Graves disease is an autoimmune disorder that results in a condition called hyperthyroidism. This means that there is an overproduction of the thyroid hormone in the body.
Associated Anatomy
Thyroid Gland
Graves Disease Causes
There are no specific causes for autoimmune disorders as they are usually a result of genetic predisposition and environmental factors. There are no exact causes known yet for Graves’ disease. In this disorder, an autoimmune condition results in the overproduction of an antibody called thyroid-stimulating immunoglobulin (TSI), which causes excessive thyroid hormone production by the thyroid gland.
Signs or Symptoms of Graves Disease
The most prominent symptom of Graves’ disease is increased thyroid hormone. Other visible signs and symptoms include:
- Enlarged thyroid gland resulting in a condition called goitre
- Inflammation of the eyeballs that cause the eyes to protrude or bulge out of their sockets
- Insomnia or trouble sleeping
- Irregular heartbeats or arrhythmia
- Fatigue, nausea, weakness due to loss of weight
- Muscle weakness resulting in hand tremors
- Greater sensitivity to heat, or even heat intolerance
- Irregular menses in women
- Erectile dysfunction in men
Possible Treatment of Graves Disease
Since Graves’ disease is an autoimmune disorder, there is no treatment yet that can cure this condition. However, the visible signs and symptoms caused due to excessive thyroid hormone in the body can be reduced.
Medications
Anti-thyroid medications are not a permanent solution but are administered to decrease thyroid hormone production and, therefore, reduce the symptoms. Although typically used for blood pressure, Beta-blockers are given to alleviate symptoms.
Surgery
In cases where medication cannot yield any significant effect, surgery is recommended to remove the thyroid gland itself.
Radioactive therapy
In this therapy, radioactive iodine is given orally to patients, which on entering the body attacks some of the thyroid cells and kills them, thereby reducing the production of thyroid hormone. This may be used in combination with medications.
Risk Factors of Graves Disease
Autoimmune disorders are caused due to genetic predispositions combined with environmental factors. However, some other risk factors for Graves’ disease are:
Gender
Women are more susceptible to Graves’ disease than men.
Family history
A family history of thyroid problems or any other autoimmune disorder such as rheumatoid arthritis, type 1 diabetes, etc. can put one at more risk for Graves’ disease.
Existing diseases
Existing conditions like Celiac disease, Vitiligo, Pernicious Anaemia, or hormonal disorders like Addison’s disease can make someone more likely to develop Graves’ disease.
Graves Disease Stages
Graves’ disease does not progress over time unless it is left untreated. With proper medication and disease management, a healthy life is possible with Graves’ disease.
Typical Test of Graves Disease
Graves’ disease is diagnosed using routine thyroid tests like blood tests that detect the thyroid hormone levels, radioactive iodine tests, or an imaging scan of the thyroid glands. For confirmatory diagnosis, the doctors may run an antibody test that measures the thyrotropin-binding inhibitory immunoglobulins (TBII) antibodies and TSI.
Primary Prevention of Graves Disease
A primary prevention strategy is yet to be developed as there is no way of knowing the exact cause of Graves’ disease.
- People with existing thyroid conditions should avoid smoking or any other recreational activity that involves nicotine and should control their alcohol consumption.
- In certain patients with higher thyroid levels, studies recommend using external antibodies to neutralise the excessive thyroid hormone production and prevent hyperthyroidism.
Secondary Prevention of Graves Disease
For people with existing hyperthyroidism, secondary prevention includes:
- Screening for TSH antibodies
- Administration of radioactive iodine
- Treatment with thyroid medications
Graves’ disease is unlikely to progress if monitored regularly with appropriate medications and treatment.
Alternate Name
Toxic Diffuse Goitre
Differential Diagnosis of Graves Disease
Differential diagnosis of Graves’ disease from hyperthyroidism detects the presence of an enlarged thyroid gland and ophthalmological symptoms such as protruding eyeballs out of sockets. This condition is a complication of untreated Graves’ disease and is a differential symptom. Moreover, hyperthyroidism with anaemia, vitamin D deficiency and presence of TSI markers is a typical case of Graves diseas.
Epidemiology of Graves Disease
Graves’ disease is a rare autoimmune disorder, and is more likely to affect women than men. Typically, people in their 30s to 50s are more susceptible to Graves’ disease.
Expected Prognosis of Graves Disease
Graves’ disease is easily manageable with medication and constant attention. It does not increase the mortality rates of a person if appropriately managed.
Natural Progression of Graves Disease
If left untreated, Graves’ disease can result in a condition called Thyroid storm due to the excess of thyroid hormone in the body. This is a rare event. More common events of untreated thyroid are weakening of heart muscles, heart problems or brittle bones.
Pathophysiology of Graves Disease
Due to the disease’s autoimmune nature, the immune system of the body attacks the cells of the thyroid gland, and causes overproduction of TSIs. This causes the thyroid gland to produce excess thyroid hormone, which imbalances the body’s metabolism and may affect other organ functions.
Possible Complication of Graves Disease
A possible complication of Graves’ disease is osteoporosis. The thyroid hormone plays a crucial role in the metabolism of vitamin D and bone formation. Due to imbalanced hormone levels, metabolism is affected and osteoporosis may develop.
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