Graves’ disease or Graves-Basedow disease is a disease of the thyroid gland. It is a type of hyperthyroidism, an excessive activity of the thyroid gland of autoimmune origin that causes thyrotoxicosis or Basedow disease that causes excessive levels of thyroid hormones in the blood. It usually appears before the age of 40 and is more common in women.
Causes of Graves’ disease
Physical or emotional stress among others
The thyroid gland produces thyroid hormones that help the body use energy, maintain body temperature, and help the brain, heart, muscles, and other organs function normally. Graves’ disease is caused by a malfunction of the immune system that generates an antibody against a part of the thyroid gland cells.
The main causes of Graves’ disease are:
– Family history.
– Suffer from other immune disorders such as rheumatoid arthritis.
– Age and sex. It generally manifests itself before the age of 40, mainly in women.
– Have physical and emotional stress.
– Recent pregnancy or childbirth.
– Smoke.
Symptoms of Graves’ disease
Anxiety, irregular heartbeat or weight loss, among others
Symptoms of Graves’ disease are usually:
– Anxiety or nervousness.
– Sleeping problems.
– Irritability and mood swings.
– Irregular heart rhythm.
– Increased sweating.
– Involuntary weight loss.
– Increased appetite.
– Difficulty achieving concentration.
– Memory loss.
-Enlargement of the thyroid gland (goiter). In this case it is called ‘toxic goiter’.
– Decreased libido.
– Thick, red skin on the tops of the feet or over the shins (Graves’ dermopathy).
– Fatigue.
– Muscle weakness in shoulders and hips.
– Changes in menstrual cycles.
– Erectile dysfunction in men.
– Possible breast enlargement in men.
– Frequent bowel movements.
– Hair loss and/or weakening.
– Tremor in the hands.
– Graves’ eye disease: Protruded and painful eyeballs; double vision; light sensitivity; feeling of sand in the eyes; itchy eyes and watery, irritated eyes.
Graves’ dermopathy is rare and Graves’ eye disease or Graves’ ophthalmopathy can occur in approximately 30 percent of cases and occurs because the inflammation and signs of the autoimmune attack affect the muscles and tissues around the eye. the eyes
Diagnosis of Graves’ disease
Physical exam and blood tests
The primary care physician will perform a physical examination, collect a description of symptoms, and order a blood test to determine levels of thyroid-stimulating hormone (TSH) and levels of the thyroid hormones thyroxine (T4) and triiodothyronine (T3). ; hormones based on tyrosine, one of the 20 amino acids that make up proteins. It is possible to refer the case to an endocrinologist.
The T3 test measures both protein-bound T3 and free-floating T3 in the blood. The free T4 test measures the amount that enters the tissues where it is necessary and the bound T4 test measures the amount that binds to proteins without entering the body’s tissues.
The ranges defined as normal may vary depending on the laboratory but are usually:
T3: 60 to 180 nanograms per deciliter (ng/dL) or 0.92 to 2.76 nanomoles per liter (nmol/L)
Free T3: 130 to 450 picograms per deciliter (pg/dL) or 0.002 to 0.007 nanomoles per liter (nmol/L)
A normal and typical range is 0.9 to 2.3 nanograms per deciliter (ng/dL) or 0.012 to 0.03 nanomoles per liter (nmol/L).
– Nanogram: billionth of a gram.
– Picogram: billionth of a gram.
– Nanomol: unit of substance.
You can also do a radioactive iodine absorption test, a thyroid ultrasound; and eye tests to confirm the diagnosis of ophthalmopathy such as computed tomography (CT) or magnetic resonance imaging (MRI).
Graves’ disease treatment and medication
Control thyroid function
The goal of treatment is to get the thyroid to function normally. To treat symptoms of heart rate, sweating and anxiety, beta-blocker drugs can be administered although they cannot be prescribed to patients with asthma.
Antithyroid drugs such as methimazole or propylthiouracil are the direct treatment option for Graves’ disease.
If the patient does not respond well to treatment, the option may be thyroid removal surgery or treatment with oral radioactive iodine, which will cause hypothyroidism, low thyroid activity that has other symptoms, and another treatment.
Ophthalmopathy caused by Graves’ disease can be treated with corticosteroids such as prednisone; premiums on glasses to correct double vision if applicable; Orbital decompression surgery to remove the bone between the orbit (eye socket) and the air spaces around the orbit (sinuses).
Prevention of Graves’ disease
Genetic testing
No preventive measures have been described against Graves’ disease.
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