Graves’ disease is one of the common forms of hyperthyroidism. It affects about 1 in 200 people. This article will guide you through the information about Graves’ disease, its signs and symptoms, and its treatment.
Graves’ disease is an autoimmune disorder that results in a hyperactive thyroid gland. Graves’ disease is named after an Irish Physician Robert Graves who described this disease 150 years ago. Graves’ disease is more commonly noticed in women than in men.
The thyroid gland is a small butterfly-shaped gland that is located in front of your neck. These thyroid glands secrete thyroid hormones that control how your body uses energy. They nearly affect each and every organ in the body. They even control the way the heart beats.
In Graves’ disease, the immune system creates antibodies known as thyroid-stimulating immunoglobulins. These antibodies attach to the healthy thyroid cells. This can cause the thyroid to secrete more thyroid hormone than your body needs.
If this disorder is left untreated, then hyperthyroidism can lead to serious problems in the menstrual cycle, bones, muscles, heart, and fertility.
Graves’ disease can also affect your eyes and skin.
People who are more likely to develop Graves’ disease based on certain factors such as:
1) Age - People between the ages 30 and 50 are more likely to develop Graves’ disease, but it can occur at any age.
2) Gender - Women are more likely to develop Graves’ disease than men. It is about 7-8 times more common in women than men.
3) Autoimmune diseases - People with other autoimmune diseases are also at a higher risk of developing Graves’ disease. Autoimmune diseases like:
4) Hereditary - People with family members who had a history of Graves’ disease are more likely to develop Graves’ disease.
5) Stress - Stressful events may trigger the onset of Graves’ disease.
6) Pregnancy - Pregnancy or any recent childbirth may increase the risk of developing Graves’ disease.
7) Smoking - Smoking can affect the immune system, which in turn increases the risk of developing Graves’ disease.
The exact causes of Graves’ disease are still not known. It is also hard to determine who will get it. In Graves’ disease, the immune system produces antibodies called thyroid-stimulating immunoglobulins which will target the body’s own healthy thyroid cells. People can inherit the ability to produce antibodies against their own healthy thyroid cells. There is no proven cause for Graves’ disease.
Graves’ disease and hyperthyroidism have many similar symptoms. Symptoms like
Tachycardia (rapid heart rate).
Goiter (swelling of the thyroid gland).
Frequent bowel movements.
It occurs when the eyes are enlarged as a result of retraction of the eyelids. Eyes begin to bulge out from the eye sockets.
Certain reports say that 30 percent of people who develop Graves’ disease are likely to get a mild case of Graves’ ophthalmopathy. And about 5 percent of people with Graves’ disease may get severe Graves’ ophthalmopathy. The signs of Graves’ ophthalmopathy are,
- Bulging eyes.
- Pressure in the eyes.
- Pain in the eyes.
- Double vision.
- Vision loss.
- Reddened or inflamed eyes.
- Puffy or retracted eyelids.
People with Grave’s dermopathy may experience reddened and thickened skin on the shin or top of the feet.
Doctors will diagnose Grave’s disease based on the symptoms and findings during a physical examination.
Radioactive iodine uptake test
In case the diagnosis is uncertain, then the doctor may recommend further tests to confirm the diagnosis.
There are many treatments available for Graves’ disease. Graves’ disease is treated by inhibiting the overproduction of thyroid hormones by targeting the thyroid gland.
This antithyroid medication helps to prevent the thyroid gland from producing excessive thyroid hormones by stopping the oxidation of iodine in the thyroid gland. Medication can be prescribed for 12-18 months so that the condition does not come back. In certain cases, medications can be prescribed for a while longer.
The symptoms usually improve within four to six weeks of taking the medication. Antithyroid medication can be taken along with other therapies like radioactive iodine therapy or surgery.
Radioactive Iodine Therapy
Radioactive iodine therapy can be used to treat Graves’ disease. It is a non-invasive and very effective procedure. Iodine is used to produce thyroid hormones. Radioactive iodine can be taken orally, which directly targets the thyroid gland. The radioactive iodine slowly destroys the overactive thyroid cells.
Surgery is now very rare as the other treatments for Graves’ disease have steadily improved in treating the condition. Surgery is usually recommended when other treatments fail to improve the condition.
Thyroidectomy is in which part of the thyroid gland or whole of the thyroid gland is removed. It depends on the severity of the symptoms.
People after surgery may experience neck pain or weak voice. A scar may be present after surgery, depending on the type of surgery done. In case the whole thyroid gland is removed, then the body will not be able to produce thyroid hormones leading to a condition called hypothyroidism.
You need to discuss with your doctor and decide your diet. Foods that need to be avoided when having Graves’ disease:
Foods that contain gluten may make the treatment more difficult.
Excessive iodine intake may trigger the condition of hyperthyroidism.
Avoid meat and other animal products.
