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Graves-Basedow disease: symptoms, causes and treatment

Graves-Basedow disease: symptoms, causes and treatment

March 28, 2024

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

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

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. That is, the excessive and abnormal production of thyroid hormones.


Since these thyroid hormones have different 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.

Among all these symptoms, it is possible that the best known is the development of an ocular protuberance caused by Graves' ophthalmopathy , which usually causes serious eye problems to between 25 and 80% of affected people.

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


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

What symptoms does it present?

As mentioned above, thyroid hormones play a fundamental role in any metabolic and functional process of our tissues, so any alteration in their production can lead to an infinity of symptoms.

In the specific case of Graves' disease, there is hyperactivation 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
  • Sensitivity to heat
  • Increased perspiration and / or warm, moist skin
  • Weight loss despite maintaining normal eating habits
  • Goiter or enlarged thyroid glands
  • Alteration of the menstrual cycle
  • Erectile dysfunction and / or decreased sexual desire
  • Increase in bowel movements
  • Graves' ophthalmopathy
  • Graves dermopathy
  • Palpitations
  • Feeling fatigue
  • Anxiety
  • Irritability

Of all the above symptoms, Graves 'ophthalmopathy and Graves' dermopathy are the most easily identifiable. We explain them below:

Graves' ophthalmopathy

Although it does not have to happen in all people, About 30% of cases of Graves 'disease show signs and symptoms of a condition called Graves' ophthalmopathy . This type of alteration is characterized by an alteration of the immune system that causes the inflammation of the muscles and tissues that surround the eyes. As a result, the person develops bulging eyes very characteristic of this disease.

In addition, this ocular alteration usually leads to discomfort and symptoms related to vision. 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 the reddening and thickening of the skin; especially at the height of the shins or on the top of the foot.

Causes

Given its autoimmune nature, It is known that Graves' disease is caused by a failure in the functioning of the immune system . However, the exact reason for this defect has not yet been determined.

In a properly functioning immune system, there is a normal antibody production response to the appearance of a virus, bacteria or any pathogen in order to attack. However, in Graves' disease, for reasons that are still not understood, the body produces antibodies to attack part of the cells of the thyroid glands.

These antibodies related to Graves' disease, called thyrotropin receptor antibodies, act as a hormone that regulates the pituitary gland. As a consequence, this antibody overrides the normal regulation of the functioning of the thyroid, causing an overproduction of thyroid hormones or hyperthyroidism.

Risk factor's

Although it is not known exactly what triggers Graves' disease, There are a number of risk factors associated with its appearance . Risk factors for Graves' disease include:

  • Family history with cases of Graves' disease
  • Sex: women have a higher incidence of this condition
  • Age: the probability of developing this disease increases after 40 years of age.
  • Experimentation of emotional or physical stress
  • Pregnancy
  • Smoking

Is there a treatment?

The main objective of treatment for Graves' disease is to inhibit the production of thyroid hormones and block the effect they have on the body. For this, the patient can undergo the following treatments for Graves' disease.

1. Radioactive iodine therapy

By means of the administration of radioactive iodine orally, there is a decrease in the size or shrinkage of the thyroid gland, so that the symptoms decrease gradually 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 block the effect they exert on the body. These drugs include:

  • Propranolol
  • Atenolol
  • Metoprolol
  • Nadolol

4. Surgery

Thyroidectomy or subtotal thyroidectomy involves the partial or complete removal of the thyroids. After surgery, it is very possible that the person needs supplements to supply the body with the normal amounts of thyroid hormones needed.

5. Treatment of Graves' ophthalmopathy

While people with mild eye problems may resort to the use of drops, artificial tears or ocular lubricating gels, the most serious cases of Graves' ophthalmopathy are the following interventions or treatments:

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

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.

The Look of Graves (March 2024).


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