Graves' Disease

Graves' disease is an immune disorder that causes hyperthyroidism (overproduction of thyroid hormones) due to the presence of antibodies that stimulate the thyroid gland. It is the most common cause of primary hyperthyroidism.

The disease, also known as Graves' hyperthyroidism, has a good prognosis if detected early and treated as prescribed by a physician. Otherwise, it can progress and lead to multiple symptoms and serious complications, as thyroid hormones regulate the function of various organs.

Symptoms

The most characteristic symptoms of Graves' disease include:

• Diffuse goiter: A uniform enlargement of the thyroid gland.
• Weight loss despite an increased appetite.
• Diarrhea and rapid bowel movements.
• Nervousness and irritability.
• Insomnia.
• Excessive sweating and heat intolerance.
• Tachycardia and/or arrhythmias.
• Hand tremors.
• Muscle weakness.
• Pretibial myxedema: Skin changes (orange-peel texture) and swelling in the legs.
• Graves' ophthalmopathy: This condition affects 1 in 3 people with Graves' disease. It occurs when antibodies bind to the eye muscles, causing exophthalmos (bulging eyes), pain, dry eyes, and double vision.

Causes

The exact cause of Graves' disease is not fully understood. The most widely accepted theory suggests that an environmental trigger (such as a virus) provokes an abnormal immune response in genetically predisposed individuals. This phenomenon leads the body to develop autoantibodies that bind to the thyroid-stimulating hormone (TSH) receptor, the TSH receptor antibody (TRAb), or the thyroid-stimulating immunoglobulin (TSI), activating them. As a result, excessive amounts of thyroid hormones T3 (triiodothyronine) and T4 (thyroxine) are produced. These hormones regulate metabolism, so when their levels are elevated, the body experiences an energy surplus.

Risk Factors

The main risk factors for developing Graves' disease include:

• Sex: It primarily affects women. The likelihood increases during pregnancy.
• Age: The disease usually develops in individuals over 30 years old.
• Family history of Graves' disease or Hashimoto's thyroiditis.
• Other autoimmune disorders, such as type 1 diabetes, vitiligo, or rheumatoid arthritis.
• Stress.
• Smoking or the use of nicotine-based products.

Complications

Without proper treatment, Graves' disease can cause:

• Tachycardia.
• Arrhythmias.
• Stroke.
• Heart failure.
• Osteoporosis.
• Vision problems.
• Menstrual cycle irregularities.
• Reduced fertility.
• Pregnancy complications (such as preterm birth, miscarriage, preeclampsia, or fetal growth restriction).
• Thyroid storm (thyrotoxic crisis): A rare but life-threatening complication of hyperthyroidism, considered a medical emergency. Symptoms include high fever, tachycardia, and agitation, and it can be fatal if not treated promptly.

Prevention

Graves' disease cannot be prevented, which is why early diagnosis and treatment are crucial.

What Kind of Doctor Treats Graves' Disease?

Graves' disease is diagnosed and treated by a multidisciplinary team of endocrinologists, immunologists, and ophthalmologists when vision is affected.