Graves' Disease

Graves' disease affects the immune system that attacks healthy thyroid gland tissue and causes hyperthyroidism (overproduction of thyroid hormones). The name of the condition was coined by Irish physician Robert Graves, who wrote about it for the first time in the 1800s.

The reason for Graves' disease is unknown.

• The thyroid is a tiny, butterfly-shaped endocrine gland located at the front of the neck and is protected by the skin.
• The thyroid secretes several hormones to maintain metabolism (the pace at which your body turns food into energy).

The signs and symptoms of Graves' disease appear gradually over weeks or months. Hyperthyroidism due to Graves' disease accelerates some bodily functions. Some of these symptoms might be present for you at once, while others might not.

Symptoms of hyperthyroidism include:

• Feeling unsteady and/or anxious
• Losing weight
• Difficulty sleeping, such as insomnia
• Enlarged thyroid gland (goiter)
• Experiencing diarrhea or more frequent bowel movements
• Hair loss and texture changes (brittle)
• Sweating excessively and heat intolerance
• Rapid heartbeat (palpitations)
• Increased appetite
• Thin, warm, and moist skin
• Menstrual changes
• Muscle weakness

Other signs of ocular disease due to Graves' disease include:

• Bulging eyes
• Gritty, irritated eyes
• Pressure or pain in your eyes
• Blurred or double vision
• Swelling of the tissues around the eyes or puffy eyes
• Light sensitivity

Eye complications due to Graves' disease are called thyroid eye disease or Graves' ophthalmopathy or orbitopathy. This disorder only manifests in about one-third of people with Graves' disease. If you have these symptoms, you must visit your eye doctor (optometrist or ophthalmologist).

Pretibial myxedema, also called Graves' dermopathy, is a lumpy, reddish thickening of the skin on the shins that occurs infrequently in persons with Graves' disease. Although it is primarily moderate and harmless, some people may experience pain.

Even though Graves' disease can affect anyone, a few things can make it more likely to occur, such as:

• Gender: Compared to men, women have a higher risk of developing Graves' disease.
• Age: People younger than 40 years typically get Graves' disease.
• Other autoimmune diseases: There is a higher risk for people with other immune system diseases, including type I diabetes or rheumatoid arthritis.
• Emotional or physical stress: In people with genes that raise their risk, stressful life experiences or illnesses could lead to the development of Graves' disease.
• Family history: Because a family history of Graves' disease is a known risk factor, there is likely a gene or genes that can make a person more susceptible to the disorder.
• Smoking: Increases the risk of Graves' disease because it might impair immunity. Graves' ophthalmopathy is more likely to occur in smokers with Graves' disease.
• Pregnancy: Recent childbirth or pregnancy may raise the risk of the condition, especially in women who have genes that make them more susceptible.

The major treatment goals for Graves' disease include decreasing the synthesis of thyroid hormone and preventing the hormones' impact on the body.

Several treatments include:

• Radiation therapy: Uses a single dose of radioactive iodine in liquid or pill form. Over two to three months, radiation gradually kills thyroid gland cells (other body parts do not get exposed to radiation). The thyroid gland shrinks, and hormone levels return to normal. Pregnant or nursing individuals should not get this therapy. If you receive this treatment, you may eventually develop hypothyroidism (an underactive thyroid), which necessitates medication. Hypothyroidism is more accessible to treat and less detrimental to long-term health than hyperthyroidism.
• Beta-blockers: Propranolol and metoprolol are frequently used as the first line of treatment for Graves' disease. Until other hyperthyroidism therapies act, these drugs control heart rate and protect the cardiovascular system. They do not stop the production of thyroid hormones.
• Antithyroid medications: Propylthiouracil and Tapazole (methimazole) prevent the thyroid from producing thyroid hormone. Low white blood cell counts and skin rashes are unusual adverse effects of these medications, which increase your risk of infection. Some people rarely develop liver diseases.
• Surgery: A thyroidectomy entails the surgical removal of the complete or part of the thyroid gland. Some produce insufficient thyroid hormone following surgery, leading to hypothyroidism. They may need to take Synthroid (levothyroxine) or other thyroid replacement hormone drugs for life.

Treatment for Graves' ophthalmopathy

For moderate Graves' ophthalmopathy symptoms, use over-the-counter artificial tears all day long and lubricating gels at night.

If the symptoms are more severe, the doctor might advise the following:

• Corticosteroids
• Tepezza (teprotumumab)
• Prisms
• Orbital decompression surgery
• Orbital radiotherapy

Graves' ophthalmopathy does not always show immediate improvement with treatment. Symptoms may even get worse for three to six months. Then, the symptoms usually normalize and get better for a year or more, often without treatment.

Treatment for Graves’ disease frequently works successfully. Underactive thyroid is frequently brought on by either thyroid surgery or radioactive iodine (hypothyroidism).

Hypothyroidism can result in the following if thyroid hormone replacement medication is not used properly:

• Depression
• Physical and mental sluggishness
• Gaining weight
• Constipation and dry skin
• Cold intolerance
• Abnormal women's menstrual cycles