Graves disease, named after Robert J. Graves, MD, is an autoimmune condition which affects the thyroid gland. Graves is one of the most common forms of thyroid dysfunction. While it is a serious condition and can lead to death if untreated, when properly cared for Graves is rarely fatal and straightforward to treat.
The thyroid gland produces hormones which control metabolism. When a person has an overactive thyroid it produces too many of those hormones and it causes the entire metabolic system to go into overdrive. Some of the tell tale symptoms of a thyroid malfunction are hot flashes and sensitivity to heat, pounding heart, delirium, overall weakness and fatigue, sweating, rapid unexplained weight loss, frequent bowl movements and trembling.
A goitre may form and frequently the thyroid gland will enlarge to twice its size or more. An additional symptom caused by swollen eye muscles that makes the eyeball protrude is also caused by Graves disease. Eye signs are not as common as the other indicators, however, so you should not rule out Graves if that condition is not present. A lesser degree of eye irritation that causes dry, red eyes may also be caused by Graves disease. Over time, if Graves is not diagnosed, the eye condition resulting from the swelling can become more serious and even cause full or partial blindness.
Another possible symptom that sometimes shows up is a thickening and redness of the skin in front of the tibia. The tibia is the large bone at the front of the lower leg. If this symptom is present it is usually painless and the severity of the symptom is not necessarily in proportion to the progression of the disease.
Graves can also cause disruption in a woman’s menstrual cycle, changing the timing or completely stopping it until treatment to get the illness under control.
Cause
The condition actually starts outside of the thyroid. Graves is an immune system abnormality. Thyroid Stimulating Immunoglobulins recognizes and binds to the thyrotropin receptor (TSH receptor). TSH is the hormone that tells the thyroid how much to produce. This mimics the TSH to that receptor and activates the secretion of thyroid hormones, thyroxine (T4) and triiodothyronine (T3). The result is very high levels of circulating thyroid hormones. The negative feedback regulation will not work for the thyroid gland.
Who Gets Graves Disease?
This disease is usually hereditary and is more common in women under 40 years of age. It affects up to 2% of the female population, sometimes appears after childbirth and occurs 7 to 8 times more often in women than in men. Genetic factors are a major factor accounting for possibly around 80% of the risk. Since Graves’ disease is an autoimmune disease which appears suddenly, it is thought that a viral or bacterial infection may trigger antibodies which cross-react with the human TSH receptor. This may trigger the start of Graves’ disease in individuals genetically prone to the disease.
Treatment for the Disease
Graves disease is completely controllable and usually goes into remission or even disappears completely over time. The most common treatment is a combination of antithyroid drugs, radioactive iodine and possibly removal of the thyroid gland.
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