Graves’ Disease
Affects the function of the thyroid
| Download this episode | Graves’ disease is an autoimmune disease that affects the function of the thyroid, which is a small, brownish red gland in the lower neck that’s shaped like a butterfly. The thyroid makes hormones that help regulate a wide variety of critical body functions. For example, thyroid hormones control the way your body uses energy, so they affect nearly every organ in your body, even the way your heart beats. In people with Graves’ disease, the thyroid is overactive and makes more hormones than the body needs. As a result, many of your body’s functions speed up. If left untreated, Graves’ disease can cause osteoporosis, heart problems, and problems getting pregnant and during pregnancy. The disease is named after Irish surgeon Robert James Graves, who described this form of hyperthyroidism in 1835. It’s estimated that around 1 in 100 Americans suffer from the condition, which usually appears in mid-adulthood, although it may occur at any age. | Anyone can get the autoimmune disorder Graves’ disease although it’s more common in women and in people older than 30. You are more likely to develop the disease if you have a family history of the disease or you have another autoimmune disorder, such as rheumatoid arthritis, type 1 diabetes, pernicious anemia or lupus. Severe emotional stress or trauma may trigger Graves’ disease. Mothers who have recently given birth are at an increased risk for the disorder, since pregnancy affects the thyroid gland. The risk of developing Graves’ disease is seven times higher in the year after giving birth, which suggests that pregnancy might trigger the disease in some women. Infection may play a role in the development of Graves’ disease as researchers have found a link between Graves’ and infection with the virus that causes mononucleosis. Smoking is a leading risk factor for the eye problem seen in Graves, called Graves’ opthalmopathy. | Some of the more common symptoms of Graves’ disease, an immune system condition that affects the thyroid gland, include tremors and palpitations, which are a fast beating or fluttering heart. Changes in your menstrual cycle, not sleeping well, a fast or irregular heartbeat and having a slight tremor of the hands or fingers are other symptoms. Bulging eyes, light sensitivity and blurred or double vision, a condition called thyroid eye disease or Graves’ opthalmopathy, is another possible sign of the disease. Graves’ disease often causes the symptoms of hyperthyroidism, which is also called an overactive thyroid. In older adults, hyperthyroidism is sometimes mistaken for depression or dementia. Older adults may have different symptoms, such as loss of appetite or withdrawal from people, than younger adults with hyperthyroidism. You may want to ask your doctor if you or your loved one shows any of these symptoms. | To properly diagnose Graves’ disease, a physical exam as well as some other tests are necessary. Dr. Donald Lee Bodenner, director of the UAMS Thyroid Center, says a thyroid function test checks the patient’s blood for levels of the main thyroid hormone, T4, and the thyroid-stimulating hormone TSH. A high level of T4 plus a low level of TSH is a sign of an overactive thyroid gland. Sometimes, routine screening of thyroid function shows mild overactive thyroid in a person without symptoms. When this happens, a doctor may suggest treatment or watchful waiting to see if levels return to normal. An antibody blood test looks for antibodies that suggest Graves’. A radioactive iodine uptake test tells how much iodine the thyroid gland is using. The thyroid gland uses iodine to make thyroid hormone. Higher levels of iodine suggest hyperthyroidism. Dr. Bodenner says this test can also help rule out other possible causes of an overactive thyroid. | There are several ways to treat Graves’ disease. The Food and Drug Administration has approved two medicines, methimazole, or MMI, and propylthiouracil, or PTU, both of which keep the thyroid gland from making too much thyroid hormone. Radioactive iodine is a type of iodine that damages the thyroid gland by giving it radiation. The RAI destroys thyroid cells so that your thyroid gland cannot make as much thyroid hormone. This cures the overactive thyroid gland, but it can lead to underactive thyroid gland. If this happens, you will need to take thyroid hormone for the rest of your life. As with RAI, surgery cures an overactive thyroid but it can lead to an underactive thyroid. You will need to take thyroid hormone to replace the needed thyroid hormone that your body can no longer make. Your doctor may also suggest you take a medicine called a beta blocker. They slow down your heart rate and reduce symptoms such as shaking and nervousness.
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More common in women and people over 30
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Tremors and palpitations
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Watchful waiting warranted
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Several methods of treatment
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