Graves Disease is a condition that affects the thyroid. The thyroid is a gland that produces hormones responsible for controlling metabolism, Thyroxine (T4) and Triiodothyronine (T3) (Medline Plus, 2024). It is a small butterfly shaped gland and is located in the neck (Cleveland Clinic, Thyroid, 2026). Graves Disease is a chronic, autoimmune condition that causes the thyroid to make too much thyroid hormone, Hyperthyroidism (Medline Plus, 2024). Graves Disease is more common among women, as well as individuals over 30 years old (Mayo Clinic, 2024).
Grave's Disease is caused by the immune system producing antibodies against the thyroid. These antibodies cause the thyroid cells to work overtime causing them to overproduce and release thyroid hormones (Cleveland Clinic, 2026)(Mayo Clinic, 2024).
Because the overproduction of thyroid hormones affect all other organ systems, the symptoms of Graves Disease are widespread. Symptoms include:
- Nervousness
- Irritability
- Slight tremor in fingers and hands
- Heat sensitivity
- Weight loss despite increased hunger
- Goiter - enlarged thyroid gland
- Menstrual changes
- Erectile dysfunction
- Decreased Libido
- Increased bowel movements
- Graves Opthalmopathy (Thyroid Eye Disease) - includes: bulging of eyes, double vision, gritty eyes, eye pain and pressure, photophobia - light sensitivity
- Grave's Dermopathy - thick discolored skin
- Fatigue
- Heart palpatations
- Insomnia
- Hair loss
- Dyspnea - shortness of breath
- Tachycardia - rapid heartbeat
- Muscle weakness (Medline Plus, 2024)(Mayo Clinic, 2024)(Cleveland Clinic, 2026),
There are several risk factors for Graves Disease. Risk factors include:
- Family history - often family history of either thyroid conditions or autoimmune conditions raise risk of Graves Disease
- Sex - women are at increased risk
- Age - increased occurence between 30 - 60 years of age
- Other autoimmune conditions
- Smoking - increases risk
- Selenium and Vitamin deficiences (Medline Plus, 2024)(Mayo Clinic, 2024)(Cleveland Clinic, 2026).
Several exams/tests should/can be done in order to diagnose Grave's Disease. Firstly, a physical exam, medical history and family history should be performed. Tests that can be conducted in order to diagnose includes:
- Blood tests - Thyroid Stimulating Hormone (TSH), T3 and T4 levels. TSH levels, produced by the pituitary gland, are lower, while T3 and T4 levels are higher.
- Radioactive iodine uptake - scan of thyroid after ingesting a small amount of radioactive iodine and shows the rate of iodine uptake by the thyroid.
- Thyroid antibody blood test
- Doppler Ultrasound - looks for increased blood flow in thyroid. Can be used during pregnancy when Radioactive iodine uptake cannot be performed
- Orbit CT Scan (Medline Plus, 2024)(Mayo Clinic, 2024)(Cleveland Clinic, 2026).
Several treatments can be used for Grave's Disease. Treatment can either stop hormone production in the thyroid or block the effect of the hormones within the body (Mayo Clinic, 2024). Treatments include:
- Radioactive iodine therapy - destroys thyroid hormone producing cells causing them to shrink. May increase risk of Thyroid Eye Disease. Cannont be used with pregnant women.
- Anti-Thyroid medications - blocks iodine from being used by thyroid to produce hormone.
- Beta Blockers - block the effects of hormones within the body. Cannot be used with individuals with asthma or diabetes.
- Thyroidectomy - surgery where thyroid is removed.
- Treatments for Thyroid Eye Disease
- Corticosteroids - decreases inflammation behind eyeballs and delivered through vein.
- Teprotumumab (Tepezza) - delivered through IV every three weeks
- Prisms - used in eye glasses to correct for double vision.
- Orbital Decompression Surgery - orbit bone between the eye socket and orbital sinuses are removed increasing space for eyeballs to move into usual placement. Used if pressure on optic nerve increases possibility of loss of vision.
- Orbital Radiotherapy - X-rays destroys some tissue behind eyes (Medline Plus, 2024)(Mayo Clinic, 2024)(Cleveland Clinic, 2026).
Complications may occur due to Grave's Disease. If it is untreated or undermanaged, the likelihood of the complications occuring increases. Complications od untreated Grave's Disease include:
- Pregancy concerns - miscarriage, premature delivery, fetal thyroid issues, poor fetal growth, heart failure in mother, pre-eclampsia
- Heart Conditions - irregular heart rhythms, heart failure
- Thyroid Storm - development of hyperthyroidism is accelerated and the sudden increase in thyroid hormones can cause fever, sweating, confusion, delirium, severe weakness, tremor, irregular heartbeat, severe low blood pressure, and coma. Is a medical emergency.
- Brittle bones - increased thyroid hormones makes it difficult for Calcium to move into the bones. (Medline Plus, 2024)(Mayo Clinic, 2024)(Cleveland Clinic, 2026)
For Grave's Disease resources, visit:
References
Cleveland Clinic (2026) Grave's Disease. Cleveland Clinic. Retrieved from https://my.clevelandclinic.org/health/diseases/15244-graves-disease#diagnosis-and-tests
Cleveland Clinic (2026) Thyroid. Cleland Clinc. Retrieved from https://my.clevelandclinic.org/health/body/23188-thyroid
Mayo Clinic. (2024) Grave's Disease. Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/graves-disease/symptoms-causes/syc-20356240
Medline Plus (2024) Grave's Disease. Medline Plus. Retrieve from https://medlineplus.gov/ency/article/000358.htm
No comments:
Post a Comment