Graves’ disease
DEFINITION
Graves’ disease is an immune system disorder that results in the overproduction of thyroid hormones (hyperthyroidism). Although a number of disorders may result in hyperthyroidism, Graves’ disease is a common cause.
Because thyroid hormones affect a number of different body systems, signs and symptoms associated with Graves’ disease can be wide ranging and significantly influence your overall well-being. Although Graves’ disease may affect anyone, it’s more common among women and before the age of 40.
The primary treatment goals are to inhibit the overproduction of thyroid hormones and lessen the severity of symptoms.
CAUSES
Graves’ disease is caused by a malfunction in the body’s disease-fighting immune system, although the exact reason why this happens is still unknown.
One normal immune system response is the production of antibodies designed to target a specific virus, bacterium or other foreign substance. In Graves’ disease — for reasons that aren’t well understood — the body produces an antibody to one part of the cells in the thyroid gland, a hormone-producing gland in the neck.
Normally, thyroid function is regulated by a hormone released by a tiny gland at the base of the brain (pituitary gland). The antibody associated with Graves’ disease — thyrotropin receptor antibody (TRAb) — acts like the regulatory pituitary hormone. That means that TRAb overrides the normal regulation of the thyroid, causing an overproduction of thyroid hormones (hyperthyroidism).
Cause of Graves’ ophthalmopathy
This condition results from a buildup of certain carbohydrates in the skin — the cause of which also isn’t known. It appears that the same antibody that can cause thyroid dysfunction may also have an “attraction” to tissues surrounding the eyes.
Graves’ ophthalmopathy often appears at the same time as hyperthyroidism or several months later. But signs and symptoms of ophthalmopathy may appear years before or after the onset of hyperthyroidism. Graves’ ophthalmopathy can also occur even if there’s no hyperthyroidism.
SYMPTOMS
Common signs and symptoms of Graves’ disease include:
- Anxiety and irritability
- A fine tremor of your hands or fingers
- Heat sensitivity and an increase in perspiration or warm, moist skin
- Weight loss, despite normal eating habits
- Enlargement of your thyroid gland (goiter)
- Change in menstrual cycles
- Erectile dysfunction or reduced libido
- Frequent bowel movements
- Bulging eyes (Graves’ ophthalmopathy)
- Thick, red skin usually on the shins or tops of the feet (Graves’ dermopathy)
- Rapid or irregular heartbeat (palpitations)
Graves’ ophthalmopathy
About 30 percent of people with Graves’ disease show some signs and symptoms of a condition known as Graves’ ophthalmopathy. In Graves’ ophthalmopathy, inflammation and other immune system events affect muscles and other tissues around your eyes. The resulting signs and symptoms may include:
- Bulging eyes (exophthalmos)
- Gritty sensation in the eyes
- Pressure or pain in the eyes
- Puffy or retracted eyelids
- Reddened or inflamed eyes
- Light sensitivity
- Double vision
- Vision loss
Graves’ dermopathy
An uncommon manifestation of Graves’ disease, called Graves’ dermopathy, is the reddening and thickening of the skin, most often on your shins or the tops of your feet.
When to see a doctor
A number of medical conditions can cause the signs and symptoms associated with Graves’ disease. See your doctor if you experience any potential Graves-related problems to get a prompt and accurate diagnosis.
Seek emergency care if you’re experiencing heart-related signs and symptoms, such as a rapid or irregular heartbeat, or if you develop vision loss.
