Graves' disease is a disorder of the immune system resulting in the overproduction of hormones by the thyroid gland, or hyperthyroidism. Like most other immune system irregularities, its cause is unknown, though research to date has shown that heredity, age, gender and stress level are risk factors for the condition. Graves' disease is the most frequent cause of hyperthyroidism and is most common in women between 20 and 40 years of age. Graves' disease is usually treatable and may even resolve on its own in a few months. Left untreated, however, a severe case can become life-threatening. If you believe you have Graves' disease and are seeking treatment, call Southside Eye Care at (757) 484-0101 to schedule a consultation with our knowledgeable eye doctors!
What Is Graves’ Eye Disease, Also Known As Thyroid Eye Disease (TED)?
Graves’ disease is an autoimmune disease that affects the thyroid and, as a result, organs like the skin and eyes. It is characterized by abnormal enlargement of the thyroid (goiter) and the overproduction of thyroid hormone (hyperthyroidism). The hormones produced in the thyroid gland interact with many different systems of the body. For this reason, the specific symptoms of Graves’ disease can vary widely from person to person.
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What Health Problems Does Graves’ Disease Cause?
Thyroid hormones are involved in numerous bodily processes, including brain development, body temperature, and nervous system function. The hyperthyroidism caused by Graves' disease can contribute to physical and mental fatigue, feeling jittery or anxious, irritability, weight loss, and more. Because thyroid hormones support several biological functions, untreated hyperthyroidism can affect the menstrual cycle, fertility, muscle tissue, bones, and the heart. There is also a risk of what is called Graves’ ophthalmopathy.
Graves’ ophthalmopathy develops when the immune system attacks the muscle and tissue around the eyes. In Graves' ophthalmopathy, the eye sockets can become inflamed and swollen. This results in the retraction of the eyelids and eye bulging. When the eyes are affected by Graves' disease, symptoms such as light sensitivity, dry eyes, irritation, blurriness, and double vision may occur.
Symptoms Of Graves' Disease
Graves' disease causes many symptoms similar to those found in patients with other types of hyperthyroidism, but is the only form of hyperthyroidism to affect the eyes. About half of the patients with Graves' disease have eye symptoms, including: bulging eyes, dry eyes, pressure, pain, redness or puffiness of the eyes, excessive tearing, light sensitivity and double vision. Since the thyroid gland helps to regulate multiple organs and muscles, the other symptoms of Graves' disease are many and varied, affecting numerous parts of the body. Symptoms of Graves' disease may include:
- Trouble sleeping, fatigue, anxiety, irritability
- Sweating, rapid or irregular heartbeat
- Hand tremors, muscle weakness
- Sensitivity to heat
- Unexplained weight loss
- Goiter, an enlarged thyroid gland
- Change in menstrual cycles, erectile dysfunction, reduced libido
- Frequent bowel movements or diarrhea
- Eye problems, known as Graves' ophthalmopathy
- Thick, red skin on the shins or feet, known as Graves' dermopathy
What Is The Prognosis For Graves’ Disease?
People with hyperthyroidism caused by Graves' disease will require lifelong care provided by at least one specialist. While the thyroid will not regulate itself, consistent clinical management can keep the thyroid in check. As a result, patients may enjoy prolonged periods of remission during which symptoms are milder.
Is Graves’ Disease Curable?
It is difficult to say whether Graves' disease is curable because there are multiple perspectives on what this might mean. Certain treatments can "cure" hyperthyroidism by removing the thyroid gland altogether. However, this approach causes an equal and opposite condition, hypothyroidism, which would require the patient to take long-term medication to support the functions regulated by thyroid hormone.
Rather than say that Graves' disease can be cured, many experts prefer to call the condition treatable and manageable with ongoing clinical therapies and oversight by an experienced specialist.
Diagnosis Of Graves' Disease
Graves' disease can be diagnosed through physical examination, a blood test to determine the patient's serum level of thyroid hormones and imaging tests such as CT scan or MRI. Since the thyroid gland requires iodine to produce its hormones, the physician may also order a radioactive iodine uptake test.
Treatment Of Graves' Disease
Treatment for this disease depends on the severity of the disease and the patient's overall health, and may include: beta blockers, anti-thyroid medication, radioactive iodine and, if other methods fail, surgery.
Risks Of Graves' Disease
If left untreated, Graves' disease can result in a condition known as a thyrotoxic storm or thyrotoxicosis, a life-threatening emergency. During a thyrotoxic storm, the patient spikes an extremely high fever, has severe tachycardia and presents with extreme agitation, shaking, sweating and confusion. While a rare occurrence, a thyrotoxic storm may cause pulmonary edema, heart failure and death.
Is Graves’ Disease Hereditary?
People who develop Graves' disease may carry specific genes that make them more susceptible to this condition. These genes modify or weaken the response of the immune system. However, the genes that contribute to this disease also need a trigger to activate them. This is often an environmental factor, such as intense stress. Scientific studies have found that people with Graves' disease often have a family history of either autoimmune or thyroid problems, but not necessarily of Graves' disease specifically. For example, a person with this condition may have a family member who has hypothyroidism or another autoimmune disease, such as juvenile diabetes or vitiligo.
Is Graves’ Disease An Autoimmune Disorder?
Yes. The immune system makes specialized proteins called antibodies. These proteins act against foreign bodies like toxins and viruses. Antibodies might directly destroy microorganisms or may coat them so the white blood cells produced by the immune system can. The body makes specific antibodies to destroy specific substances, referred to as antigens. In Graves' disease, the immune system produces an abnormal antibody that mimics the function of normal thyroid-stimulating hormone. This antibody, thyroid-stimulating immunoglobulin, attaches to the surface of healthy thyroid cells and increases their production of thyroid hormones. The overproduction is what we call hyperthyroidism.