What is Graves’ disease?

GRAVES’ DISEASE is an autoimmune disorder that affects the thyroid gland. It causes the body to make too much thyroid hormone, and that condition is called hyperthyroidism, or overactive thyroid.

Thyroid hormones affect many organs in the body, so Graves’ disease symptoms also can affect those organs. Anyone can get Graves’ disease; however, it is more common in women and in people older than 30.

The thyroid is a small, butterfly-shaped gland in the front of your neck. Thyroid hormones control the way your body uses energy, so they affect nearly every organ in your body, even the way your heart beats.

It naturally produces enough thyroid hormone, using iodine from food sources, to help control metabolism, weight, body temperature, heart rate, menstrual cycles, and other bodily functions. Thyroid hormone production is managed by the pituitary gland, which makes thyroid-stimulating hormone, the hormone that essentially tells the thyroid to produce higher or lower hormone levels, based on the body’s needs at a given time.

According to Dr Orlando Thomas, medical doctor and functional medicine practitioner at Thomas Medical and Shockwave Centre, with Graves’ disease, the immune system produces antibodies that mistakenly cause the thyroid to make more thyroid hormones than your body needs. As a result, many of your body’s functions speed up.

“Grave’s disease often causes symptoms of hyperthyroidism and can affect your eyes and skin. Symptoms can come and go over time, and they can vary from person to person and may include weight loss, despite an increased appetite, rapid or irregular heartbeat, nervousness, irritability, trouble sleeping, fatigue, shaky hands, muscle weakness, sweating or trouble tolerating heat, frequent bowel movements and an enlarged thyroid gland, called a goiter,” Dr Thomas said.

The cause of Graves’ disease is not yet known, but researchers believe some people have a genetic predisposition to the condition, and may develop this autoimmune disease after being exposed to one or more external triggers including viral infections, bacterial infections, changes in hormone levels (in women), and having iodine levels that are higher than normal.

Increased risk

People who are at increased risk of Graves’ disease include smokers, women in the postpartum period, people who experience a lot of stress, people who receive highly active antiretroviral therapy, people who are exposed to high levels of iodine, and children with Down syndrome.

To confirm a diagnosis of Graves’ disease, your doctor may order one or more thyroid tests, and include your medical history, and also perform a physical exam to look for signs of Graves’ disease.

“Graves’ disease is not fatal, but complications may negatively impact a person’s overall health or life expectancy. When Graves’ disease is untreated or is not well controlled, some people may experience complications like arrhythmia, heart failure, or stroke. The condition may also increase the risk of osteoporosis and broken bones. Although there is no cure for Graves’ disease, treatments are available to help manage the condition,” Dr Thomas said.

There is no cure for Graves’ disease, but the following treatments may help manage the condition:

• Beta-blockers, which may reverse hyperthyroidism symptoms. This medication may slow a rapid heartbeat, reduce perspiration, and help to lower anxiety levels.

• Anti-thyroid medications, that alter the way the thyroid interacts with iodine, preventing the gland from producing thyroid hormone.

• Radioactive iodine treatments, which destroy a portion, or all, of the thyroid, preventing it from producing too much hormone. If the gland is completely destroyed, patients need to take thyroid hormone replacement medication for the rest of their lives.

• Surgery, during which all of the thyroid is removed (total thyroidectomy). Once the thyroid gland has been removed, thyroid hormone cannot be produced, thereby eliminating hyperthyroidism. If the entire gland is removed, patients will need to take thyroid hormone replacement medication for the rest of their lives.

People with Graves’ disease may be able to manage their condition with medication and other treatments. A small percentage of people with Graves’ disease, especially those with mild Graves’ disease, may go into remission. The remission may only be temporary, particularly among children.

keisha.hill@gleanerjm.comSOURCE: Thomas Medical and Shockwave Centre; Yale Medicine