Grave’s Disease

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Grave's Disease

Grave’s Disease is an autoimmune disorder that leads to the overproduction of thyroid hormones. The condition is called hyperthyroidism. Amongst the various causes of hyperthyroidism, Grave’s disease is the most common source. This disease is more common in women and people below 40 years of age.

Causes of Grave's Disease

A malfunction in the body’s disease-fighting system or immune system causes Grave’s disease. The immune system of our body normally produces antibodies that target specific bacteria, virus, or any foreign matter. However, in Grave’s disease, the immune system produces antibodies to one part of the cells in the thyroid gland (a hormone-producing gland present in the neck). Function of thyroid is usually regulated by a hormone released by pituitary gland (a tiny gland at the base of the brain). Thyrotropin receptor antibody (TRAb), an antibody associated with Graves’ disease behaves like the regulatory pituitary hormone. Because of this TRAb supersedes the normal thyroid regulation, causing an overproduction of thyroid hormones (hyperthyroidism).

Symptoms of Grave's Disease

The symptoms and signs of Grave’s disease can be:

  • Heat sensitivity
  • Anxiety
  • Fatigue
  • Increase in perspiration
  • Erectile dysfunction or reduced libido
  • Irritability
  • Bulging eyes (Grave’s ophthalmopathy)
  • Warm, moist skin
  • Palpitations (rapid or irregular heartbeat)
  • Frequent bowel movements
  • Fine tremors of the fingers or the hands
  • Weight loss
  • Sleep disturbance
  • Red, thick skin mostly on the top of feet or on the shins (Grave’s dermopathy)
  • Enlargement of the thyroid gland (goiter)

Diagnosis of Grave's Disease

Your doctor may perform a physical examination to check for the signs and symptoms of Grave’s disease and diagnose the condition. He or she might ask you about your family history and medical history.

  • Blood tests: Blood tests help in determining the levels of thyroid-stimulating hormone (TSH). TSH hormone is a pituitary hormone that stimulates the thyroid gland. Blood tests also determine the levels of thyroid hormones. If you are suffering from Grave’s disease, you might have a lower level of TSH than normal with high levels of thyroid hormones.
  • Ultrasound: It uses high-frequency sound waves for producing the images of structures present in the body. It reveals an enlargement in the thyroid gland. Many people, like pregnant women, who can’t undergo radioactive iodine uptake may find the test useful.
  • Radioactive iodine uptake: Your doctor will determine the rate of uptake of iodine by the thyroid gland by giving you some amount of radioactive iodine. He or she will measure the amount in the thyroid gland with the help of a specialized scanning camera. The doctor can determine whether the Grave’s disease or any other ailment is the cause of hyperthyroidism by determining the amount of radioactive iodine taken up by your body.
  • Imaging tests: Your doctor might recommend special imaging tests like an MRI or a CT scan.

Treatment options for Grave's Disease

The goal of the treatment is to stop the production of thyroid hormones and block the effect of these hormones on the body.

Radioactive Iodine Therapy

You take radioactive iodine (radioiodine) in your mouth under this therapy. The thyroid gland takes this radioiodine into its cells and the radiation destroys the overactive thyroid cells with the passage of time. Ultimately, your thyroid gland shrinks while reducing the symptoms within a few weeks to a few months. It may increase your risk of new or deteriorated symptoms of Grave’s ophthalmopathy. The treatment is not for breastfeeding women or pregnant women.

Anti-thyroid medications

These medications interfere with the use of iodine by the thyroid gland to produce hormones. Your doctor might prescribe you medications like methimazole and propylthiouracil. Methimazole (Tapazole) is the first choice of doctors while prescribing medications. However, for women in their first trimester, propylthiouracil is the first choice of drug. Hyperthyroidism may relapse if you use these two drugs alone without any additional treatment. If you take any of these drugs for more than a year, then it may show long-term results. You may also use anti-thyroid drugs before or after radioiodine therapy for supplemental treatment.

Beta blockers

Beta blockers do not inhibit thyroid hormone production. However, they block the effect of hormones on your body. They provide relief from tremors, heat intolerance, irregular heartbeats, sweating, muscle weakness, anxiety, diarrhea, and irritability. Asthmatics must refrain from taking these drugs as beta-blockers trigger an attack of asthma. They may also complicate diabetes treatment.

Surgery

Another treatment option for Grave’s Disease is thyroidectomy (removal of the thyroid) or subtotal thyroidectomy (removal of a part of your thyroid). You might need treatment to supply thyroid hormones in normal amounts after the surgery. The associated risk with this treatment is probable damage to the nerve controlling your parathyroid glands (tiny glands located near thyroid gland) and vocal cords. You might need to take lifelong thyroid medications after this surgery.

Lifestyle and Home Remedies

  • Releasing stress: Stress worsens or triggers Grave’s disease. So, easing your stress might be helpful. You can listen to music or take a warm bath to relieve stress. Take the help of your doctor to create a plan involving good exercise, proper nutrition, and relaxation in your regular schedule.
  • Eating well and exercise: Taking a balanced diet and exercising well helps to improve the symptoms during treatment. This makes you feel better. Weight-bearing exercises help to maintain bone density.

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