Graves Disease - Causes, Symptoms, Treatment

Published: 29th July 2008
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Graves' disease is the most common cause of overactive thyroid gland (hyperthyroidism). It is caused by an antibody that acts like thyroid-stimulating hormone (TSH) and causes the thyroid gland to produce excess thyroid hormones. This antibody has been given a variety of names and abbreviations including: TSH-receptor antibodies (TRAbs or TSH-Rabs), Thyroid Stimulating Immunoglobulins (TSI), Thyroid Binding Inhibiting Immunoglobulins (TBII) and Long Acting Thyroid Stimulator (LATS).

Graves' disease is one of the most common autoimmune diseases, affecting 13 million people and targeting women seven times as often as men. Patients with Graves' disease produce an excessive amount of thyroid hormone.

Causes

Graves' disease involves the immune system of the body. Normally, the immune system protects you from infection and abnormal body cells by recognizing and destroying cells using antibodies, which are produced by blood cells known as lymphocytes. In Graves' disease, the lymphocytes in the body's immune system produce antibodies that actually attack the body's own tissue instead of protecting. As a result of this attack, the antibodies cause the thyroid gland to overproduce thyroid hormones. Although 10 to 15 percent of the population have the type of immune system that can lead to Graves' disease, only about one in ten ever actually develop hyperthyroidism. Severe emotional stress is thought to be a factor in triggering the disease.

Symptoms

Patients with Graves' disease can exhibit a variety of symptoms related to hyperthyroidism, including diffuse goiter (enlarged thyroid gland), rapid pulse, weight loss and trembling. In addition, some patients with Graves' disease exhibit symptoms unique to this form of hyperthyroidism, including ophthalmopathy (bulging eyes) and rarely, pretibial myxedema (swelling of shins) (ATA, 2003). The symptoms of Graves' disease stem partly from hyperthyroidism and partly as a consequence of autoimmunity.

Generally, the symptoms of Graves' disease are identical to the symptoms of hyperthyroidism, a condition that can be caused by Graves' disease. Classic symptoms include an enlarged thyroid gland (goiter), nervousness, heat intolerance, weight loss, sweating, diarrhea, tremors, palpitations and exophthalmos (swelling of the tissue behind the eyeballs causing protrusion of the eyeball).

Treatment

There's no treatment to stop your immune system from producing the antibodies that cause Graves' disease. Treatments to control the signs and symptoms of Graves' disease are designed to decrease the production of thyroxine or to block its action.

Treatment with antithyroid medications must be given for six months to two years, in order to be effective. Even then, upon cessation of the drugs, the hyperthyroid state may recur. Side effects of the antithyroid medications include a potentially fatal reduction in the level of white blood cells. The development and widespread adoption of radioiodine treatment has led to a progressive reduction in the use of surgical thyroidectomy for this problem. In general, RAI therapy is effective, less expensive, and avoids the small but definite risks of surgery.

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