What is Graves Disease ?
Graves disease (name after Irish doctor Robert James Graves who discovered this disease in 1835) is an immune system disorder that leads to the overproduction of thyroid hormones (hyperthyroidism).
Although the variety of disorders might result in hyperthyroidism, Graves’ disease is a common cause.
Graves’ disease might affect anyone, it’s more common among women and before the age of 40.
The main treatment goals are to restrain the overproduction of thyroid hormones and reduce the hardness of symptoms.
What Is Graves ophthalmopathy And Graves dermopathy ?
Graves Ophthalmopathy : It is an autoimmune disease defined by enlargement of the extraocular muscles and increase in fatty or connective tissue volume.
Graves dermopathy : It a skin condition characterized by red, swollen skin, usually on the shins and ace of the feet.
Graves Disease Symptoms
Graves’ disease symptoms are the same as hyperthyroidism symptoms.
However, individuals with Graves’ disease can also have other symptoms not associated with hyperthyroidism.
It can be a challenge to detect Graves’ disease early on. In fact, Graves’ disease is usually confused with other conditions, which may make it very tough to diagnose.
That’s why it’s necessary to concentrate on your symptoms to help your doctor make a correct diagnosis.
Here is the common signs and symptoms of graves’ disease :
♦ bulging eyes
♦ chest pain
♦ difficulty sleeping and/or insomnia
♦ elevated blood pressure
♦ hand tremors
♦ increased sweating
♦ irregular menstrual periods
♦ irritability or nervousness
♦ more frequent stools and/or diarrhea
♦ muscle weakness
♦ rapid or irregular heartbeat
♦ sensitivity to heat
♦ shortness of breath and/or difficulty breathing
♦ unexplained weight loss (typically despite an increase in appetite)
♦ vision problems or changes
♦ lumpy reddish patches and thickening of the skin of the shin
♦ neck to look swollen
Graves Disease Causes And Risk Factors
Graves’ disease is caused by a defect in the body’s disease-fighting immune system, though the precise reason why this happens remains unknown.
One normal immune system response is the production of antibodies designed to focus on a particular virus, bacterium or other foreign substance.
In Graves’ disease — for an unknown reason— the body generates an antibody to 1 part of the cells in the thyroid gland, a hormone-producing gland in the neck.
Normally, thyroid function is regulated by a hormone released by a small gland at the bottom of the brain (pituitary gland).
The thyrotropin receptor antibody (TRAb) Related to graves disease — acts like the regulatory pituitary hormone.
Which means that TRAb overrides the normal regulation of the thyroid, inflicting an overproduction of thyroid hormones (hyperthyroidism).
Who are at risk of graves disease
Many factors are thought to play a role in getting Graves’ disease. These may include:
Genes : Some people are at risk of Graves’ disease due to their genes. Researchers are working to search out the gene or genes involved.
Gender : Women are at higher risk of getting graves disease then man.
Stress : Severe emotional stress or shock may increase risk of getting gravels disease.
Pregnancy : pregnancy affects the thyroid. As many as 30 % of young women who get Graves’ disease are pregnant in the 12 months before the onset of symptoms.
This means that pregnancy may trigger Graves’ disease in some women.
Infection : Infection may play a role in the onset of Graves’ disease, however, no studies have shown infection to directly cause Graves’ disease.
Smoking : Smoking. Smoking Will Increase Risk of graves disease. Smokers who have Graves’ disease also are at doubled risk of having Graves’ ophthalmopathy.
Graves Disease Diagnosis
Physical test : Your doctor examines your eyes to see if they are irritated or protruding and looks to see if your thyroid gland is enlarged.
because Graves’ disease will increase your metabolism, your doctor can check your pulse and blood pressure and look for signs of tremor.
Blood sample : Your doctor can order blood tests to see your levels of thyroid-stimulating hormone (TSH), the pituitary hormone that usually stimulates the thyroid gland, as well as levels of thyroid hormones.
Individuals with Graves’ disease usually have less than normal levels of TSH and higher levels of thyroid hormones.
