Thyroid hormones are a substance produced by the thyroid glands. These hormones perform a multitude of functions in our body, especially in metabolic processes, but they are especially known for their role in regulating energy and body temperature.

Although without its functioning our organism would find it very difficult to survive, its hyperproduction can also lead to different physical diseases, one of them being Graves-Basedow disease . Therefore, we will dedicate this article to talk about what Graves’ disease is and what its symptoms, causes and treatment are.

What is Graves-Basedow disease?

Graves’ disease, also known as Graves-Basedow disease, is a disease of the immune system that affects the thyroid, being the most common cause of hyperthyroidism. It is the most common cause of hyperthyroidism, i.e., the excessive and abnormal production of thyroid hormones.

Since these thyroid hormones have a variety of roles in several different body systems, the symptoms of Graves’ disease can be very varied and can significantly interfere with a person’s overall health.

Of all these symptoms, the best known may be the development of an eye lump caused by Graves’ ophthalmopathy , which usually causes serious eye problems in 25-80% of affected people.

The specific causes of Graves-Basedow disease have not yet been clarified . However, it is hypothesized that a combination of genetic and environmental factors cause this condition. Regardless of the cause, there is a treatment for Graves-Basedow disease that may consist of radioactive iodine therapy, drug therapy, or thyroid surgery.

According to studies, Graves’ disease appears with seven times more incidence in women than in men, with a 0.5% probability of occurrence in men and 3% in women. Usually, the first symptoms of this disease appear around the age of 40 to 60, but the reality is that anyone can be affected by it.

What symptoms do you have?

As mentioned above, thyroid hormones have a fundamental role in any metabolic and functional process of our tissues, so any alteration in their production can bring about an infinite number of symptoms.

In the specific case of Graves’ disease there is an overactivation of the thyroid glands (hyperthyroidism), so the symptoms of the disease are related to the excessive production of thyroid hormones.

The main symptoms of Graves’ disease are

  • Soft tremor in hands and fingers
  • Heat sensitivity
  • Increased perspiration and/or warm, moist skin
  • Weight loss despite maintaining normal eating habits
  • Goiter or enlarged thyroid glands
  • Disruption of the menstrual cycle
  • Erectile dysfunction and/or decreased sexual desire
  • Increased bowel movements
  • Graves’ Ophthalmopathy
  • Graves’ Dermopathy
  • Palpitations
  • Feeling of fatigue
  • Anxiety
  • Irritability

Of all the above symptoms, Graves’ ophthalmopathy and Graves’ dermopathy are the most easily identified. They are explained below:

Graves’ Ophthalmopathy

Although it does not have to occur in everyone, about 30% of Graves’ disease cases show signs and symptoms of a condition called Graves’ ophthalmopathy . This type of disorder is characterized by an alteration of the immune system that causes inflammation of the muscles and tissues surrounding the eyes. As a result, the person develops bulging eyes that are very characteristic of this disease.

In addition, this eye disorder often leads to vision-related symptoms and discomfort. These include:

  • Sandy feeling in the eyes
  • Eye pressure or pain
  • Swollen or retracted eyelids
  • Red or swollen eyes
  • Hypersensitivity to light
  • Double vision
  • Loss of vision

Graves’ Dermatopathy

The second most visible and characteristic sign of Graves’ disease is a very rare dermal manifestation, called Graves’ dermopathy, which consists of redness and thickening of the skin; especially at the level of the shins or on the top of the foot.

Causes

Given its autoimmune nature, Graves’ disease is known to be caused by a failure of the immune system to function . However, the exact reason for this defect has not yet been determined.

In a well-functioning immune system, a normal antibody production response occurs when a virus, bacteria or any pathogen appears in order to attack. However, in Graves’ disease, for reasons not yet understood, the body produces antibodies to attack part of the cells of the thyroid glands.

These Graves’ disease-related antibodies, called thyrotropin receptor antibodies, act as a pituitary regulatory hormone. As a result, this antibody overrides the normal regulation of thyroid function, causing an overproduction of thyroid hormones or hyperthyroidism.

Risk factors

Although it is not known exactly what triggers Graves’ disease, there are a number of risk factors associated with its occurrence . Risk factors for Graves’ disease include

  • Family history of Graves’ disease
  • Sex: women have a higher incidence of this condition
  • Age: The probability of developing this disease increases from the age of 40 onwards.
  • Experiencing emotional or physical stress
  • Pregnancy
  • Smoking

Is there a treatment?

The main goal of treatment for Graves’ disease is to inhibit the production of thyroid hormones and block their effect on the body. To do this, the patient may undergo the following treatments for Graves’ disease.

1. Radioactive iodine therapy

By administering radioactive iodine orally, the size or shrinkage of the thyroid gland is decreased, so the symptoms gradually decrease over several weeks or months.

2. Antithyroid drug therapy

Antithyroid drugs, such as propylthiouracil and methimazole, interfere with the functioning of the thyroid glands to decrease hormone production.

3. Beta-blocking drugs

Unlike antithyroid drugs, beta-blockers do not inhibit the production of thyroid hormones, but rather block their effect on the body. These drugs include

  • Propranolol
  • Atenolol
  • Metoprolol
  • Nadolol

4. Surgery

Thyroidectomy or subtotal thyroidectomy is the partial or complete removal of the thyroid. After the surgery, you may need supplements to supply your body with the normal amounts of thyroid hormones.

5. Treatment of Graves’ Ophthalmopathy

While people with mild eye problems may resort to the use of eye drops, artificial tears, or lubricating gels, more severe cases of Graves’ ophthalmopathy are recommended:

  • Corticosteroids
  • Glasses with prisms to eliminate double vision
  • Orbital decompression surgery
  • Orbital Radiation Therapy

Bibliographic references:

  • Menconi, F., Marcocci, C. & Marinò, M. (2014). Diagnosis and classification of Graves’ disease. Autoimmunity Reviews, 13(4-5): 398-402.
  • Brent, G. A. (2008). Clinical practice. Graves’ disease. The New England Journal of Medicine, 358 (24): 2594-2605.