Grave's disease
Your thyroid is a butterfly-shaped gland in your neck, just above your collarbone. Thyroid hormones control the rate of many activities in your body. These include how fast you burn calories and how fast your heart beats. If your thyroid is too active, it makes more thyroid hormones than your body needs. This is called hyperthyroidism. Grave's disease, an autoimmune disorder, is the most common cause of hyperthyroidism. The symptoms can vary from person to person. Symptoms commonly caused by hyperthyroidism include:
· Being nervous or irritable.
· Mood swings.
· Fatigue or muscle weakness.
· Heat intolerance.
· Trouble sleeping.
· Hand tremors.
· Rapid and irregular heartbeat.
· Frequent bowel movements or diarrhea.
· Weight loss.
· Goiter, which is an enlarged thyroid that may cause the neck to look swollen.
Other symptoms are specific to Graves' disease and can include:
· Thickening and reddening of the skin on the shins.
· Bulging eyes.
· Blurry vision or vision loss.
· Double vision.
To diagnose Graves' disease, your doctor will look at your symptoms, blood tests and sometimes a thyroid scan. Treatment is with medicines, radioiodine therapy or thyroid surgery. No single treatment works for everyone.
INTRODUCTION
Graves’ disease is the most common cause of hyperthyroidism. Hyperthyroidism means an overactive thyroid gland. The thyroid is a butterfly-shaped gland in the neck. If your thyroid is too active, it makes more thyroid hormones than your body needs. This can affect many different parts of the body and cause a lot of health problems. Treatment may include medicines, surgery or other therapies. No single treatment works for everyone. This health information explains Graves’ disease. It talks about symptoms and causes of Graves’ disease, as well as how the condition is diagnosed and treated.
THE THYROID
The thyroid is a gland located at the front of your neck. It sits beneath your voice box, also called the larynx. The thyroid has two parts and is shaped like a butterfly. These parts are called lobes. The thyroid makes hormones. Thyroid hormone affects heart rate, blood pressure, body temperature and weight.
CAUSES
Graves’ disease is an autoimmune disease. This means the body’s immune system attacks the body’s own tissues by mistake. Normally the immune system helps keep us healthy by fighting germs and other foreign substances. But with an autoimmune disease, the immune system does not act normally. In Graves' disease, the immune system makes antibodies that cause the thyroid to make more thyroid hormone than the body needs. When this happens, it is called an overactive thyroid, or hyperthyroidism. Graves' disease is just one cause of an overactive thyroid gland. An overactive thyroid causes every function of the body to speed up. This includes the heart rate and metabolism. Metabolism is the rate at which your body turns food into energy. An overactive thyroid can also affect:
· Body temperature.
· Cholesterol levels.
· Muscle strength.
· Menstrual cycles in women.
· Weight.
There are many factors that can trigger the start of Graves’ disease. These include:
· Being pregnant within the last 12 months.
· Experiencing severe stress or emotional trauma.
· Having an infection.
Other risk factors for Graves’ disease include:
· Being female.
· Having certain genes.
· Having another autoimmune disease, such as lupus or rheumatoid arthritis.
Having a family history of autoimmune diseases also raises a person’s risk of developing Graves’ disease.
SYMPTOMS
Symptoms often begin in the 20s and 30s, although they can happen at any age. People with Graves’ disease may have common symptoms of hyperthyroidism, including:
· Fatigue or muscle weakness.
· Nervousness or irritability.
· Sensitivity to heat and increased sweating.
· Trouble sleeping.
Hyperthyroidism can also cause:
· Frequent bowel movements or diarrhea.
· Hand tremors.
· Rapid and irregular heartbeat.
· Unexplained weight loss.
In women, hyperthyroidism may affect the menstrual cycle. Women with Graves’ disease can experience:
· Lighter menstrual flow and less frequent periods.
· Problems getting pregnant.
In some people, hyperthyroidism and Graves’ disease can result in a goiter. A goiter is an enlarged thyroid that may cause the neck to look swollen. It may interfere with normal breathing and swallowing. Some symptoms of Graves’ disease are not seen in people with hyperthyroidism from other causes. These symptoms include:
· Eye problems.
· Thickening and reddening of the skin on the shins.
The eye problems caused by Graves’ disease are called Graves’ ophthalmology, or GO. Symptoms of GO include:
· Bulging eyes.
· Blurry vision or vision loss.
· Double vision.
· Dry, irritated eyes.
· Pressure or pain in the eyes.
· Sensitivity to light.
Talk to your health care provider if you notice any of these symptoms or other changes. Finding a problem early makes treatment easier in most cases.
DIAGNOSIS
Your health care provider will first ask about your symptoms. He or she will also ask about your family’s medical history in addition to your own. A physical exam will be performed. Your health care provider will feel your neck and thyroid gland. You may be asked to swallow to help them determine if the gland is functioning normally. A blood sample will be taken and sent to a lab for testing. Another test that may be done is called radioactive iodine uptake, or RAIU. An RAIU tells how much iodine the thyroid takes up. A high uptake suggests Graves' disease. This test can be helpful in ruling out other causes of an overactive thyroid. A thyroid scan may be done, as well. This test shows how and where iodine is distributed in the thyroid. With Graves’ disease, the entire thyroid is involved and the iodine shows up throughout the gland.
TREATMENT
There are 3 treatment options for Graves’ disease:
· Medicines.
· Radioiodine therapy.
· Surgery.
Medicines used to treat Graves’ disease keep the thyroid from making too much thyroid hormone. The medicines are generally not used for more than 1 or 2 years. In some people, the thyroid returns to normal when the medicine is stopped. But for most people, the overactive thyroid comes back. With radioiodine therapy, a pill that contains RAI is swallowed. RAI is a type of iodine that damages the thyroid by specifically delivering radiation to the overactive thyroid cells. The radiation destroys thyroid cells, resulting in less thyroid hormone being made. Radioiodine therapy cures an overactive thyroid. But you will likely need to take thyroid hormone for the rest of your life to replace the needed thyroid hormone your body can no longer make. Surgery is the third treatment option for Graves’ disease. Most or all the thyroid is removed to cure the overactive thyroid. As with RAI, you will need to take thyroid hormone to replace the needed thyroid hormone your body can no longer make. In addition to these treatments, your health care provider may also prescribe a beta-blocker. Beta-blockers are medicines that block some of the action of thyroid hormone on your body. This slows down your heart rate and reduces other symptoms. Beta-blockers work quickly. They can help you feel better while waiting for your treatment to work. Without treatment, Graves' disease can lead to many health problems. These include heart problems, weak bones and even death. It is important to get treatment for Graves’ disease and to follow your health care provider’s instructions.
SUMMARY
Graves’ disease is the most common cause of hyperthyroidism. Hyperthyroidism means an overactive thyroid gland. The thyroid is a butterfly-shaped gland in the neck. If your thyroid is too active, it makes more thyroid hormones than your body needs. This can affect many different parts of the body and cause a lot of health problems. An overactive thyroid causes every function of the body to speed up. This includes the heart rate and metabolism. An overactive thyroid can also affect:
· Body temperature.
· Cholesterol levels.
· Muscle strength.
· Menstrual cycles in women.
· Weight.
Blood tests and possibly a thyroid scan may be used to diagnose Graves’ disease. Treatment for Graves’ disease may include medicines, surgery or other therapies. No single treatment works for everyone.
