Grave’s disease is the most common cause of hyperthyroidism.  It is an autoimmune disorder that causes the immune system to attack healthy thyroid cells. 

Your immune system triggers the increase in making TSI, or thyroid  stimulating immunoglobulin.  The TSI attaches to healthy thyroid cells, which causes there to be an overproduction.  This raise in TSI can be triggered by stress, a virus, an infection, or pregnancy. 

Hyperthyroidism is when your thyroid is overactive.  The thyroid gland has an overproduction of thyroid hormones.  This can affect your overall health including systems like your heart, skeletal muscle, eyes, skin, bones, and liver. 

 

Risk Factors

Women are at higher risk of getting Grave’s disease.  You are also at higher risk if you have a family history of the condition as well as if you have one of the following other autoimmune conditions, rheumatoid arthritis, Lupus, type 1 diabetes, celiac disease, or vitiligo. 

 

Symptoms 

Symptoms of Grave’s disease can take weeks to months to develop.  They develop very slowly over time.  Symptoms can include, anxiety, irritability, hand tremors, heat sensitivity, weight loss, enlarged thyroid gland, chance in menstrual cycles, reduced libido, frequent bowel movements, bulging eyes, fatigue, thick skin, irregular heartbeat, rapid heartbeat, sleep disturbances, or hair loss. 

Out of every one in three people who have Grave’s disease they can develop Grave’s ophthalmopathy, which is an eye condition.  Symptoms of Grave’s ophthalmopathy may start before or during the symptoms of hyperthyroidism.  Symptoms of Grave’s ophthalmopathy are bulging eyes, irritated eyes, puffy eyes, light sensitivity, pressure in the eye, and blurred vision.  Symptoms are usually mild, and they can develop even if your hyperthyroidism has been treated.  

Another symptom you may experience is Grave’s dermopathy.  Which is when the skin on the shins or tops of your feet become reddish, thick, and rough.  

 

 

Diagnosis

Your doctor can run a few tests to diagnose you with Grave’s disease.  They will probably first start with a physical exam and a medical history. 

A thyroid blood test can be done to check the level of thyroid hormone in your blood.  Another thing your doctor will want to check is your TSH, thyroid stimulating hormone, levels.  TSH is usually suppressed when you have Grave’s disease.  So a low number of TSH means that your thyroid is overproducing. 

READ MORE: Thyroid Tests – What Do High TSH Levels Mean?

A thyroid antibody test may also be done.  This test helps identify the types of autoimmune thyroid conditions. 

A radioactive iodine uptake test is another way to diagnose Grave’s disease.  In this test you will take a small amount of radioactive iodine orally.  Then your doctor will measure the amount of iodine in your thyroid.  If your thyroid has absorbed a lot of the iodine that is a sign of Grave’s disease. 

A doppler ultrasound of the thyroid gland can also detect increased blood flow in the thyroid.  If none of these tests work, your doctor may want to run a CT scan or an MRI to get a better look at your thyroid gland. 

 

Treatment Options

Grave’s disease is a chronic condition.  So the goal of treatment is to stop thyroid hormone production, and to control or lessen the symptoms caused by hyperthyroidism. 

One of the first options of treatment is a Beta blocker.  Beta blockers like propranolol, or metoprolol will help regulate the heart rate.  These beta blockers do not stop thyroid hormone production, so this medication will usually be paired with another treatment plan to help stop the hyperthyroidism. 

Anti-thyroid medications like methimazole are another treatment option.  These medications help block thyroid production.  There are some side effects or risks when taking this medication long term.  It can cause liver disease or failure, a skin rash, joint pain, or a decrease in white blood cells. 

Radioactive iodine therapy is another treatment option.  You take radioactive iodine orally.  The thyroid needs iodine to produce cells, so when it absorbs the radioactive iodine, the radiation kills overactive thyroid cells over time.  This treatment can take weeks to months to start seeing results.  The goal of this treatment is to shrink the thyroid gland and lessen symptoms.  While waiting for this treatment to work, your symptoms may increase and it can cause Grave’s ophthalmopathy. 

Surgery is an option when no other treatment works.  This treatment is left for extreme cases that are very severe, or don’t respond to other treatment options.  A thyroidectomy or subtotal thyroidectomy can be performed by a surgeon.  This is the removal of all or part of the thyroid gland.  After surgery you will need to be on hormone replacement to help your body produce the right amount of hormones forever.  

 

Takeaway

Grave’s disease is a chronic condition that is the most common cause of hyperthyroidism.  It affects women more commonly than men, but can affect both.  It is an autoimmune condition that causes the thyroid gland to be overactive.  It can cause symptoms that can get in the way in day to day tasks if left untreated.  

 

 


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