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Graves's disease

Graves’ disease is an autoimmune disorder that affects the functioning of the thyroid gland, causing hyperthyroidism (an overactive thyroid).

A man having his thyroid examined by a doctor

One of the most common of all thyroid disorders, Graves’ disease is a condition that originates within the body’s own immune system, which for reasons not yet entirely understood by medical science begins to produce antibodies that target the thyroid gland.

These antibodies mimic thyroid-stimulating hormone (TSH), a hormone naturally released by the pituitary gland in the brain, and as a result Graves’ disease causes the thyroid gland to make an excess of thyroid hormone (this is known as hyperthyroidism). This overabundance of thyroid hormone in the bloodstream cranks up the body’s metabolism of food into energy, resulting in many of the condition’s common symptoms.

What are its symptoms?

Onset of Graves' disease usually occurs in a person’s twenties or thirties. 

Manifesting with the classic signs of hyperthyroidism, Graves’ disease symptoms include:

  • Enlarged thyroid (goitre)
  • Insomnia
  • Hand tremor
  • Heart palpitations or rapid heartbeat
  • Sensitivity to heat
  • Increased sweating
  • Weight loss, despite increased appetite
  • Fatigue
  • Muscle weakness
  • Loss of libido
  • Menstrual irregularities
  • Frequent bowel movements

An estimated 30 percent of Graves’ disease sufferers experience eye problems. Known as Graves’ ophthalmopathy, this is characterised by swelling and inflammation around the eyes and sometimes bulging of the eye and vision problems. 

Graves’ dermopathy, marked by thickened red skin on the feet or shins, is another sign of Graves’ disease.

How is it diagnosed? 

The first step in reaching a Graves’ disease diagnosis is an assessment of your symptoms by your doctor who will look for signs of hyperthyroidism, as well as for indications of Graves’ ophthalmopathy and dermopathy, which distinguish it from other types of hyperthyroidism

A thyroid function test, performed using a blood sample, will be able to measure the levels of various thyroid-related hormones. Graves’ disease presents with low TSH levels and high thyroid hormone levels. 

A radioactive iodine uptake (RAIU) test may be employed to determine the thyroid’s uptake of iodine, which it uses to make hormones, the results of which can also signal Graves’ disease.

What are your treatment options? 

Graves’ disease treatment focuses on managing the levels of thyroid hormones in the body. Anti-thyroid drugs to inhibit the production of too much thyroid hormone may be prescribed, but it may be several months before you see any effect. During this time, the patient may be given a beta-blocker that is useful in controlling the symptoms of hyperthyroidism (particularly tremors, heart palpitations and anxiety). 

Radioactive iodine therapy is another option, whereby orally-administered radioactive iodine is used to gradually destroy the overactive cells of the thyroid gland. This treatment for Graves’ disease can result in an underactive thyroid (also known as hypothyroidism), meaning thyroid activity declines to a level where you may need to supplement the body with additional thyroid hormone.

Surgery to remove the thyroid entirely will also result in hypothyroidism, which can be medically managed.

Can it be prevented? 

An autoimmune disease, Graves’ disease is not brought about by outside infection but originates within the body, a malfunction of the immune system, which causes the body’s disease-fighting defensive system to target its own cells. 

As much remains to be understood about why this happens, there is little that can be done to prevent Graves’ disease. However, smokers with Graves’ disease are more likely to experience eye-related symptoms than their non-smoking counterparts, so quitting smoking is important. 

It’s also thought that stress and trauma can trigger the onset of Graves’ disease, so take steps to manage your stress levels.

IMAGE CREDIT: 123rf.com

The accuracy of this information was checked and approved by physician Dr Thomas Blake in July 2016