Another laboratory test measures the levels of the antibody which causes graves disease. This test usually is not necessary to create a diagnosis, however, a negative result may indicate another cause for hyperthyroidism.
Radioactive iodine uptake : Your body needs iodine to form thyroid hormones. your doctor will measure the rate at which your thyroid gland takes up iodine By giving you a small quantity of radioactive iodine and later measuring the amount of it in your thyroid gland with a specialized
Scanning camera : the amount of radioactive iodine taken up by the thyroid gland helps your doctor to verify which condition causes hyperthyroidism.
This test is also combined with a radioactive iodine scan to show a visual image of the uptake pattern.
Ultrasound : Ultrasound uses high-frequency sound waves to provide pictures of structures inside the body.
Ultrasound helps you to determine whether your thyroid gland is enlarged or normal in size, and is most helpful in people who not able to undergo radioactive iodine uptake, like pregnant women.
Imaging tests : If the diagnosis of Graves’ ophthalmopathy is not clear from a clinical assessment, your doctor could order an imaging test, like CT scan, a specialized X-ray technology that produces thin cross-sectional pictures.
Magnetic resonance imaging (MRI), that uses magnetic fields and radio waves to make either cross-sectional or 3-D picture, also may be used.
Gaves Disease Treatment
The purpose of treatment for Graves’ disease is to stop the production of thyroid hormones and to prevent the impact of the hormones on the body. Some treatments include:
Radioactive iodine therapy
With this therapy, you’re taking radioactive iodine, or radioiodine, by mouth. to stop overproduction of thyroid hormone, the doctor gives you radioiodine which destroys overactive thyroid cells.
This causes your thyroid gland to shrink, and symptoms reduce gradually, sometimes over many weeks to many months.
Radioiodine therapy could increase your risk of new or worsened symptoms of Graves’ ophthalmopathy.
This side effect is usually mild and temporary, however, the therapy might not be suggested if you already have moderate to severe eye issues.
Other side effects could include tenderness within the neck and a temporary increase in thyroid hormones.
Radioiodine therapy is not used for treating pregnant ladies or ladies who are breastfeeding.
By This treatment production of thyroid hormone is totally stop, later on, you need treatment to fulfill the need of thyroid hormone in your body.
Anti-thyroid medications interfere with the thyroid’s use of iodine to produce hormones. These prescription medications include propylthiouracil and methimazole (Tapazole).
Because propylthiouracil will increase your risk of liver disease, so Doctor prescribed methimazole (Tapazole).
When these 2 medicines are used alone, a relapse of hyperthyroidism could occur at a later time.
Taking the drug for longer than a year, however, could lead to better long-term results. Anti-thyroid medicine can also be used before or after radioiodine therapy as a supplemental treatment.
Side effects of both medicines include rash, joint pain, liver failure or a decrease in disease-fighting white blood cells.
Methimazole is not used to treat pregnant ladies within the first trimester due to the slight risk of birth defects. Therefore, propylthiouracil is the preferred anti-thyroid drug during the first trimester for pregnant ladies. when the first trimester, methimazole use is usually resumed and propylthiouracil is no longer prescribed.
These medications do not inhibit the production of thyroid hormones, however, they do block the effect of hormones on the body. they’ll provide fairly speedy relief of irregular heartbeats, tremors, anxiety or irritability, heat intolerance, sweating, diarrhea, and muscle weakness.
Beta blockers include:
Metoprolol (Lopressor, Toprol-XL)
Beta blockers are not given to people with asthma because the medicine could active the respiratory disease. These medicines can also harmful for the people with diabetes.
Surgery to remove all or part of your thyroid (thyroidectomy or subtotal thyroidectomy) is also a possibility for the treatment of Graves’ disease.
After the surgery, you will probably need treatment to provide your body with normal amounts of thyroid hormones.
Risks of this surgery include potential harm to the nerve that controls your vocal cords and the tiny glands placed adjacent to your thyroid gland (parathyroid glands).
Your parathyroid glands manufacture a hormone that controls the extent of calcium in your blood. Complications are rare under the care of a surgeon experienced in thyroid surgery.