Do you feel like your heart is beating faster for no reason? Do you sweat even at the slightest thing? Do you lose weight even when you eat well? Do you sometimes feel very restless and anxious? If these things are common to you, the reason may be that a small butterfly-shaped gland in your body, the thyroid gland, is working a little too hard. Today we are going to talk about Graves' Disease, a condition that causes this condition, but can be well controlled if treated properly.
What is Graves' Disease, simply put?
Simply put, Graves' disease is a disease caused by a small mistake in our body's immune system. We call this an autoimmune disease . Normally, our immune system fights off germs that cause disease. But in this disease, our own immune system mistakenly attacks our own thyroid gland in our neck.
This attack stimulates the thyroid gland and causes it to produce too much thyroid hormone. This condition is called hyperthyroidism . It is like a car with the accelerator pedal pressed down, causing our metabolism to speed up. Graves' disease is the main cause of hyperthyroidism. It can also be hereditary. It can affect not only the thyroid gland, but also our eyes and skin.
What are the most common symptoms of this disease?
Because Graves' disease causes your body's metabolism to speed up, you may experience a variety of symptoms. Some people may have just one or two of these symptoms, while others may experience many of the things on this list. These symptoms don't appear all at once, but gradually develop over weeks or months.
| Symptom | A simple explanation |
|---|---|
| Rapid heartbeat (Tachycardia) | Feeling like your heart is pounding for no reason. |
| Heat intolerance and excessive sweating | You constantly feel hot and sweaty, even though it's normal for others. |
| Weight loss | Body weight is clearly reduced despite eating well. |
| Tremor | A subtle tremor in the hands. |
| Constant anxiety and restlessness | Constantly feeling anxious and restless. |
| Changes in the digestive system | Frequent bowel movements or needing to go to the bathroom more often than usual. |
| Swelling of the neck (Goiter) | Swollen appearance of the front of the neck due to an enlarged thyroid gland. |
| Insomnia and hair loss | Difficulty sleeping at night and hair loss. |
| Changes in the monthly menstrual cycle in women | Decreased menstrual bleeding, irregular or stopped menstrual cycle. |
If you have one or more of these symptoms, it's best to see a doctor for advice without worrying about it.
How does this affect the eyes and skin?
About one in three people with Graves' disease, although not everyone, will develop eye problems. This condition is called Graves' Orbitopathy or Thyroid Eye Disease .
- Bulging eyes
- Double vision
- A gritty, gritty feeling in the eyes
- Difficulty looking at light (Photophobia)
- Feeling of pressure or pain inside the eyes
In addition, a very small number of people (about 4%) may develop a condition in which the skin on their legs becomes thickened, lumpy, and discolored. This is called pretibial myxedema .
Why does Graves' disease occur?
As we discussed earlier, the main reason for this is a malfunction in our own immune system. Our body produces an antibody called Thyroid-Stimulating Immunoglobulin (TSI) . This TSI antibody attaches to the cells of the thyroid gland and sends the wrong signal to the gland to "make more hormones, make more."
Scientists have not yet discovered the exact reason why the immune system malfunctions in this way, but it is believed that two main factors contribute to this.
1. Genetics: If someone in your family has Graves' disease or other thyroid diseases, you are at higher risk of developing this disease.
2. Environmental Factors: Excessive stress, pregnancy and postpartum, and some viral infections can be a 'trigger', that is, an initial push, for the onset of this disease.
What are the dangerous conditions that can occur if left untreated?
Graves' disease is a medical condition that requires immediate medical attention . If left untreated or not managed properly, it can lead to serious complications.
- Heart disease: The risk of developing serious conditions such as irregular heartbeat ( Atrial Fibrillation - Afib ), heart attack, and stroke increases.
- Osteoporosis: Due to the effects of calcium levels in the body, bones become weak and prone to breaking easily.
- Thyroid Storm: This is a rare but potentially life-threatening emergency . In this condition, the thyroid gland releases a large amount of hormones into the bloodstream in a very short period of time. Symptoms include high fever, rapid heartbeat, and confusion. In such a situation, you should immediately go to the Emergency Department (ETU) of a hospital.
- Problems during pregnancy: If left untreated during pregnancy, it can affect both the mother and the baby in the womb. There are risks such as miscarriage, premature birth, and low birth weight.
How does a doctor accurately diagnose this disease?
When you go to see a doctor, he or she will ask about your symptoms, your family medical history, and perform a physical exam. They may then recommend several tests to confirm the diagnosis.
- Thyroid Blood Tests: These tests measure the levels of thyroid hormones (T4, T3) and TSH (thyroid stimulating hormone) in the blood. In Graves' disease, thyroid hormone levels are elevated and TSH levels are very low.
- Thyroid Antibody Tests: Checks for antibodies in the blood, such as TSI, which causes Graves' disease.
- Thyroid uptake and scan: A small amount of radioactive iodine is given to the patient to drink, and a scan is performed to see how much of the iodine is absorbed by the thyroid gland. In Graves' disease, the gland absorbs too much iodine.
- Doppler Ultrasound: If you are pregnant or breastfeeding, the radioactive iodine test is not recommended. In such cases, this scan can measure the blood flow to the thyroid gland and give an idea of the disease.
What are the treatments for Graves' disease?
Although Graves' disease is a lifelong (chronic) condition, treatment can help control hormone levels. Sometimes, the disease can go into temporary remission after treatment.
| Treatment method | What happens to it? |
|---|---|
| Beta-blockers | These do not reduce thyroid hormones, but they quickly control symptoms such as rapid heartbeat, tremors, and anxiety. They are used to provide relief until other treatments take effect. |
| Antithyroid Medications | Drugs such as Methimazole and Propylthiouracil inhibit the production of hormones by the thyroid gland. |
| Radioiodine Therapy | You are given a liquid or capsule containing radioactive iodine to drink. This iodine is absorbed by the thyroid cells and gradually destroys them, reducing hormone production. |
| Surgery | Thyroidectomy is a surgical procedure that removes all or part of the thyroid gland. |
After radioactive iodine treatment and surgery, a thyroid hormone deficiency, also known as hypothyroidism, often occurs. You will then have to take thyroid hormone pills for the rest of your life. However, hypothyroidism is much easier to manage than hyperthyroidism.
The important thing is that each of these treatment options has its pros and cons. It's important to discuss with your doctor which treatment option is best for you.
Take-Home Message
- Graves' disease is an autoimmune disease that can be well controlled with treatment, so don't be unnecessarily afraid.
- If you have symptoms such as heart palpitations, weight loss, excessive sweating, and anxiety for no reason, don't ignore them.
- If this disease is not treated, serious complications affecting the heart and bones can occur.
- Be sure to talk to your doctor to choose the best treatment for you.
- Once the disease is diagnosed, it is very important to follow the doctor's instructions exactly and to go to clinics on time.
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