Graves’ Disease

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Graves’s disease was named after Robert J. Graves (Irish Doctor), circa in the 1830s[1]. Graves’ disease is an autoimmune condition caused by the malfunction of the thyroid glands by immune cells resulting in enlargement of the thyroid gland and overproduction of the thyroid hormone. The symptoms are mainly associated with the eyes, and treatments range from medications […] Read More

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Graves’ Disease

Graves’s disease was named after Robert J. Graves (Irish Doctor), circa in the 1830s[1]. Graves’ disease is an autoimmune condition caused by the malfunction of the thyroid glands by immune cells resulting in enlargement of the thyroid gland and overproduction of the thyroid hormone. The symptoms are mainly associated with the eyes, and treatments range from medications to diets. Also known as “Graves Eye Disease” or “Thyroid Eye Disease. ” This disease greatly affects multiple organs resulting in multiple organs dysfunction. It is mostly associated with the eyes, brain development, nervous system function, body temperature, etc. 

Diagnosis

To diagnose the disease, the Doctor will go through the medical history for a review and then perform a physical examination to identify the condition. After that, the following laboratory tests may be considered:
  1. Imagery Tests such as CT and MRI scans.
  2. Blood test: TSH (Thyroid Stimulating Hormone) test, Thyroid Stimulating Immunoglobulin is considered a diagnostic test in Graves’ disease.
  3. Radioactive Iodine Uptake test (RAIU): It measures the amount of iodine the thyroid gland absorbs. An increase in the level of iodine indicates Graves’ disease.
  4. Thyroid scan: Ultrasound image of thyroid gland shows: enlargement of the thyroid gland. Most useful in pregnant females.
  5. Tissue Biopsy

Treatment

To cure Graves’ disease, there is consideration of the following treatments:
  • Antithyroid medications: Methimazole, Propylthiouracil.
  • Beta-blockers
  • Radioactive Iodine Therapy
  • Surgery: Thyroidectomy is indicated in a larger thyroid gland or in cases where the nodule indicates a tumor.
  • Orbital decompression in case of opthalmopathy[2].
 

Recommended Diet

Foods to take
  • Berries: blackberries, blueberries, raspberries, etc.
  • Dairy products (source for calcium): cheese, milk, yogurt, etc.
  • Cruciferous vegetables: cabbage, broccoli, etc.
  • Food containing vitamin D: salmon, eggs, mushrooms, etc.
  • Protein foods: beans, nuts, chicken, turkey, etc.
  • Omega-3 fatty acids: fish, olive oil, walnut, etc.
  • Calcium rich food.
  • Low iodine food products
  • Food containing selenium, iron products
Foods to avoid
  • Caffeine: coffee, chocolate, tea, soda, etc.
  • Food allergens: wheat-based foods (gluten), soy, corn, etc.
  • Iodine containing food items: bread, seafoods, salt, sea vegetables.
  • Also, avoid meat and other animal products.
   

Symptoms

The following symptoms may be observed:

Tissue around the eyes is attacked, resulting in inflammation and swelling which causes:

  • Redness and pain.
  • Dry eye resulting in irritation.
  • Bulging of the eyes.
  • Increased pressure in the eye socket.
  • Deep headache as a result of eye pressure pains.
  • Poor vision.
  • Eye scarring and double vision.

Skin effects such as:

  • Thickened skin around the shin area.
  • Thinning of skin that causes easy bruising.
  • Skin injuries that heal slowly.
  • Acne.

Fatty deposits in areas such as 

  • The face; resulting in a round, moon-shaped face.
  • The midsection (abdomen).
  • Between the shoulders and upper back; resulting in a buffalo hump.

Stretch marks on the breast, arms, thighs, abdomen, etc, that appear purple or pink.

Other symptoms may include:

  • Hand tremors
  • Loss of weight
  • Fatigue and tiredness
  • Muscular weakness
  • Psychological changes such as depression, mood swings, irritability, nervousness, anxiety, etc.
  • Insomnia or sleeping inability.
  • Dehydration and heightened thirst
  • Prone to infections
  • Frequent urination
  • Diarrhea
  • Rapid heartbeat
  • High blood pressure and sugar.
  • Goiter
  • Osteoporosis
  • Erectile dysfunction
  • Inability to become pregnant.

Causes

The immune system's function in the body is to attack external invaders like bacteria and infections. It does this by producing antibodies. When excessive antibodies are produced, the immune system begins to fight against healthy tissues and cells in the body.

In Graves disease, the immune system produces excessive antibodies called thyroid-stimulating immunoglobulins and they begin to fight against healthy thyroid cells.

The factors that are likely to increase the risk of Graves disease include:

  1. Hereditary; risk of having the condition is high if family members have it.
  2. Other autoimmune diseases.
  3. Age; commonly found in people younger than 40
  4. Gender; females develop the condition more than males.
  5. High-stress level.

FAQ

  • Can Graves’ disease be cured naturally?

Lemon balm of the mint plant family is considered to be a treatment for Graves’ disease. In theory, it is said to have the ability to reduce thyroid-stimulating hormones (TSH).

Studies have linked certain spices including turmeric and green chilis to a reduced frequency of thyroid diseases such as hyperthyroidism and can be considered good treatments for Graves’ disease. Turmeric also has anti-inflammatory properties.

  • What is the best treatment for Graves’ disease?

Radioactive iodine treatment and antithyroid drugs have proven to be effective in slowing down thyroid hormone secretion, however, in some cases, surgery is the best approach for Graves’ disease..

  • Can Graves eye disease go away?

Graves’ disease often improves on its own by adapting to proper diet and continuing to take medications regularly. In some patients, however, symptoms may persist despite specific medications and treatment of the overactive thyroid gland.

  • How does Thyroid eye disease start?

It occurs when the body’s immune system attacks the tissue around the eyes causing inflammation in the tissues around and behind the eye. This results in irritation, redness, and pain, the eye bulges out causing starring and poor vision.

  • What is the prognosis for Graves’ disease?

Though the average treatment time for Graves’ disease is about 12 to 18 months, treatment can continue for many years in individuals who do not want radioactive or surgical treatment for their Graves’ disease.

 

 

References:

  1. Ellis H. Robert Graves: 1796-1852. Br J Hosp Med (Lond). 2006 Jun. 67(6):313. [Medline].
  2. Alsuhaibani AH, Carter KD, Policeni B, Nerad JA. Effect of orbital bony decompression for Graves’ orbitopathy on the volume of extraocular muscles. Br J Ophthalmol. 2011 Sep. 95(9):1255-8. [Medline].

 

Dr. Aruna