While the exact cause of Graves’ disease is unknown, certain factors may put you at an increased risk of developing the autoimmune disease.
Graves' disease is caused by dysregulation of the immune system that results in the production of antibodies that attack the thyroid cells. What exactly triggers the immune system to produce antibodies is unknown.
Graves' disease is an autoimmune disease in which your own body attacks the cells of the thyroid gland. It affects 1 out of every 200 Americans and is the main cause of hyperthyroidism, in which the thyroid gland produces high levels of thyroid hormones. Graves' disease often runs in families.
Certain factors put you at an increased risk of Graves’ disease, which includes:
- Family history: Having a close family member, such as a parent, grandparent, or sibling, with Graves’ disease increases your risk of the disease. Some genes may increase your susceptibility to this disease, which these genes are most likely passed down to you from your parents.
- Sex: Women are more prone to this disorder than men.
- Age: The condition is more common in people younger than 40 years of age.
- Other autoimmune diseases: Other autoimmune disorders such as rheumatoid arthritis or type I diabetes can increase your risk of Graves’ disease.
- Emotional or physical stress: Stressful events can trigger Graves' disease if you have genes that increase your risk.
- Pregnancy: Pregnancy or childbirth can trigger Graves’ disease if you already have genetic factors for the disease.
- Smoking: Cigarette smoking can increase the risk of Graves' disease.
- Hormone disorder: Any hormonal disorder such as Addison's disease can increase the risk of Graves’ disease.
- Anemia: Pernicious anemia (caused by vitamin B12 deficiency) can trigger Graves’ disease.
- Skin disorder: A skin disease that involves changes in skin color such as vitiligo increases the risk of Graves' disease.
What are the symptoms of Graves’ disease?
In Graves' disease, secretion of the thyroid hormone increases, which affects many body functions. Thus, signs and symptoms of Graves' disease can vary.
Common signs and symptoms of Graves’ disease include:
- Anxiety
- Irritability
- Weight loss
- Goiter (enlargement of the thyroid gland)
- Erectile dysfunction
- Decreased libido
- Fatigue
- Pounding heartbeat
- Irregular heartbeat
- Insomnia (difficulty falling or staying asleep)
- Graves' dermopathy (thick, red skin usually on shine or top of feet)
About 30 percent of people with Graves' disease exhibit a constellation of eye symptoms known as Graves' ophthalmopathy, which includes:
- Bulging of the eyes
- Pain in the eyes
- Double vision
- Puffy or retracted eyelids
- Gritty sensation in the eyes
- Diarrhea
How is Graves’ disease diagnosed?
Your doctor may diagnose Graves' disease by checking your symptoms and looking at your family history for any thyroid disease or autoimmune disease. To confirm their diagnosis, they will order one or more of the tests that include:
- Blood tests: Blood tests to check levels of thyroid hormones (T3 and T4), thyroid-stimulating hormone, and thyroid antibodies
- Doppler ultrasound: It can detect the cause of enlargement of the thyroid gland such as a thyroid nodule or cyst.
- Radioactive iodine uptake test: The doctor will inject you with a small amount of radioactive iodine. The amount of iodine taken by the thyroid gland is then measured. In Graves' disease, a high amount of iodine is absorbed by the thyroid gland.
- Imaging test: Computed tomography or magnetic resonance scans of the thyroid gland may be needed to know in detail about structural deformities or tumors in the thyroid gland.
How is Graves’ disease treated?
Graves’ disease is a chronic condition that has no cure, but treatment can help control thyroid hormone production and the bad effects of increased thyroid hormones on the body. With proper medical care, the symptoms of Graves’ disease can go away temporarily (remission).
Treatment for Graves’ disease may include:
- Beta-blockers:
- These block the effect of the hormone on the body and help reduce the problem of irregular heartbeats, tremors, and anxiety. Examples include:
- Your doctor may not prescribe you beta-blockers if you have asthma or diabetes because they increase asthma attacks and interfere with the treatment of diabetes.
- Radioactive iodine therapy:
- Antithyroid treatment:
- These block the production of thyroid hormones. Examples include:
- Surgery:
- Surgical removal of all or part of the thyroid gland is known as thyroidectomy or subtotal thyroidectomy. After the surgery, you may be put on synthetic thyroid hormone therapy as a replacement for your thyroid hormones.