Graves’ disease is an autoimmune disease that affects the thyroid gland. In this disease, there is an overproduction of thyroid hormones. Thyroid hormones control the body’s metabolism, so they affect almost all the organs of the body. Hyperthyroidism predominantly affects the following organs:
- Heart: The abnormally high heart rhythm, called atrial fibrillation occurs in about 20% of people. A heart condition called mitral valve prolapse in which the mitral valve is weakened causing irregular heartbeat is seen in children.
- Bones: The bones of a person suffering from hyperthyroid are brittle and prone to fractures.
- Muscles: Weak muscles with an increased tendency to weakness and swelling is seen.
- Nervous system: Tremors, irritability, and anxiety may be seen.
- Gut: Diarrhea is seen.
- Preterm birth of the child
- Fetal thyroid dysfunction
- Poor fetal growth
- Maternal heart failure
- High blood pressure in pregnant women
- Heart failure in pregnant women
- Disorder of heart rhythm
- Thyroid storm (a life-threatening condition causing increased heart rate, blood pressure, and extremely high temperature)
- Osteoporosis (brittle bones)
- Weight loss
- Graves ophthalmopathy (eye disease causing double vision, light sensitivity, and eye pain)
What causes Graves disease?
Graves disease is an autoimmune disorder in which the immune system releases abnormal antibodies that mimic the thyroid-stimulating hormone (TSH). TSH, released by the pituitary gland, activates the thyroid gland to produce thyroid hormones. Abnormal antibodies lead to the overproduction of thyroid hormones. Hereditary can play a major role in determining the susceptibility of abnormal antibodies.
Who is at risk of developing Graves disease?
Graves disease mainly affects women between the ages of 30 and 50 years. People with the following conditions are at risk of developing Graves disease:
- Family history of thyroid disease
- Celiac disease (a digestive disorder causing indigestion of gluten)
- Vitiligo (skin disorder causing changes in skin coloration)
- Pernicious anemia (iron deficiency caused due to lack of vitamin B12)
- Hormone disorder, such as Addison disease
- Autoimmune diseases, such as rheumatoid arthritis, lupus, or type 1 diabetes
What are the symptoms of Graves disease?
Hyperthyroidism augments certain body functions. Symptoms of Graves disease include:
- Enlarged thyroid (goiter)
- Hand tremors
- Muscle weakness or tiredness
- Heat intolerance
- Irritability or nervousness
- Weight loss without any efforts
- Arrhythmia (fast, irregular heartbeat)
- Difficulty sleeping
- Eye inflammation, causing eyeballs to protrude from the socket
- Excessive perspiration
- More frequent bowel movements
- Reddish, thickened, and lumpy skin, especially on the shins and upper feet
- Change in frequency or total cessation of menstrual periods
- Trembling hands
How is Graves disease treated?
Treatment for Graves disease involves lowering the thyroid level or blocking the action of the thyroid. The three main treatments of Graves disease include:
- Antithyroid medications: Methimazole (MMI) or Propylthiouracil blocks the thyroid from producing excess thyroid hormone. Avoid MMI during the early stages of pregnancy.
- Radioactive iodine (RAI): RAI destroys thyroid cells to prevent the thyroid gland from producing more thyroid hormone. It can sometimes lead to an underactive thyroid gland.
- Surgery (thyroidectomy) to remove all or some of the thyroid gland.
Medications, such as beta-blockers, may block some of the effects of excess thyroid hormone. They slow down the heart rate and reduce the symptoms of shakiness and nervousness.
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