Graves’ disease is an autoimmune disorder that leads to an overactive thyroid – known as hyperthyroidism. The thyroid lies near the windpipe at the base of the throat and is a butterfly-shaped gland. It produces important hormones such as triiodothyronine (T3) and thyroxine (T4), which plays an important role in the metabolic process.
A feedback system that includes the pituitary gland is responsible for regulating the production of thyroid hormones. The pituitary is a pea-sized organ, and it lies at the base of your brain. Thyroid-stimulating hormone or TSH is made in the pituitary to stimulate the thyroid gland to produce T3 and T4. When one has Graves’ disease, the immune system will make an autoantibody named thyroid-stimulating immunoglobulin or TSI. TSI acts like TSH and tells the gland to produce too much T3 and T4. The thyroid gland will enlarge over time due to this reason.
The National Institute of Health states that Graves’ disease affects 1 in 200 patients in the United States. The condition is eight times more common in women than men. This condition mostly affects people between the ages of 30 and 50 years. But it can occur in children as well as the elderly. People with a family history of the condition or those who suffer from another autoimmune disorder like type-1 diabetes, rheumatoid arthritis, lupus, or pernicious anemia are at a higher risk of developing Graves’ disease.
Other Risk Factors
- Recent childbirth
- Trauma or emotional stress
- Infection with Epstein-Barr virus – the virus that is responsible for causing mononucleosis (mono)
Symptoms and Complications
Graves’ disease has a wide range of symptoms. Most of them are mild and could go unnoticed at first. But they develop slowly and worsen over time. Different individuals may experience a different combination of symptoms at different times. Here are some common symptoms:
- Problems with vision
- Fatigue and tiredness
- Difficulty in focusing
- Eye irritation and tearing
- Goiter or an enlarged thyroid gland
- Hand tremors
- Frequent bowel movements
- Heat sensitivity
- Decreased sex drive or erectile dysfunction
- Sleeping difficulties
- Muscle weakness
- Irregular menstrual periods
- Irregular heartbeat – arrhythmia or palpitations
- Reddening and thickening of the skin on tops of the feet or shins
- Nervousness and restlessness
- Delayed growth and puberty in children
- Increased appetite but unexplained weight loss
Graves’ can cause a condition known as Graves’ ophthalmopathy or exophthalmos. The condition causes swelling behind the eyes and makes them bulge outward. It can dry and irritate the eyes and affect the vision of the individual. It can also damage the cornea and the optic nerve – which can result in vision loss over time. This complication can affect more than 30% of patients who are diagnosed with Graves’. Smoking is a risk factor for this complication.
A woman with Graves’ disease – untreated – can pass the thyroid autoantibodies to her baby during pregnancy. The baby will suffer from temporary hyperthyroidism once it’s born. Long-term exposure to excessive thyroid hormones can result in osteoporosis. Sudden increases in thyroid hormones could result in a thyroid storm or thyrotoxic crisis – which can be life-threatening at times.
Graves’ is diagnosed based on the symptoms such as an enlarged thyroid or goiter or bulging eyes. But 50% of patients suffering from the condition may not have obvious signs and symptoms. A laboratory test can confirm the diagnosis of the condition. Lab tests are also performed to evaluate the health of the gland.
One or more lab tests are performed to determine whether your thyroid gland is functioning properly. Here are some of the tests:
Your healthcare provider will order the above tests periodically to monitor hormone production and thyroid function.
The lab tests used to diagnose Graves’ disease or separate it from other autoimmune diseases include: (These tests will determine the presence of thyroid antibodies)
- TRAb or Thyroid stimulating hormone receptor antibody – This is a less specific test than TSI
- TSI or thyroid-stimulating immunoglobulin – Graves’ disease is diagnosed with the presence of this antibody
- Anti-TPO or Anti-thyroid peroxidase antibody – This is an autoantibody found in most people who suffer from Graves’ disease as well as Hashimoto thyroiditis.
If you are suffering from Graves’ disease, the above laboratory tests will help diagnose the condition.