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Graves' Disease: Causes, Symptoms, Risk factors, Complications, Diagnosis and Treatment

The thyroid gland secrete two main types of hormones: thyroxine (T-4) and triiodothyronine (T-3), which affect each cell of the body by maintaining the rate of consumption of fats and carbohydrates, and help control the body temperature and heart rate, And regulating the production of proteins.

The thyroid gland also excretes Calcitonin, which regulates calcium levels in the blood.

Hyperthyroidism can occur due to a number of medical conditions, including:
  • Graves' Disease
  • Toxic adenoma
  • Plummer's Disease
  • Thyroiditis
Today we will talk more in detail about Graves' Disease:

Graves-Disease
Source: homeopathyplus.com
Graves' Disease is an autoimmune disease that affects the thyroid gland, which is the most common cause of hyperthyroidism und Thyroid hypertrophy. Graves Disease usually affects women between the ages of 20 and 40.

Causes

Graves Disease is caused by an imbalance in the body's immune system, although the exact cause of the disease is still unknown.

The response of the immune system to a healthy person is to produce antibodies designed to target a particular virus, bacteria, or other foreign substance. With Graves Disease, the body produces, for reasons that are not fully understood, an antibody to one part of the cells in the thyroid gland.

Thyroid function is usually regulated by a hormone produced by the pituitary gland, and the antibody in Graves Disease (TSH receptor autoantibodies TRAb) plays a role such as the role of the pituitary hormone, which means that the antibody to the TSH receptor autoantibodies (TRAb) Beyond the normal regulation of thyroid gland, causing excessive secretion of thyroid hormones.

Symptoms
  • Anxiety and irritability
  • Simple tremors in the hands or fingers
  • Sensitivity to heat and increased sweating or warmth and moisture in the skin
  • Enlarged thyroid gland (goitre)
  • Change in menstrual cycles
  • Erectile dysfunction or decreased libido
  • Frequent defecation
  • Graves ophthalmopathy (also known as thyroid eye disease (TED), dysthyroid/thyroid-associated orbitopathy (TAO), Graves' orbitopathy (GO)
  • Fatigue
  • Increase the thickness and redness of the skin usually in the legs or higher feet (Graves' dermopathy)
  • Increased heart rate or irregularity (palpitations)
  • Thyrotoxicosis may cause unexplained weight loss due to increased metabolic rate
Risk factors
  • Family history
  • Sex: Women are more susceptible to the disease
  • Age: Graves Disease usually develops in people under the age of 40.
  • Other autoimmune disorders increase the risk of disease (type 1 diabetes or rheumatoid arthritis)
  • Emotional or physical stress: may be the beginning of the launch of Graves Disease in genetically predisposed persons
  • Pregnancy or childbirth (especially among women who are genetically predisposed)
  • Smoking: (Also, smokers with Graves Disease are more at risk of developing Graves ophthalmopathy)
Complications
  • Pregnancy complications: may result in miscarriage, preterm delivery, fetal thyroid failure, delayed fetal development, heart failure, or preeclampsia
  • Heart problems: In the absence of treatment, Graves Disease can cause heart arrhythmias, changes in the heart muscles and function and the inability of the heart to pump enough blood to the body (congestive heart failure)
  • Thyroid storm: a rare complication of Graves Disease, but life-threatening and requires submission to immediate medical care
  • Osteoporosis: Bone strength depends in part on the amount of calcium and other minerals in it. The overlap of excess thyroid hormone with the body's ability to integrate calcium into bones leads to osteoporosis
Diagnosis
  • Physical examination.
  • Blood tests: to determine the thyroid-stimulating hormone TSH levels and levels of thyroid hormones, (usually people with disease Graves suffer from low levels of thyroid-stimulating hormone, high levels of thyroid hormones)
  • Radioisotope of iodine uptake
  • Ultrasound: To determine whether the thyroid gland is overgrown (it is more useful in people who can not be subjected to radioisotope of iodine uptake, such as pregnant women)
  • Imaging tests MRI & CT: (if Graves ophthalmopathy was not clear from clinical assessment)
Treatment
The goal of the treatment is to inhibit the production of thyroid hormones and to prevent the effect of the hormone on the body. Some treatment methods include:
  1. Radioactive iodine therapy: Because of the need of the thyroid to iodine to produce hormones, radioactive iodine spreads in the thyroid cells. Radioactivity destroys hyperactive thyroid cells over time, resulting in thyroid contraction and gradual reduction of symptoms. This usually takes several weeks to Several months
  2. antithyroid drugs: Beta-blockers (Propranolol-atenolol): These drugs do not prevent the production of thyroid hormones but inhibit their effects on the body such as arrhythmias, diarrhea, muscle weakness, etc.
  3. Surgery: Thyroidectomy or partial thyroidectomy (mostly after surgery, the patient will need to be treated to supply the body with a normal amount of thyroid hormones)
Note 1: Graves ophthalmopathy occurs in 30% of people with Graves Disease, where inflammation and other immune system conditions affect the muscles and other tissues around the eyes. Signs and symptoms may include:
  • bulging eyes (exophthalmos)
  • The feeling of sand in the eyes
  • Pressure or pain in the eyes
  • Shrinkage of eyelashes
  • Red eyes or inflammation of the eyes
  • Sensitivity to light
  • Double vision
  • Loss of sight
Treatment of graves ophthalmopathy includes corticosteroids and surgery to reduce pressure on the eye

Note 2: Graves' dermopathy
One of the unusual manifestations of Graves Disease

It is a reddening of the skin and the increase of its thickness, often in the legs or higher feet.

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