Graves’ Disease

What is Graves’ disease?

Graves’ disease is an autoimmune disease that causes the thyroid gland to become overactive, a condition called hyperthyroidism.

Prognosis of Graves’ disease

Although Graves’ disease generally responds well to treatment, it can lead to:

  • Depression
  • Physical and mental sluggishness
  • Dry skin
  • Constipation
  • Intolerance to cold

Symptoms of Graves’ disease

The most common symptoms of Graves’ disease include:

  • Shaky hands
  • Rapid heartbeat
  • Sensitivity to heat
  • Goiter — a visibly enlarged thyroid
  • Unexplained weight loss
  • Increased appetite
  • Changes in menstrual cycles
  • Erectile dysfunction and loss of libido

Graves’ disease can also affect mood in a number of ways, including:

  • Increased feelings of anxiety
  • Feeling nervous and jittery
  • Irritability

In some cases, you may develop eye conditions, which affect 30% of people with Graves’ disease. These may include the following:

  • Pressure or pain in and around the eyes.
  • Sensitivity to light
  • Double vision
  • Reduced vision and damage to the cornea
  • Itching and irritation of the eyes

If left unchecked, Graves’ disease can sometimes lead to complications such as:

  • Problems during pregnancy, such as miscarriage, preeclampsia, or premature delivery
  • Heart problems, such as heart rhythm disorders or heart failure

What causes Graves’ disease?

An autoimmune disorder occurs when the body mistakes healthy cells for harmful cells and attacks them. In Graves’ disease, the body’s immune system produces antibodies that in turn cause the thyroid gland to grow and become overactive.

Studies indicate that there is a genetic component to Graves’ disease, as it tends to run in families.

Medical tests for Graves’ disease

At first, your doctor will ask about your symptoms and medical history. On the other hand, the doctor may perform a physical exam to check for any signs of Graves’ eye disease, an enlarged thyroid gland, or a tremor.

They will then take a blood sample to test for any increase in thyroid stimulating hormone (TSH), a hormone produced by the thyroid gland. This is usually enough to make a diagnosis of Graves’ disease, but in some cases you may need imaging tests, such as a CT scan or MRI of your neck.

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Can it be prevented?

Smoking is a major risk factor, so smoking cessation is recommended to prevent Graves’ disease.

Treatments for Graves’ disease

The main treatment for Graves’ disease is medication.

If the patient has severe symptoms, the doctor may prescribe beta-blockers in the short term, to counteract the effects of an overactive thyroid gland.

In the long term, your doctor will prescribe medications that inhibit the production of hormones in the thyroid gland. Initially, you will be given a high dose of medication, which will be reduced periodically if your symptoms have been controlled. The goal is to gradually return thyroid function to normal and to stop long-term medication.

There are several medications available to counteract the thyroid gland. Each has different side effects and risks and it is important to consult with your health care provider.

If medication does not restore normal thyroid function, your doctor may recommend more invasive treatments to shrink the thyroid gland, which include:

  • Radioactive iodine therapy: this involves taking iodine by mouth. The radioactivity of the iodine destroys some of the thyroid cells. Initially, radioactive iodine therapy may worsen some of the symptoms of Graves’ disease, but these are usually temporary. This treatment is not recommended if the patient is pregnant or breastfeeding.
  • Surgery: Surgery involves removing part or all of the thyroid gland. After surgery, you may need hormone replacement medications to bring your thyroid hormone levels back to normal. There are a number of possible complications associated with thyroid surgery, so it is only recommended when other treatment approaches have failed.

When Graves’ disease causes eye problems, they usually improve with the treatment indicated for overactive thyroid. Even so, radioactive iodine can worsen eye conditions. For this reason, in some cases specific medications are required to reduce eye inflammation and irritation.

Which specialist treats it?

The specialist in charge of treating Graves’ disease is the ophthalmologist.