Grave's disease
Grave's disease

The thyroid gland is a butterfly-shaped organ located in the lower part your neck. It uses the iodine found in foods and converts it into thyroid hormones: thyroxine (T4) and triiodothyronine (T3). Thyroid problems occur when there is a low production (hypothyroidism) or overproduction (hyperthyroidism) of hormones. Hyperthyroidism is caused by many risk factors and one among them is Graves’ disease.

Graves’ disease is an autoimmune disorder that affects the thyroid gland leading to hyperthyroidism or overproduction of thyroid hormones. It is also known as Basedow’s disease. It is commonly known as toxic diffuse goiter. It is the common cause of hyperthyroidism and is often diagnosed among women less than 40 years. The risk of Grave’s disease is associated with many factors like genes, gender, stress, pregnancy, and infections.

SYMPTOMS OF GRAVES’ DISEASE

The signs and symptoms include:

  • Anxiety
  • Hand tremors
  • Weight loss (even with normal eating habits)
  • Muscle weakness and fatigue
  • Goiter
  • Change in menstrual cycles
  • Insomnia
  • Reduced libido
  • Palpitations
  • Frequent bowel movements
  • Excessive sweating
  • Changes in vision
  • Thickening of the skin (rare)

A small percentage of people may experience Graves’ dermopathy and ophthalmopathy. People with Graves’ dermopathy may experience red and thick skin on the top of the feet. People with Graves’ ophthalmopathy may experience enlarged or bulging eyes.

TREATMENT OPTIONS FOR GRAVES’ DISEASE

The goal of the treatment is to inhibit the excess production of thyroid hormone and to treat the effect of hormones on the body. Some of the treatment options include:

Anti-thyroid medications

Propylthiouracil and methimazole are anti-thyroid medications used to treat Graves’ disease. These drugs are used for long-term therapy or to suppress the thyroid gland before the surgery.  Agranulocytosis (decreased white blood cell count) is a serious side effect seen with these drugs. Other side effects that can be seen are rash, peripheral neuritis, and joint pain. Methimazole is not prescribed for the pregnant women during the first trimester as it causes birth defects.

Beta-blockers

Beta-blockers such as propranolol, atenolol, metoprolol, and nadolol are used to treat Graves’ disease. These drugs do not inhibit the production of thyroid hormones, but they provide symptomatic relief. They treat symptoms such as irregular heartbeats, tremors, anxiety or irritability, heat intolerance, and sweating, etc. These drugs are not prescribed for the people with asthma.

Radioiodine therapy

It is the common treatment for Graves’ disease. In this therapy, radioactive iodine is administered orally. The iodine damages the overactive thyroid cells, thus leading to decrease in symptoms. As there is a decline in thyroid function, you may develop hypothyroidism. Therefore, your doctor prescribes thyroid hormone supplementation simultaneously with radioiodine therapy. This therapy is not recommended for pregnant women and individuals with moderate to severe eye problems.

Surgery

Surgery involves the removal of all or a part of a thyroid gland (thyroidectomy or subtotal thyroidectomy). This treatment is mostly used to treat young individuals and pregnant women. Your doctor may choose surgery if you have a large goiter or if thyroid cancer is suspected.  The potential risk factors that you may experience include damage to the vocal cords recurrent laryngeal nerve, or parathyroid glands.

Treatment for Grave’s ophthalmopathy

Your doctor may prescribe lubricating eye drops or non-steroidal anti-inflammatory drops in mild cases. In severe cases, corticosteroids such as prednisone can be prescribed to reduce eye irritation and swelling.

Undergo regular health check-up,s and if you experience any of the symptoms related to Grave’s disease, consult your doctor immediately. Early treatment can prevent further complications.

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