The exact cause is unclear, although experts believe this disease is triggered by a combination of genetic and environmental factors. Like in all cases of autoimmune diseases, the immune system in Graves’ disease attacks the body and creates antibodies called thyroid-stimulating immunoglobulin’s (TSIs), which stimulate the thyroid gland to produce more thyroxine (thyroid hormone) than the body requires.
The risk factors for developing Graves’ disease include:
- Family history of Graves’ disease (main risk factor)
- Gender: women are more susceptible
- Age: the disease usually develops in people younger than 40 years
- Stress may act as a trigger for the onset of this and other autoimmune diseases
- Recent emotional or physical trauma may also act as a trigger in this disease
- Injury or surgery of the thyroid gland
- Smoking increases the risk of contracting the disease
- Recent studies showed being pregnant or recently giving birth may increase the risk of Graves’ disease, especially in women with a family history of this disorder
- Studies also show pollution, iodine therapy, selenium intake and injection of certain medications (such as ethanol, interferon beta-1b or interleukin-4 therapy) may also trigger the disease
Though the mechanism for what happens in Graves’ is well understood, the underlying cause is still a mystery. Researchers think that a combination of genetics (a person has a greater chance of developing the disease if other family members have it) and an outside trigger (such as a bacteria or virus) cause the condition. People with other autoimmune disorders are more likely to develop it than the general population.
Conditions linked with Graves’ disease include the following:
- Rheumatoid arthritis
- Addison's disease
- Type I diabetes
- Pernicious anemia
- Celiac disease
Normally, thyroid function is regulated by a hormone released by a tiny gland at the base of the brain (pituitary gland). The antibody associated with Graves’ disease, the thyrotropin receptor called TRAb, acts similar to the regulatory pituitary hormone. That means TRAb overrides the normal regulation of the thyroid, causing an overproduction of thyroid hormones (hyperthyroidism).
Researchers are also trying to investigate other specific genes that trigger Graves’ disease.
What is Graves’ disease?
Graves’ disease is an autoimmune disorder that causes the immune system to overstimulate the thyroid gland and produce too much thyroid hormone. This can eventually cause hyperthyroidism (overactive thyroid), which Graves’ is the leading cause of this condition according to the American Thyroid Association.
Having excess thyroid hormone in the bloodstream makes the body’s metabolism hyperactive and affects many different parts of the body. As a result, Graves’ disease symptoms can be extremely varied.
Common signs and symptoms of Graves’ disease include:
- Anxiety and irritability
- A fine tremor of the hands or fingers
- Heat sensitivity and an increase in perspiration or warm, moist skin
- Weight loss, despite normal eating habits
- Goiter (enlargement of the thyroid gland)
- Change in menstrual cycles
- Erectile dysfunction or reduced libido
- Frequent bowel movements
- Graves’ ophthalmopathy (bulging eyes)
- Thick, red skin usually on the shins or tops of the feet (Graves’ dermopathy)
- Rapid or irregular heartbeat (palpitations)
- Sleep disturbance
- Chest pain
- Elevated blood pressure
- Increased sweating
- Muscle weakness
- Rapid or irregular heartbeat
- Shortness of breath or difficulty breathing
- Vision problems or changes
What are the treatment options for Graves’ disease?
The treatment goals for Graves’ disease are to stop the production of thyroid hormones and to block the effect of the hormones in the body.
Some treatments may include:
- Radioactive iodine therapy
- Radioactive iodine (radioiodine) is administered orally.
- This causes the thyroid gland to shrink, and the symptoms lessen gradually, usually over several weeks to months.
- Antithyroid medications
- Surgery to remove all or part of the thyroid (thyroidectomy or subtotal thyroidectomy) is also an option to treat Graves’ disease.
- After surgery, the patient will likely need treatment to reinstate the body’s normal amounts of thyroid hormones.
However, all these medications and surgery may come with certain potential complications. Doctors may decide which treatment suits the patient the best.
Graves’ disease is rarely life-threatening, but it can lead to serious heart problems, weak bones, the breakdown of muscle, and eye and skin diseases. These complications may decrease normal life expectancy if left untreated.
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WebMD. Graves’ Disease. https://www.webmd.com/women/understanding-Graves-disease-basics
American Thyroid Association. Graves’ Disease: https://www.thyroid.org/Graves-disease/
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