even when surgery has been done. Patients with Graves’ Disease should always see their doctors and have their blood tested once a year. Because Graves’ Disease is an inherited illness, its development could not be helped; but if detected and controlled early, patients can still enjoy a normal healthy life.
Graves Disease Pictures
