Graves’ disease often does not get the attention needed from medical professionals, perhaps because it is rarely fatal. However, Graves' must be treated to avoid complications such as bone/muscle wasting, heart problems, and thyroid storm – a very serious, life-threatening event. The condition is serious for the millions of individuals who at times, are having problems with their thyroid and experience extreme highs and lows physically and emotionally. The impact on their personalities as they struggle with Graves’ can severely strain their relationship with family and friends.
Graves' disease is an autoimmune disease
Diseases of the immune system have a genetic predisposition. In a normal body, the immune system defends itself against germs and viruses. Other examples of autoimmune disease include Type I diabetes, multiple sclerosis, rheumatoid arthritis, lupus erythematosis, psoriasis, and celiac disease. Autoimmune diseases can affect different parts of the body.
Graves' disease and hyperthyroidism
Graves’ disease, also known as toxic diffuse goiter, is the most common cause of hyperthyroidism - a disorder that occurs when the thyroid gland makes more thyroid hormone than the body needs.
The thyroid is a small, butterfly-shaped gland in the front of the neck below the larynx, or voice box. The thyroid gland makes two thyroid hormones, triiodothyronine (T3) and thyroxine (T4). Thyroid hormones affect metabolism, brain development, breathing, heart and nervous system functions, body temperature, muscle strength, skin dryness, menstrual cycles, weight, cholesterol levels, and emotional & cognitive functions.
Thyroid hormone production is regulated by another hormone called thyroid-stimulating hormone (TSH), which is made by the pituitary gland located in the brain.
In Graves’ disease, the immune system makes antibodies called thyroid-stimulating immunoglobulin (TSI) that attach to thyroid cells. TSI mimics the action of TSH and stimulates the thyroid to make too much thyroid hormone. Sometimes the antibodies can instead block thyroid hormone production, leading to a confusing clinical picture.
Eye and Skin Involvement
Patients with Graves’ disease may experience some level of eye involvement, requiring consultation with an experienced ophthalmologist. Symptoms can include dry eyes, swelling, redness, eyelid retraction, and a “gritty” sensation. Less common complications include bulging (proptosis), double vision, and compression of the optic nerve. Symptoms typically progress and then stabilize over a period of 2-3 years. For more serious complications, surgical options are available to restore eye function and appearance.
Very occasionally, Graves’ patients develop a lumpy reddish thickening of the skin in front of the shins known as pretibial myxedema. This condition is usually diagnosed and treated by a dermatologist.
Graves' disease - Fast Facts
The National Institutes of Health (NIH) provides the following statistics:
- Graves’ Disease affects approximately 2 to 3% of the population or almost 10 million people. The figure may be higher because some may have eye involvement but not diagnosed with thyroid problems.
- Graves' is five to 10 times more common in women than men.
- Graves' usually occurs in middle age, but also occurs in children, adolescents and the elderly.