As we near the end of Thyroid Awareness Month, let’s take some time to discuss another disease associated with the thyroid, Graves’ disease. While hypothyroidism disorders (such as Hashimoto’s thyroiditis) result in an inability to produce sufficient quantities of thyroid hormones, Graves’ disease creates the opposite problem. It leads to hyperthyroidism, or excess thyroid hormone production. About 50% to 80% of the hyperthyroidism cases in the United States are due to Graves’ disease.
What is it?
Graves’ disease is an autoimmune disease (meaning a disorder involving the body attacking itself) that causes the thyroid to overproduce thyroid hormones. This occurs when immunoglobulins bind to and activate the thyroid stimulating hormone (TSH) receptor, causing an enlarged thyroid and stimulating excess thyroid hormone production. Doctors typically diagnose this disease by examining blood test results. Individuals with Graves’ disease usually have high levels of the two most common thyroid hormones, thyroxine and triiodothyronine.
These thyroid hormones perform many important functions in the body, but overproduction could lead to anxiety, irritability, hand tremors, heat sensitivity, difficult breathing, fatigue, goiters, weight loss, erectile disfunction, heat sensitivity, or an irregular heartbeat. Graves’ disease can also lead to dermopathy and ophthalmopathy. Dermopathy is a skin condition that results in thick red skin and the formation of skin lesions. The appearance of dermopathic skin resembles the outside of an orange. Ophthalmopathy is an eye disorder in which the eyes protrude and the eyelids retract when opening or closing. This is an autoimmune response that leads to bulging eyes, blurry vision, infrequent blinking, and general irritation. If unmanaged in pregnant women, it can cause issues like high blood pressure, heart failure, miscarriage, premature birth, or fetus abnormalities. Graves’ disease patients typically have a higher risk for other autoimmune diseases and cancer than healthy individuals.
Risk factors for Graves’ disease include family history, gender, age, environment and the presence of other autoimmune diseases. It is much more likely to affect women than men, and it most commonly develops in people under the age of 40. Leaky gut syndrome can lead to a variety of autoimmune conditions, including Graves’ disease. Smoking, iodine exposure, and excessive physical and emotional stress have also been linked to an increased risk of Graves’ disease.
What can I do about it?
There are several treatment options available for Graves’ disease, but experts agree that no treatment option is ideal.1 Anti-thyroid medications can be prescribed to inhibit hormone production, but possible downsides to this treatment include poor adherence, high relapse rate, and side effects like joint pain, liver failure, and a weakened immune system. A thyroidectomy procedure can be performed to remove the thyroid entirely, but this usually results in a lifelong requirement to take hormone replacement drugs due to hypothyroidism. Radioactive iodine therapy is the most common treatment for Graves’ disease. The radioiodine enters overactive thyroid cells and destroys them over time. This will lessen Graves’ disease symptoms over time, but it also gradually shrinks the thyroid gland and will ultimately lead to hypothyroidism. Regardless of the chosen treatment, good nutrition, exercise, and stress reduction can help to lessen symptoms of Graves’ disease, so be sure to work with your doctor to incorporate them into your overall treatment plan.
1Streetman, D. D., & Khanderia, U. (2003). Diagnosis and treatment of Graves disease. The Annals of pharmacotherapy, 37(7-8), 1100–1109. https://doi.org/10.1345/aph.1C299
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