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· 22 Nov 2021

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What is Grave's Disease?

#Gravesdisease
#Grave’s disease is an autoimmune disease. Grave’s disease affects your thyroid gland, a butterfly-shaped organ found at the front area of your lower neck. Your thyroid gland is very key because it produces hormones that help your body regulate vital functions like sleep, mental health, fertility, body temperature, growth and development, and heart rate. This means that when you have Grave’s disease, your thyroid gland is impaired and cannot accomplish these functions. If you’re diagnosed with Grave’s disease, it means that your thyroid is producing excess hormones than body requirements. This most often leads to a disease called hyperthyroidism, which causes your body’s metabolism to speed up. Hyperthyroidism mostly occurs during middle adulthood but can also happen at any age. The disease affects 3% of the population and it’s 7-8 times more likely to affect women than men. Its peak age is between 40-60 years of age. Grave’s disease is the number one cause of hyperthyroidism.

What Causes Grave’s Disease?

Ideally, your immune system produces proteins known as antibodies to fight against foreign invaders like bacteria and viruses. In Grave’s disease, your body’s immune system creates antibodies that make your thyroid grow and produce an excess of thyroid hormone. We know these antibodies as Thyroid Stimulating Immunoglobulins (TSIs). The TSIs bind to your thyroid cell receptors, which are typically where Thyroid-Stimulating Hormone (TSH) attaches itself. The invading TSIs trick your thyroid into growing excessively and therefore release so many thyroid hormones, causing hyperthyroidism. Instead of your body producing antibodies to target specific invaders, your immune system by mistake produces TSIs. The TSIs then target your healthy thyroid cells.


What Are the Signs and Symptoms of Grave’s Disease?

Early signs of Grave’s disease differ from one person to another. These symptoms are often mistaken with symptoms of other diseases, therefore delaying the diagnosis and treatment. Before the diagnosis, people suffering from Grave’s disease notice that they cannot tolerate heat, are unintentionally losing weight, and have constant heart palpitations. In addition, the common early symptoms include:
●    Weight loss despite increased appetite. Why? Because the metabolism of food is quick, making you hungry and does not encourage the storage of any glucose in the food.
●    Tremors
●    Heat intolerance and sweating
●    Chest pinas, palpitations, and irregular heartbeats.
●    Shortness of breath and difficulty in breathing.
●    Muscles, weakness, and fatigue
●    Restless, irritability, anxiety, and mood swings.
●    Difficulty sleeping and disturbed sleep.
●    Increased stool frequency with or without diarrhea.
●    Reduced libido or erectile dysfunction.
●    Vitamin B12 deficiency.


How is Grave’s Disease Diagnosed?

Once you have visited a hospital, the doctor may recommend the following tests based on your symptoms.
Blood tests. These tests evaluate the levels of TSH in your bloodstream. TSH is a pituitary gland hormone that tells your thyroid to produce thyroid hormones. If someone has Grave’s disease, TSH will be lower than normal and your thyroid hormones levels will be higher. A blood test can also measure the level of antibody called thyrotropin receptor antibody (TRAb) that causes Grave’s disease.
Radioactive iodine uptake. Ideally, your body uses iodine to make thyroid hormones. In this test, you’ll be given a small amount of radioactive iodine to measure the rate at which your body absorbs it.
Ultrasound. An ultrasound uses high-frequency sound waves to produce images of your thyroid gland. This will show if you have an enlarged thyroid, which could mean you have Grave’s disease.


What is the Treatment for Grave’s Disease?

The principal goal for treatment is to stop the overproduction of thyroid hormones and their effects on your body. You can consider the following treatment options:

Radioactive iodine therapy. Doctors give this as a small single pill. When this pill is swallowed, the radioactive iodine enters your bloodstream and is absorbed by your overactive thyroid cells. In the end, the thyroid shrinks, and your levels of thyroid hormones return to normal.
Anti-thyroid medications. These drugs are also called antithyroid agents. They work by blocking the ability of your thyroid gland to produce new thyroid hormones. An outstanding example of these drugs is methimazole and is preferred because of its reduced side effects.
Surgery. Sometimes surgery can be performed if other treatment options are not effective. This procedure is called thyroidectomy and involves the removal of all or most of your thyroid gland. Surgery can also affect the parathyroid glands that regulate the production and absorption of calcium. It can also affect the nerves that control your vocal cords.
Beta-blocker medications. Your doctor may prescribe beta-blockers besides the ones mentioned above. These drugs do not affect your thyroid hormone levels but can help slow your heart rate and reduce other symptoms like nervousness and tremors.


What Are the Complications of Grave’s Disease?

Goiter. As your thyroid gland continues to grow bigger and bigger, without treatment, it looks swollen. The enlarged thyroid gland caused by Grave’s disease is known as diffuse thyrotoxic goiter. It gets bigger to an extent of causing difficulty in swallowing, coughing, and disrupted sleep.
Thyroid eye disease (TED). The eye problems linked to Grave’s disease are known as Grave’s ophthalmopathy or TED. It occurs in over 30% of people with hyperthyroidism and can run from mild to severe. Its characteristics include red eyes, tearing, a feeling of sand or dust in your eyes, and light sensitivity. As the disease progress, it can worsen to cause bulging of the eyes, a condition known as exophthalmos. This happens when Grave’s disease triggers an inflammation of the eye muscles, hence making the muscles and tissues swell. As the eye orbits continue to swell, they push the eyes forward, making someone look as if he/she is staring.
Skin thickening. Some people suffering from Grave’s disease may end up developing thick skin. They can also have skin lesions that appear to be patchy or pink. They mostly develop in the front of the legs and feet. This condition is also called pretibial myxedema.


Summary

Grave’s disease affects your thyroid gland, making it hyperactive. Without proper treatment, it can cause heart problems, weak and brittle bones, and pregnancy complications. If someone can seek treatment early, he/she can help lower the chances of health complications and live a normal life. Sometimes it may be hard for people with Grave’s disease to explain how they’re feeling because the disease is an overwhelming one. They may also not understand why they are sick, and it’s okay to feel that way. The only thing that can help them apart from medical treatment is family and friends’ support. Try to understand them as much as you can. Anytime you try to judge people with medical conditions, take a minute and put yourself in their shoes. Would you like to be treated the way you treat them? If not, be humane enough and extend your love to them.