Are you feeling tired and out of sorts these days? Do you get anxious over the smallest things, do you feel like your heart is racing, and can't sleep at night? If you're losing weight despite eating well, you might be thinking that it's all because of overwork or stress. Of course, that could be the cause. But these symptoms could also be due to a problem with your thyroid gland, which is like a little butterfly in your neck. Today we're going to talk about one such condition, Graves' Disease. Don't worry, this is a manageable disease if you understand it properly.
Simply put, what is Graves' Disease?
Imagine that you have an army protecting your country. The job of this army is to protect the country from external enemies. Our body also has a similar defense system, which we call the immune system . But sometimes this defense system makes a mistake. Instead of an external enemy, they start attacking a good, healthy organ in our own body.
Graves' Disease is one such condition. What happens here is that our immune system mistakenly attacks our own thyroid gland . This attack causes the thyroid gland to become overactive and overworked. The amount of thyroid hormone it produces is much higher than the body needs. In medicine, we call this condition hyperthyroidism , or overactive thyroid. Graves' Disease is the main cause of this condition.
Although this is a lifelong (chronic) condition, with the right treatment, it can be well controlled and you can live a normal life.
Are these symptoms familiar to you?
Graves' Disease causes our body's metabolism, which is the rate at which energy is produced and used, to increase dramatically. It's like stepping on the accelerator of a car all the time. This can cause a variety of symptoms. Some people may only experience one or two of these symptoms, while others may experience many of these symptoms at once.
See the table below for what these characteristics are.
| Symptom | A simple explanation |
|---|---|
| Weight loss | Becoming thin even though you eat well and have an appetite. |
| Rapid heartbeat (Tachycardia) | It feels like your heart is beating fast, pounding, even when you're just standing there. |
| Heat intolerance and excessive sweating | Feeling unbearably hot and constantly sweating, even in an environment that is normal for others. |
| Anxiety and restlessness | Feeling anxious, restless, and easily angered for no reason. |
| Tremor | A subtle tremor in the hands. |
| Insomnia | The problem of not being able to sleep at night. |
| Swelling of the neck (Goiter) | A swelling and enlargement of the thyroid gland in the front of the neck. |
| Changes in the digestive system | Frequent bowel movements (diarrhea) or needing to go to the bathroom several times a day. |
| Changes in the menstrual cycle in women | Decreased menstrual bleeding or irregular/stopped menstruation. |
Can eyes and skin also be affected?
Yes, Graves' Disease can affect not only the thyroid gland, but sometimes the eyes and skin as well.
Effects on the eyes (Graves' Orbitopathy)
About one in three people with Graves' Disease may develop this condition. It is also called Thyroid Eye Disease . What happens here is that the immune system attacks the muscles and tissues around the eyes. Therefore,
- Bulging eyes: The eyes appear large and bulging.
- Feeling pain or pressure in the eyes.
- Itching as if there is sand in the eyes.
- Double vision.
- Difficulty seeing outdoors in bright light (Photophobia).
Skin effects (Graves' Dermopathy)
This is a rare condition. It involves thickening of the skin on the legs, especially the shins, and taking on a red or purple color with bumps. It is also called Pretibial Myxedema .
Why do we get Graves' Disease?
As we discussed earlier, the main reason for this is a malfunction in our own immune system. Due to this malfunction, the body produces a type of antibody called Thyroid-Stimulating Immunoglobulin (TSI) . These TSI antibodies attach to the cells of the thyroid gland and send the wrong signal to the gland to "make more hormones, make more."
Scientists are still not 100% sure why the immune system malfunctions in this way, but they believe there are several factors that contribute to this.
- Genetic Factors: Research has found that 79% of Graves' Disease is caused by our genes. This means that if someone in your family (mother, father, siblings) has thyroid disease or other autoimmune diseases, you are at higher risk of developing the disease.
- Environmental Factors: The remaining 21% of risk comes from environmental factors. That is,
- Stress: Long-term, severe stress can be a cause of autoimmune diseases like this.
- Pregnancy and childbirth: This condition can occur with hormonal changes in the body during pregnancy and after childbirth.
- Viruses and infections: This disease can occur after certain viral infections, as the immune system functions differently.
