Thyroid disease affects an estimated 20 millions Americans. Many will not be aware of their condition. One such thyroid disease is Graves Disease, which is an autoimmune disease that damages the thyroid gland. Graves Disease is most commonly diagnosed in women, as are many thyroid conditions. Women are five to eight times more likely to develop thyroid disorders than men.
The thyroid gland is located in the middle of the lower neck and produces the hormones that regulate the body’s metabolism. When the thyroid is damaged or dysfunctional the amount of these hormones can be affected. In some instances, the thyroid does not produce enough hormones. This condition is called hypothyroidism. Conversely, hyperthyroidism is when the thyroid produces too much of the hormones.
Graves Disease is the most common form of hyperthyroidism. Understanding the signs and symptoms of Graves Disease can help lead to early diagnosis and prompt treatment that can stave off some of the more severe complications of the disease.
Graves Disease can manifest itself in several difference ways as the thyroid affects most systems in the body. Some common symptoms include enlargement of the thyroid gland, weight loss despite normal appetite, change in menstrual cycles, hot flashes or increase sweating, fatigue, rapid or irregular heartbeat, and feelings of anxiety or irritability.
Many of these symptoms can be present in a variety of hyperthyroid conditions including toxic nodular goiter and thyroiditis. Graves Disease alone can produce two distinct symptoms: bulging eyes and a thickening and reddening of the skin especially on the shins and upper feet.
If you have any combinations of these symptoms, it would be prudent to see your healthcare provider to have a physical exam and laboratory tests done to rule out hyperthyroidism. There are three main tests that help to diagnose Graves Disease. These include thyroid function tests, radioactive iodine uptake test or RAIU, and antibody tests.
The thyroid function test checks blood levels of the chief thyroid hormone T4 and also the thyroid-stimulating hormone or TSH. A high level of T4 with a simultaneously low level of TSH may suggest signs of an overactive thyroid. The RAIU measures how much iodine the thyroid is using. The thyroid uses iodine to produce the thyroid hormone, and higher levels of iodine can be an indicator of Graves Disease. Lastly, the presence of certain antibodies can be a sign of Graves Disease as well. A history and physical coupled with the results of these tests can help your provider indicate whether you may have Graves Disease.
Once diagnosed, the goal of treatment is to reduce the amount of thyroid hormone the body produces. This can be achieved through several different treatment options including medications that lower thyroid hormone production, radioactive iodine, RAI therapy, and finally surgery on the thyroid.
Currently there are two approved medications for the treatment of Graves Disease, methimazole or MMI and propylthiouracil or PTU. Each of these medicines inhibits the thyroid from making too much hormone. RAI therapy involves taking radioactive iodine by mouth, and the radiation over time destroys the overactive thyroid cells. Lastly surgery to remove all or part of the thyroid will lessen or stop completely the production of the thyroid hormone. Sometimes, this surgery can lead to an underactive thyroid and the patient will need to take thyroid hormone.
Proper treatment of Graves Disease is critical to prevent complications often associated with this condition. Common problems include heart problems—irregular heartbeats or arrhythmia, atrial fibrillation, and most dangerous, heart failure. A disorder called thyroid storm that is a very rare but life-threatening condition caused by a overproduction of thyroid hormone can increase heart rate, blood pressure, and body temperature to dangerously high levels, Thyroid storms can be precipitated by traumatic events like surgery or illness.
Another complication of untreated Graves Disease can be increased bone loss leading to a more serious condition called osteoporosis. Finally Graves Disease in women of childbearing age may present significant challenges to fertility, pregnancy, and birth outcomes.
For all these reasons, it is important to consult your healthcare provider if you experience any combinations of symptoms so they can properly diagnose and handle this treatable condition.