Graves’ disease is an autoimmune disease that occurs when the immune system makes antibodies known as thyroid-stimulating immunoglobulin (TSI). These antibodies attach to the cells of the thyroid. They then imitate thyroid-stimulating hormone (TSH), which causes the thyroid to make more thyroid-stimulating hormone than the body needs.
When Graves’ disease develops, experts say that these antibodies can block the body’s thyroid hormone production. Consequently, Graves’ disease is said to be the most common cause of hyperthyroidism. Hyperthyroidism occurs when the thyroid gland produces more thyroid hormone than the body needs. Unfortunately, the symptoms of hyperthyroidism can look like other health problems, so it can be misdiagnosed.
In general, the thyroid gland is an important body regulator. It’s like a thermostat of sorts, keeping the body in balance. So when the thyroid becomes overactive, as in this case of Graves’ disease, hyperthyroidism develops.
Risk Factors of Graves' Disease
Though anyone can develop Graves’ disease, it’s most common among women. In fact, women are five to 10 times more likely to develop this condition than men.
In addition, a number of other factors can increase the risk of Graves’ disease. The first is family history. That’s because genes may play a role in just who develops this disorder.
Age may also be a factor. Though those of any age can develop this condition, it’s most often seen in those under 40.
Stress, pregnancy and smoking can also increase the risk of developing Graves’ disease. And if you have another autoimmune disorder, your chances of developing this condition are also elevated. For example, the Mayo Clinic says that those with type 1 diabetes and rheumatoid arthritis have a greater chance of developing Graves’ disease than those who don’t.
Symptoms and Risk Factors
There are a number of symptoms often associated with Graves’ disease. One well-known symptom is general mood instability. Because the thyroid hormone affects moods, those with Graves’ disease can become irritable and anxious. This can be frustrating for both the person affected and family members.
The thyroid is also a temperature regulator. As a result, those with Graves’ disease may become warm and sweat often. Their hands may shake, and they may experience an irregular heartbeat.
Nearly one-third of those with Graves’ disease have Graves’ ophthalmopathy. According to the Mayo Clinic, “in Graves' ophthalmopathy, inflammation and other immune system events affect muscles and other tissues around your eyes.”
This may cause the eyes to bulge out, almost with a bug-like look. Other ocular symptoms may include double vision or vision loss, eye puffiness, sensitivity to light and a feeling of pressure in the eyes.
Graves' ophthalmopathy is a bit of an oxymoron in terms of when symptoms occur. Though it might occur simultaneously with hyperthyroidism, it also can occur at a later time. The symptoms of this condition might even be seen years before or after hyperthyroidism occurs. And at times, it can occur without hyperthyroidism at all.
Graves’ disease can also lead to a number of complications. The first involves pregnancy. This can result in miscarriages, heart failure in the mother, preeclampsia (high blood pressure) and early birth. It also can affect the growth of the fetus and lead to fetal thyroid dysfunction.
Further, untreated Graves’ disease can cause a number of heart problems. The Mayo Clinic says that some of these heart conditions can include heart rhythm disorders, issues with the heart muscles and congestive heart failure.
Untreated Graves’ disease can cause osteoporosis. This is because an excess amount of thyroid hormone affects calcium absorption. Calcium is needed for healthy bones.
And rarely, untreated Graves’ disease can cause a thyroid storm (also called accelerated hyperthyroidism and thyrotoxic crisis). A thyroid storm occurs when thyroid hormones rapidly increase. Symptoms include fever and sweating, weakness, rapid heartbeat, vomiting and diarrhea, jaundice, seizures, low blood pressure, delirium, and coma. In this case, it’s essential to get medical help immediately.
To diagnose Graves’ disease, a doctor will take a blood sample. He or she will then have the blood tested to check thyroid levels and the pituitary hormone. If THS levels are low, and thyroid hormones are high, this is an indicator of Graves’ disease. The doctor may check the levels of the antibody associated with Graves’ disease. If this test is negative, the doctor may rule out Graves’ disease as the cause of hyperthyroidism altogether.
Radioactive iodine will be administered, and, using a scanning camera, he or she will observe just how the thyroid gland uses iodine. How much radioactive iodine the thyroid gland uses will help the doctor to get a clear picture of whether or not Graves’ disease is the cause of hyperthyroidism. An ultrasound and various imaging tests may also be ordered.
Diagnosis and Treatment of Graves' Disease
If you are diagnosed with Graves’ disease, your doctor will begin treatment as soon as possible. His or her goal will be to regulate thyroid hormones to eliminate hyperthyroidism.
One method of treatment that he or she may use is radioactive iodine therapy. This method of therapy eradicates overactive thyroid cells. Consequently, the thyroid will become smaller. This method of treatment takes somewhere between a few weeks and a few months, according to the Mayo Clinic. It is important to note that this treatment is not recommended for pregnant women.
The doctor will probably prescribe anti-thyroid medications. These medications keep the body from using iodine to produce excess amounts of hormones. Beta-blockers may also be used. These medications can block hormonal effects and help to alleviate symptoms of hyperthyroidism.
Thyroid surgery also may be performed. In this case, your doctor would remove the thyroid. After surgery, medications will be used to act in the same way a thyroid would.
In addition, it will be important to eat right and exercise to manage Graves’ disease. And you will want to avoid stress to the greatest extent possible because stress can be a trigger.