The foods that are good for people with Graves’ disease are
Vitamin D-rich foods.
Foods that are rich in Magnesium.
Foods containing Selenium.
Graves’ disease cannot be cured through the diet, but you can reduce the symptoms.
Graves’ disease is a common and serious disease of the thyroid. It gives discomfort both physically and mentally to the person who has it. Graves’ disease requires careful diagnosis and continuous monitoring. Graves’ disease, when treated properly, can be expected for the problem to be controlled and lead a normal life.
If curing does mean reducing the level of thyroid hormone in the blood, Graves’ disease can be cured with the help of thyroidectomy (surgical removal of the thyroid), antithyroid drugs, and radioactive iodine therapy. However, these can increase the chances of hypothyroidism which further requires treatment.
Graves’ disease seldom produces fatal complications, but it can lead to cardiac problems and bone disorders if left untreated, resulting in fragile and thin bones.
Graves’ disease is a condition characterized by a dysfunction in the immune system of the body. Although the cause is not clear, family history, type 1 diabetes mellitus, and rheumatoid arthritis increase the risk. Also, women in the reproductive age group are more prone to get the disease.
If not treated, Graves’ hyperthyroidism causes cardiovascular complications like heart attack, cardiac failure, and stroke. However, if the optimal level of the thyroid is maintained, it is unlikely to impact longevity. On the other hand, an elevated thyroid level will reduce the lifespan and increase the chances of early death.
- Seafood and its additives like crabs, prawns, sea fish, seaweed, lobster, sushi, agar, alginate, algae, etc.
Iodized salt and iodized water.
- Egg yolks and whole eggs.
- Milk and dairy products.
- Gluten-containing foods like wheat, barley, rye, malt, etc.
- Baked food items that contain iodine dough conditioners, like bread.
Graves’ hyperthyroidism worsens with time if left untreated and can lead to life-threatening complications which affect the person's quality of life. Graves’ ophthalmopathy profoundly varies with time; in some, it remains the same without any changes for years, while in others, it improves or worsens with time. It can also be associated with worsening periods and significantly improving periods.
In mild to moderate cases of Graves’ disease, Graves’ ophthalmopathy usually returns to normal spontaneously within a span of two to three years. However, rarely in some people, it worsens over the period.
Stress increases the production of cortisol hormone, which induces the thyroid gland to produce more thyroid hormone, thereby worsening hyperthyroidism. Recent researches have also found a correlation between stress management and its positive effect on the prognosis of Graves’ disease.
- Adequate intake of water.
- Proper sleep.
- Intake of fiber-rich food.
- Consume a gluten-free diet.
- Limit the consumption of processed and goitrogenic foods.
- Do regular exercises for at least an hour daily.
- Get to know the prescribed medications.
Graves’ disease is the leading cause of hyperthyroidism, with an increased predisposition to females. It has a prevalence rate of 0.5%.
Factors like family history, female sex, pregnancy, smoking, emotional or physical stress, less than 40 years of age, and other autoimmune conditions increase the risk of developing Graves’ disease.
Thyrotropin receptor antibody produced in Graves’ disease overregulates thyroid hormone production by acting as a regulatory pituitary hormone, which results in hyperthyroidism.
- Unexplained weight loss.
- Tremor of the hands and fingers.
- Irregular menstruation.
- Erectile dysfunction.
- Increased bowel movements.
- Enlarged thyroid gland.
- Heat sensitivity.
- Palpitations (irregular heartbeat).
- Eyeball protrusion.
- Thick, reddish skin on the feet.
Blood tests that measure the level of thyroid-stimulating hormone in blood, triiodothyronine, and thyroxine help diagnose Graves’ disease. If the diagnosis is uncertain even after that, imaging tests and other blood tests may be needed.
Graves’ disease itself is not a disability, but the arrhythmias which occur in Graves’ disease is a form of disability.
Last reviewed at:
12 Jul 2021 - 5 min read
Query: Hello doctor,I am a 35-year-old female and I have a history of Grave's disease, treated with radioactive iodine 15 years ago and have been on Levothyroxine ever since. I have symptoms of hyperthyroidism and hypothyroidism and my medication has been increased several times in the past due to high TSH... Read Full »
Query: Hi doctor, I am a 29 year old female. I am trying to conceive for almost a year. In this time, I have had three miscarriages at 4 weeks, 6 weeks and 5 weeks respectively. With my last pregnancy, I was also on Baby Aspirin 75 mg and Progesterone 400 mg. But, it did not make any difference. I have b... Read Full »
Query: Hello doctor, I had total thyroidectomy three months ago. I have been on 100 mcg Levothyroxine since day one. I feel always cold, body hair would shed more than normal, muscle cramps occur fairly easily, and low energy levels. I have had Graves disease in the past. My most recent blood work showed... Read Full »
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