Graves' Disease
What is it?
Graves' disease, the most common type of hyperthyroidism, is characterized by general
over-activity of the thyroid gland. Since the thyroid is responsible for maintaining a normal metabolism,
over-activity of the thyroid gland can have some dramatic effects on your body's metabolism when too much hormone is released. Metabolism is the process by which digested nutrients are converted into energy and used for the body's cells to do their work This work includes regulating your heart rate, the amount of calories you burn when you are resting, your energy level and other bodily functions. When the thyroid is functioning abnormally it can cause an increased pulse rate, nervousness and sweating, heat intolerance, hair loss. Graves' disease is rarely fatal, and people seldom get extremely ill because of it. The disease was named after the Irish physician Robert Graves, who was the first to describe this form of hyperthyroidism.
Who gets it?
Graves' Disease is four to eight times more likely to be found in women than men. It usually occurs in young and middle-aged women and can be inherited.
What causes it?
Graves' disease involves the immune system of the body. Normally, the immune system protects you from infection and abnormal body cells by recognizing and destroying cells using antibodies, which are produced by blood cells known as lymphocytes. In Graves' disease, the lymphocytes in the body's immune system produce antibodies that actually attack the body's own tissue instead of protecting. As a result of this attack, the antibodies cause the thyroid gland to overproduce thyroid hormones. Although 10 to 15 percent of the population have the type of immune system that can lead to Graves' disease, only about one in ten ever actually develop hyperthyroidism. Severe emotional stress is thought to be a factor in triggering the disease.
What are the symptoms?
Symptoms of Graves' disease develop gradually and are sometimes mistaken for simple nervousness due to a stressful life situation. The most common symptoms are: weight loss, rapid heart rate, anxiety, fine skin, hair loss, feeling hot and perspiring a lot. Many people feel they have no control over their emotions, some feel muscle weakness and insomnia. Occasionally there are people who develop a goiter, a swelling in their neck due to an enlarged thyroid. Nearly half of all people with Graves' disease develop eye symptoms such as inflammation of the eyes, swelling of the tissues around the eyes and partisan of the eyes.
How is it diagnosed?
If your health care provider suspects that you have hyperthyroidism, a thorough medical history and physical examination can usually confirm a diagnosis. The exam may reveal an enlarged thyroid gland and a rapid pulse, in addition to delicate skin and the tremor of your fingertips. Reflexes may be rapid and you may have some of the eye or skin abnormalities described above. A final confirmation that you have hyperthyroidism is usually obtained in a simple blood test, where the thyroid hormone level is measured. Occasionally the provider will also check the blood for antibodies that attack the thyroid gland. If your thyroid gland is not enlarged or feels tender to the touch, a radioactive image, or scan, of the thyroid is obtained to show if the thyroid is making more less hormone than normal.
What is the treatment?
Currently there is no treatment available to stop production of the antibodies that cause hyperthyroidism. However, there are three courses of treatment available to help Graves' disease patients have more normal levels of thyroid hormone and to control their symptoms.
Anti-thyroid drugs are used to decrease the production of thyroid hormone. This treatment will result in prolonged remission of the disease in about 20 to 30 percent of patients and usually those with milder disease at the beginning of treatment. Beta blockers, which do not affect production of thyroid hormone, are used to control symptoms. This medicine will slow the heart rate, lower blood pressure and help calm feelings of anxiety. Because of the failure of
anti-thyroid drugs to cure the majority of patients, physicians treat most patients with radioactive iodine. Administered by mouth, the radioactive iodine goes from the stomach to the bloodstream and ultimately passes into the thyroid gland where it eventually damages some of the thyroid cells. This method, used since about 1940, poses no significant radiation risk to you and requires only a couple days treatment. Surgical removal of most of the thyroid gland is the other alternative for severe cases of Graves' disease. As with any surgery there are risks and because there are so many important structures in the area of the thyroid gland, it becomes even riskier as more complications could arise. After surgery you will need to take thyroid hormones the rest of your life.
Self-Care Tips
Although there is no known way to prevent Graves' Disease, regular physical examinations can usually detect the disease. If you have been diagnosed, the disease is easily treated with your doctor's recommendations.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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