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Graves' Disease

Named for the physician who first described it more than 150 years ago, Graves' disease is the most common cause of hyperthyroidism (overactive thyroid). It is an autoimmune disorder and occurs when the body's immune system mistakenly attacks the thyroid gland, causing it to overproduce the hormone responsible for regulating metabolism. The disease is hereditary and may develop at any age in men or women, but it is more common in women over the age of 20. Other risk factors include stress, pregnancy, and smoking.

Symptoms

With a high level of thyroid hormone in the bloodstream, the body's systems speed up and cause symptoms that are common to hyperthyroidism. Symptoms are not specific, which means they are common to other conditions, and can include:

  • Anxiety
  • Irritability
  • Fatigue
  • Increased or irregular heartbeat
  • Excessive sweating
  • Difficulty sleeping
  • Diarrhea or frequent bowel movements
  • Altered menstrual cycle
  • Enlarged thyroid (goiter)
  • Graves' ophthalmopathy
    • Bulging eyes
    • Reddening or inflamed eyes
    • Excessive tearing
    • Swelling eyelids
    • Light sensitivity
    • Ulcers, double vision, blurred vision (less common)
  • Graves' dermopathy(less common)
    • Reddening and swelling of the skin
Tests and Diagnosis

A simple physical exam can reveal an enlarged thyroid, irritated or bulging eyes, and signs of increased metabolism, including rapid pulse and high blood pressure. The doctor will also call for blood tests to check for high levels of thyroxine (T4) and low levels of thyroid-stimulating hormone (TSH), both of which are signs of Graves' disease. A radioactive iodine uptake might also be administered to measure how quickly the thyroid takes up iodine, which it needs to function properly. A high uptake of iodine is a sign of Graves' disease.

Treatment

There is no treatment to stop the immune system from attacking the thyroid gland and causing it to overproduce hormone. However, the symptoms of Graves' disease can be controlled in several ways, often with a combination of treatments. Beta blockers are medications used for rapid heart rate, anxiety, and sweating. Anti-thyroid medications are prescribed to prevent the thyroid from producing excessive amounts of hormone. And radioactive iodine is often administered to destroy all or part of the thyroid and render it incapable of overproducing thyroid hormone. Surgery to remove the thyroid gland is an option for patients who cannot tolerate anti-thyroid drugs or radioactive iodine. In most cases, successful hyperthyroidism treatment results in hypothyroidism, and patients must take hormone-replacement medication from that point forward.

Prognosis

If left untreated, Graves' disease can lead to heart problems, brittle bones, and, in rare cases, a condition called thyrotoxic crisis, which is an intensification of hyperthyroidism symptoms. But early detection is routine, and because Graves' disease responds well to treatment, the outlook for patients is usually positive. If treated with surgery, there is a very slight risk of damage to the vocal cords because of their proximity to the thyroid. In most cases after the initial treatment, patients can expect to be on a lifetime regimen of hormone-replacement medication, especially if all or part of the thyroid is removed during surgery.

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Written by: Ryan Wallace
Written: December 04, 2009
Last Updated: December 04, 2009
Published By: Healthline Networks Inc.
 
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