- Smoking: People who smoke are at a much higher risk of developing Graves' Disease. Not only that, if a smoker develops this disease, the effects on the eyes (Graves' Orbitopathy) can be very severe.
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, it can lead to serious complications.
- Heart disease: Increased thyroid hormones put a lot of strain on the heart. This can lead to atrial fibrillation (Afib), a condition in which the heart beats irregularly. This increases the risk of heart attack and stroke.
- Osteoporosis: High thyroid hormone levels cause a decrease in the amount of calcium in the bones, making them thinner and more easily broken.
- Thyroid Storm: This is a very dangerous and potentially life-threatening emergency. What happens is that the body suddenly releases a very large amount of thyroid hormones. Symptoms include high fever, rapid heartbeat, sweating, confusion, and vomiting. If these symptoms occur, you should be taken to a hospital's Emergency Treatment Unit (ETU) immediately.
- Problems during pregnancy: If Graves' disease is not controlled during pregnancy, it can cause problems for the mother and baby. It can lead to miscarriage, low birth weight, premature birth, and high blood pressure in the mother (preeclampsia).
How does the doctor diagnose this disease?
If you have the symptoms mentioned above, the first thing you should do is see a doctor. He or she will take a detailed look at your symptoms and family medical history. Then, they will order some tests to confirm the diagnosis.
- Thyroid Blood Tests: These check the levels of thyroid hormones (T3, T4) and TSH (thyroid-stimulating hormone) in your blood. In Graves' Disease, thyroid hormone levels are usually elevated and TSH levels are very low.
- Antibody Blood Tests: This test can confirm whether you have the TSI antibodies we talked about earlier in your blood.
- Thyroid Uptake and Scan: In this test, a small amount of radioactive iodine is given to you in the form of a pill. The thyroid gland of someone with Graves' Disease absorbs a large amount of this iodine. This can be seen with the scan.
- Doppler Ultrasound: This scan is done because pregnant or breastfeeding mothers cannot receive radioactive iodine. It measures the speed of blood flow to the thyroid gland. This speed is very high in Graves' Disease.
What are the treatments?
Graves' Disease is a manageable condition. There are several treatments available. You should discuss with your doctor which treatment is best for you.
| Treatment method | What happens? | What to know |
|---|---|---|
| Beta-blockers | These medications do not lower thyroid hormone levels, but they quickly control symptoms such as rapid heartbeat, trembling hands, and anxiety. | It is primarily given to control symptoms until other treatments are effective. |
| Antithyroid Medications | These medications (e.g. Methimazole, Propylthiouracil) block the production of hormones by the thyroid gland. | You may need to take these medications for months or years. Some people may even go into remission. |
| Radioiodine Therapy | Radioactive iodine, given as a capsule or liquid, gradually destroys cells in the thyroid gland, causing the gland to shrink. | After this treatment, hypothyroidism often occurs, requiring lifelong thyroxine therapy. |
| Surgery (Thyroidectomy) | Surgery removes part or all of the thyroid gland. | If the gland is completely removed, you will need to take thyroxine pills for the rest of your life. This is a good option for people who have difficulty breathing due to an enlarged gland (goiter). |
You might think that hypothyroidism, after treatment, is also a disease. Yes, it is a disease. But it is much easier to control than hyperthyroidism, and there are fewer long-term health problems.
Take-Home Message
- Graves' Disease is not something to be afraid of, but it is a treatable and controllable condition.
- If you experience symptoms such as unexplained weight loss, rapid heartbeat, trembling hands, excessive sweating, and restlessness, be sure to see a doctor.
- If someone in your family has thyroid disease, you are also at risk, so be careful.
- Once treatment begins, it is very important to take the medication as prescribed by the doctor and to go for follow-up appointments.
- If you develop symptoms of a 'thyroid storm' such as high fever, rapid heartbeat, and confusion, it is an emergency. Go to a hospital's Emergency Department (ETU) immediately.
💬 අදහස් (0)
තවමත් කිසිදු අදහසක් පළ කර නොමැත. ඔබේ අදහස පළමු වරට මෙහි එක් කරන්න.
ඔබේ අදහස එක් කරන්න