Graves Disease - Causes, Symptoms and Treatment

Peter Rodrick
Marked by nervousness and overstimulation, Grave's disease is the result of an overactive thyroid gland (hyperthyroidism). Thyroid hormones regulate metabolism and body temperature, and are essential for normal growth and fertility. But in excessive amounts, they can lead to the burn-out seen in this relatively common form of thyroid disease.

What causes Graves´ disease?

Normally, your immune system uses naturally occurring proteins (antibodies) and white blood cells (lymphocytes) to help eliminate viruses, bacteria and foreign substances (antigens) that invade your body.

Your thyroid is part of the endocrine system, which is made up of several glands and tissues that produce hormones. These chemical messengers coordinate many of your body's activities, from digestion to metabolism to reproduction. Thyroxine — a hormone produced by the thyroid — controls your metabolic rate.

Graves' Disease Symptoms

Patients with Graves' disease can develop hypersensitivity reactions resulting in hives, urticaria (itching), and angioedema, a type of swelling that often occurs on the neck, face, or hands. A condition of urticaria-related angioedema can also occur. Although common allergens and insect bites are often implicated, the cause of the hypersensitivity reaction can't always be determined.

Skin disease. In rare cases, people with Graves' disease develop Graves' dermopathy, a lumpy, reddish thickening of the skin in front of the shins. The condition is not serious and is usually painless. It is typically limited to the lower leg.

If left untreated, Grave's Disease can lead to more serious complications, including birth defects in pregnancy, increased risk of a miscarriage, and in extreme cases, death. Graves´ Disease is often accompanied by an increase in heart rate, which may lead to further heart complications.


Current Treatments:

Rather than targeting the immune response that causes Graves' disease, current Graves' disease treatments focus on restoring normal thyroid function by compensating for the hyperthyroidism of the disease. This is done either by radioiodine, antithyroid drugs, or surgery. The prevalence of each of these treatments varies regionally; each can be effective but also has potential side effects.

Graves Disease is autoimmune in nature. As the disease progresses, the excess thyroid hormone causes the immune system to malfunction, and attack various organs. A patients heart may become affected by excessive symptoms, causing palpitations, and the eyes may become bulgy, called Graves Disease orbitopathy, due to the muscles behind the eyes swelling and protruding, causing a "bug-eyed" appearance. Sometimes eye surgery is needed to relieve the pressure.

Monitoring and duration of therapy — Patients with Graves' hyperthyroidism taking a thionamide require careful monitoring. It is important to measure both serum thyroxine (T4) and triiodothyronine (T3), because serum T3 concentrations may remain high even though serum T4 concentrations become normal. The serum T3 to T4 ratio is particularly high in Graves' hyperthyroidism, and patients with so-called "T3-predominant" Graves' disease may respond less well to thionamide therapy and are less likely to attain prolonged remission.

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