Graves’ disease

What is Graves’ disease?

Graves’ disease is a lifelong (chronic) autoimmune disease that affects a person’s thyroid gland. Someone with Graves’ disease will find that their thyroid produces too much thyroid hormone. It happens when the body makes antibodies to the gland. Graves’ disease can affect your:

  • Thyroid
  • Eyes
  • Skin

The disease is one of the most common causes of hyperthyroidism, or having an overactive thyroid. It additionally heightens your metabolism, which may make you feel like you cannot control your body. Speaking with a healthcare professional once you notice early symptoms makes a tremendous difference for your treatment and overall outlook.

How common is Graves’ disease?

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About 1% of people who live in the United States are affected by Graves’ disease. Women are five times more likely to develop the disease than men. Graves’ disease can be diagnosed and occur at any age, but the condition is most common in individuals who are aged 30 and older.

What are the symptoms of Graves’ disease?

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Symptoms of Graves’ disease tend to appear gradually over a period of several weeks, or even months. The onset of symptoms can also be as quick as appearing in a few days. Some of the symptoms may be isolated, but others can occur at the same time.

 

Common symptoms include:

  • Rapid heartbeat
  • Heat intolerance and excessive sweating
  • Anxiety or nervousness
  • Tremors
  • Shortness of breath
  • Weight loss
  • Diarrhea or frequent bowel movements
  • Enlarged thyroid gland
  • Thin, warm, and moist skin
  • Insomnia
  • Light menstrual bleeding
  • Fewer or absent menstrual cycles
  • Hair loss

 

When Graves’ disease affects your eyes and/or leads to thyroid eye disease, certain symptoms to pay attention for include:

  • Double vision
  • Bulging eyes
  • Light sensitivity
  • Gritty, irritated eyes
  • Pressure or pain in eyes

 

About 1 in 3 people living with Graves’ disease develop thyroid eye disease. It is important that you speak with a doctor as soon as you notice any of the above symptoms.

What causes Graves’ disease?

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When thyroid-stimulating immunoglobulin (TSI) attaches to healthy thyroid cells, the antibody causes the thyroid to overproduce hormones. There is no clearly defined trigger for whatever causes an immune system to attack the thyroid.

 

A few environmental factors that may play a role are:

  • Viruses and infections
  • Stress
  • Pregnancy
  • The postpartum period

 

Studies have also found that Graves’ disease has a strong hereditary link for individuals.

What are the risk factors for Graves’ disease?

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Although Graves’ disease is partially hereditary, meaning that biological family history can play a role in pre-determining your condition, there are external risk factors to be aware of so that you can possibly even address them. Known risk factors include:

  • Smoking
  • Selenium and vitamin D deficiencies
  • If estrogen is your main sex hormone
  • Having another autoimmune condition (i.e.: Type 1 diabetes, pernicious anemia)

 

Make sure that you take care of yourself as much as possible, which means getting regular check-ups from your primary care provider. Consistently monitoring your health will provide specialists with more information if your primary physician refers you to one.

Can Graves’ disease lead to complications?

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Unfortunately, yes, but it doesn’t need to get to that point if you seek early treatment. Leaving Graves’ disease untreated or undermanaged can lead to a person developing:

  • Heart problems (atrial fibrillation) that can lead to heart failure or stroke.
  • Osteoporosis, which can result in repeated bone fractures.
  • Thyroid storm, which is a rare but life-threatening complication where the thyroid releases excessive amounts of thyroid hormone in a short period of time.

 

Thyroid cancer is also a risk if Graves’ disease remains undiagnosed or untreated. It is especially important to treat Graves’ disease during a pregnancy to reduce the risk of:

  • Miscarriage
  • Preeclampsia
  • Premature labor
  • Low birth rate
  • Congestive heart failure in the mother
  • Hyperthyroidism in the infant

How is Graves’ disease diagnosed?

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For the most accurate diagnosis, your healthcare provider will start by:

  • Asking you about any symptoms
  • Reviewing your medical history (i.e.: a family history of thyroid disease)
  • Doing a physical examination

 

Specific tests that you may undergo to confirm a Graves’ disease diagnosis can include:

  • Thyroid blood tests
  • Thyroid antibody blood tests
  • Thyroid uptake and scan
  • A Doppler ultrasound

 

Undergoing a Doppler ultrasound is a non-invasive diagnostic method if you cannot swallow a small amount of radioactive iodine for a thyroid uptake due to pregnancy or breastfeeding. The best course of action is to speak to your doctor about the test(s) that they recommend for you.

How is Graves’ disease treated?

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Treating a chronic condition like Graves’ disease is manageable once you find a treatment method that regulates your thyroid hormone levels. The best medical care for your Graves’ disease might even result in temporary remission.

 

Effective treatments can include:

  • Beta-blockers (propranolol and atenolol). These are among the most common ways to treat Graves’ disease early on and can regulate your heart rate.
  • Antithyroid medications (methimazole and propylthiouracil). These medications help to block the production of the thyroid hormone.
  • Radioiodine therapy. Using this type of treatment can cause hypothyroidism, but it will return your hormone levels to normal by shrinking your thyroid gland.
  • Surgery. Undergoing a thyroidectomy requires the full or partial removal of a person’s thyroid gland. The treatment method can also lead to hypothyroidism (an underactive thyroid).

 

Using radioiodine therapy or having a thyroidectomy increases the likelihood of needing to take thyroid replacement hormone medications for the remainder of your life. However, if you speak with your doctor, they will likely discuss with you how hypothyroidism is easier to treat and how there are far fewer long-term health problems than hyperthyroidism.

All of the treatment options for Graves’ disease have associated benefits and risks. Speak in detail with your provider about what the best course of action is in your case. There is further nothing wrong with getting an additional opinion.

What is the outlook for Graves’ disease?

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The prognosis is good for people who receive prompt and comprehensive treatment for their Graves’ disease. Not receiving treatment can cause long-term complications that affect your overall health and/or life expectancy. Graves’ disease does not need to affect either of those things. Taking care of yourself starts by finding a reputable doctor that you trust and making yourself an appointment as soon as you notice sudden or gradual changes.

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