What is Graves’ Disease?

Many people are affected by various thyroid conditions without knowledge. While not specifically fatal, thyroid disorders can alter the body’s important processes and may pose numerous health risks. One of these thyroid conditions is Graves’ disease.

The disease takes its name from Dr. Robert Graves, an Irish physician. While Graves did not discover the disease, he wrote an extensive study on several pregnant women who exhibited overactive thyroids and protruded eyeballs.

It is called by this name in both the United States and the United Kingdom, but in other parts of the world, it is known as Basedow’s disease, after Dr. Karl von Basedow who wrote about this thyroid disease. It also goes by the name toxic diffuse goiter and exophthalmic goiter.

The thyroid is a butterfly-shaped gland found in front of the neck, below the voice box. It is responsible for producing hormones that regulate body growth, development and metabolism. It also plays an important role in the regulation of your heart rate, body temperature and emotional state.

This is mainly because the thyroid is responsible for the secretion of triiodothyronine (T3), tetraiodothyronine (T4) and diiodothyronine (T2), hormones that have the ability to interact with the other hormones that are present in the body, like estrogen, progesterone and testosterone.

Having enough levels of these hormones is vital because an imbalance would cause a slew of adverse effects and may even result in serious diseases, such as hyperthyroidism, hypothyroidism, Hashimoto’s disease and Graves’ disease.

Graves’ disease is actually one of the leading causes of hyperthyroidism. This autoimmune disease works by making the immune system secrete antibodies that act like thyroid-stimulating hormones (TSH), which then trigger hormone secretion in the thyroid.

While Graves’ disease may strike at any time in a person’s life, the peak age is between 20 to 40 years. It has also been observed to affect women five to 10 times more, but manifests itself in a more severe form in men.

People with other autoimmune diseases are also more predisposed to Graves’ disease.

These include:

  • Vitiligo –a skin condition where white patches appear on the skin. This is caused by the destruction of melanocytes in the skin, or the cells responsible for the production of pigment.
  • Rheumatoid arthritis – an autoimmune disease that targets the joints. It usually causes swelling, pain and limited movement.
  • Lupus –a condition where the immune system starts attacking healthy cells. This is caused by the immune system’s inability to differentiate between your cells and foreign invaders.

Autoimmune diseases are among the leading cause of death in the world. The immune system serves as the filter for the body, tracking down foreign bodies that may harm the natural flow of bodily processes.

But when the immune system loses the ability to differentiate between healthy cells from disease-causing particles in the body, it starts to produce autoimmune cells. The immune system then signals the body to attack its own healthy cells by mistake.

There are numerous autoimmune diseases that target different parts of the body and some of them, like Graves’ disease, specifically attack the thyroid gland.
Graves’ disease is usually characterized by the onset of hyperthyroidism and protruding eyeballs. If you are affected by Graves’ disease, your immune system begins to create antibodies that target the thyroid gland.

These antibodies are called the thyroid-stimulating immunoglobulins (TSIs). TSIs bind to your thyroid cell receptors, tricking the thyroid into producing more thyroxine than what the body normally needs.

While the cause of autoimmune diseases may not be entirely clear, Graves’ disease may be triggered by a mix of environmental and hereditary factors.

While Graves’ is not characterized as a fatal disease, it can still lead to numerous debilitating complications if left untreated, such as:

