Graves’ disease is one of the causes of thyrotoxicosis or metabolic derangement due to excessive thyroid hormone levels in the body.
The thyroid is a butterfly-shaped gland (two lobes connected by a bridge of tissue called isthmus) located at the base of the neck and below Adam’s apple that produces and releases two hormones: triiodothyronine (T3) and thyroxine (T4).
These hormones play a crucial role in several important bodily functions such as maintaining:
- Body temperature.
- Heart rate.
- Metabolism.
- Protein synthesis.
For adjusting the level of thyroid hormones, the body has a complex mechanism.
- The hypothalamus, located above the pituitary gland in the brain, secretes the thyrotropin-releasing hormone.
- This causes the pituitary gland to produce thyroid-stimulating hormone (TSH).
- TSH stimulates the thyroid gland to produce thyroid hormones (T3 and T4).
- Depending on the levels of thyroid hormones circulating in the blood (too high or too low), the pituitary gland slows or speeds the release of TSH.
What is Graves’ disease and thyrotoxicosis?
Graves’ disease
A type of autoimmune disease that damages the thyroid gland resulting in the overproduction of thyroid hormones (hyperthyroidism).
- The most common cause of hyperthyroidism.
- The condition got its name from Robert Graves, an Irish doctor, who first described the condition in the 1800s.
- People affected with Graves’ disease produce excess thyroid hormone, sufficient enough to damage the heart and other organs.
Thyrotoxicosis
Thyrotoxicosis is a rare treatable condition that occurs due to excess thyroid hormone in the body that could be due to hyperthyroidism (production and release of excess thyroid hormones) and excess consumption of thyroid medications.
- The likelihood of thyrotoxicosis increases as age progresses.
- Women are more commonly affected by thyrotoxicosis than men.
What are the symptoms of Graves’ disease and thyrotoxicosis?
Graves’ disease
Symptoms of Graves’ disease include:
- Insomnia (difficulty sleeping)
- Goiter (enlarged thyroid)
- Eye inflammation that causes eyeballs to protrude from the sockets
- Arrhythmia (fast and irregular heartbeats)
- Fatigue (excessive tiredness)
- Hand tremors
- Heat intolerance
- Irritability
- Muscle weakness
- Unexplained weight loss
- Changes in menstrual cycles
- Erectile dysfunction or reduced libido
Thyrotoxicosis
Common symptoms of mild and moderate thyrotoxicosis include:
- Unexplained weight loss
- Tachycardia (rapid heartbeat)
- Arrhythmia (an irregular heartbeat)
- Muscle weakness
- Nervous, anxious/irritable
- Shakiness
- Increased sensitivity to heat
- Changes in menstruation
SLIDESHOW
Hyperthyroidism: Symptoms, Treatment, Medication See SlideshowHow are Graves’ disease and thyrotoxicosis treated?
Graves’ disease
Graves’ disease is a lifelong condition, but appropriate medical care can control the symptoms and reduce the risk of complications.
- Beta-blockers such as propranolol and metoprolol regulate the heart rate.
- Antithyroid medications such as methimazole (Tapazole) and propylthiouracil block the gland’s production of thyroid hormone.
- Radiation or radioiodine therapy involves one dose of radioactive iodine; over time, radiation slowly destroys thyroid gland cells.
- Surgery: complete or partial removal of the thyroid gland (thyroidectomy or subtotal thyroidectomy).
Thyrotoxicosis
Treatment for thyrotoxicosis depends on the cause and the options may include:
- Anti-thyroid drugs such as methimazole (Tapazole) and propylthiouracil (PTU).
- Radioactive iodine: oral intake of radioactive iodine makes the overactive thyroid cells absorb the iodine, which damages the cells causing the shrinkage of the thyroid gland.
- Surgery: removal of the thyroid gland (thyroidectomy).
- Beta-blockers help regulate the heartbeat.
- Glucocorticoids are a type of corticosteroid prescribed to treat thyroiditis.
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Key differences between Graves’ disease and thyrotoxicosis
| Differences | Graves’ disease | Thyrotoxicosis |
|---|---|---|
| Causes |
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| Relation with hyperthyroidism | A predominant cause of hyperthyroidism (affects 1 out of every 200 Americans) | A complication of hyperthyroidism |
| Risk factors |
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| Diagnosis |
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| Prognosis |
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| Complications |
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Thyrotoxicosis. Cleveland Clinic: https://my.clevelandclinic.org/health/diseases/21741-thyrotoxicosis
Graves' Disease. Cleveland Clinic: https://my.clevelandclinic.org/health/diseases/15244-graves-disease
Graves’ disease. Mayo clinic: https://www.mayoclinic.org/diseases-conditions/graves-disease/symptoms-causes/syc-20356240
Graves’ Disease and the Manifestations of Thyrotoxicosis. NIH: https://www.ncbi.nlm.nih.gov/books/NBK285567/
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Fine-needle aspiration biopsy of the thyroid is used to obtain tissue for analysis. Fine-needle aspiration is also performed to treat thyroid cysts. The fine-needle aspiration biopsy procedure may be recommended to make the diagnosis and/or select therapy of a thyroid nodule. Fine needle aspiration biopsy may also be recommended to drain or shrink a thyroid cyst.How Does Graves Disease Affect the Body?
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
Hyperthyroidism is an excess of thyroid hormone due to an overactive thyroid gland. Symptoms can include increased heart rate, weight loss, heart palpitations, frequent bowel movements, depression, fatigue, fine or brittle hair, sleep problems, thinning skin, and irregular vaginal bleeding.
Graves' disease is the most common cause of hyperthyroidism. Many other health problems or taking excess thyroid hormone medication can cause an overactive thyroid gland. Treatment for the condition is with medication, radioactive iodine, thyroid surgery (rarely), or reducing the dose of thyroid hormone. No diet has been shown to treat hyperthyroidism or its symptoms and signs.
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Parathyroidectomy Surgery
Parathyroidectomy is the removal of one or more of the parathyroid glands to treat hyperparathyroidism. Risks of parathyroidectomy include:- paralysis of the vocal cords,
- difficulty swallowing thin liquids,
- difficulty breathing,
- and drug reactions.
- damage to the recurrent laryngeal nerve,
- bleeding or hematoma,
- problems maintaining calcium levels in the blood,
- need for further and more aggressive surgery,
- need for a limited or total thyroidectomy,
- prolonged pain,
- impaired healing,
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Thyroid Blood Tests
Thyroid blood tests determine the adequacy of the levels of thyroid hormones in in a patient. The blood tests can determine if the thyroid gland's hormone production is normal, overactive, or underactive. The level of thyroid hormones may help to diagnose hypothyroidism or hyperthyroidism. The test may also point to other diseases of conditions of the thyroid gland.
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