  1. Thyroid storm is a very rare but extremely life-threatening condition where the function of various organs in the body becomes compromised. If untreated, patients who’ve developed thyroid storm have 50 to 90 percent mortality rate.
  2. The excessive amounts of thyroid hormones in the blood can lead to the alteration of the body’s thermo regulation, cardiovascular, immune and nervous function, and eventually to multi-organ decompensation. To get an early diagnosis, it is important that you are familiar with the symptoms of thyroid storm:
  •  High fever. The patient typically has a temperature that’s above 101.3 degrees Fahrenheit, and may go over 105.8 degrees F.
  • Tachycardia. Because of the increased activity of the nervous system, the cardiovascular system is forced to work overtime. This causes the heart to beat at a faster rate, sometimes even exceeding 140 beats per minute. Tachycardia may also be accompanied by dysrhythmias, or abnormal and irregular heartbeat.
  • Changes in mental status. Patients may exhibit restlessness, agitation and confusion. Without proper treatment, it may eventually lead to delirium and coma.
  • Vomiting and diarrhea. Accelerated intestinal transport and decreased absorption in the gut may lead to various digestive tract issues in the onset of this condition.
  • Heart problems may also arise from Graves’ disease. Because of the high amount of thyrozine in the blood, the heart is overstimulated. This causes a faster and a stronger heartbeat, which may then cause atrial fibrillation, the most common form of arrhythmia.

Atrial fibrillation is actually hard to diagnose because it shares the same symptoms with a handful of heart disorders. When a person has this condition, the heart starts to beat in an irregular manner and cause the blood to pool and form clots, which may then cause strokes and death.

Untreated Graves’ can also lead to brittle bones, miscarriages, infertility and psychosis because of the strong effect of the thyroid hormone on the various organs of the body.

One of the most pronounced symptoms of Graves’ disease is Graves’ ophthalmopathy or the uncharacteristic protruding of the eyes.

About 35 to 50 percent of people with Graves’ disease develop this condition, wherein the eyes are pushed outward because of the inflammation of tissues and muscle located behind the eye, which can also lead to the inflammation of the cornea.

This can also cause intense pressure on the optic nerve, which can then lead to vision impairment.

Graves’ ophthalmopathy usually starts with eye irritation, excessive tearing or dry eyes, and sensitivity to light. If not diagnosed early, it may lead to the swelling of the eye, eye movement difficulties, corneal ulceration and even blindness.

While not all people with Graves’  are affected by this symptom, there is no foolproof way to prevent this eye condition from developing. However, smokers have a higher predisposition to develop this symptom.

Studies have also shown that conventional treatment methods for Graves’ disease, like radiation therapy, may even worsen Graves’ ophthalmopathy.

Using a cold compress can provide relief for mild Graves’ ophthalmopathy. In severe cases where the vision of the individual is already affected, orbital decompression may be advised.

This is a type of surgery wherein a bone (located between the eye sockets) and the sinuses is removed, in order to give way to the inflamed tissues that are putting pressure on the optic nerve.

Many information sites usually say that Graves’ disease is a type of hyperthyroidism. But Graves’ disease is actually one of the most common causes of this condition.

Hyperthyroidism is characterized by the over-activity of the thyroid gland, which leads to the over-secretion of hormones in the body. The increased production of thyroid hormones not only affects the overall hormonal balance of the body but also leads to numerous health problems.

Because these two conditions are so tightly knit, the symptoms of Graves’ disease are usually identical to that of hyperthyroidism.

These include:

  • Weight loss: The thyroid hormone is responsible for metabolism in humans. The dramatic increase in thyroid hormones speeds up numerous body processes and puts the body into overdrive. One of these processes is how the body converts food into energy. This means that the body burns up fat faster than normal and cannot promote weight gain even with the increased appetite that hyperthyroidism brings.
  • Hyperthyroid myopathy, or thyrotoxic myopathy, causes muscle weakness, degeneration and fatigue. This affects 52 to 82 percent of people with hyperthyroidism. This is caused by the excessive amounts of thyrotoxine in the body: Immediate treatment should be sought when this symptom first appears and should not be ignored.
  • Difficulty sleeping: Sleep troubles arise because of increased heart rate, anxiety and night sweats, which are all brought on by the overstimulation of the thyroid.
  • Erectile dysfunction and low sex drive: Studies show that men with thyroid conditions often experience erectile dysfunction and have low sex drive. Seventy-nine percent of men with thyroid dysfunction showed some level of erectile dysfunction. This is because of the interaction between thyroid hormones and the different sex hormones produced in the body.
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