Graves’ disease is a disease of your thyroid gland. Your thyroid gland is located on the front of your neck, just above the level of your collarbone. In men it is just underneath the Adam’s apple.
The thyroid gland regulates how your body uses energy. The thyroid is also involved in calcium regulation, which affects bone health. Thyroid hormones require iodine in their production. The body does not normally make iodine, so that’s why foods, such as common table salt, may have iodine added to assist the thyroid in producing the proper amount of thyroid hormones.
Graves’ disease is the most common of all thyroid disorders and is also the most common type of hyperthyroid disease. When the thyroid gland produces too many hormones, it is called hyperthyroid disease. Producing too few hormones is called hypothyroid disease.
Why should I care about Graves’ disease?
Graves’ disease can occur in anyone at any time, but it frequently occurs in women under the age of 40. The condition is easily treated. However, left untreated, Graves’ disease, in rare cases, can actually lead to death.
Right: the Exophthalmos — bulging eyes — of Graves’ disease
Left: location of the thyriod gland
What causes Graves’ disease?
This is a very interesting situation where the body’s immune system makes antibodies that bind to the thyroid gland, causing the gland to over-produce thyroid hormones. It is unclear as to what the trigger is that causes the antibody production.
The thyroid makes two thyroid hormones: T3 and T4. These regulate the body’s metabolism. Because the hormones produced by your thyroid can affect many different parts of your body, the signs and symptoms associated with Graves’ disease can be quite profound and have a significant impact on your overall health.
Common signs of having Graves’ disease include but are not limited to:
• Weight loss, despite normal diet
• Feeling anxious or irritable
• Feeling lethargy or fatigue
• Sleeping difficulties
• Heart palpitations
• Shaking of your hands and fingers
• Increased sweating
• Extreme sensitivity to temperature
changes, including extreme cold and heat
• Lumps in the neck
• Changes in menstrual cycle for women
• Erectile dysfunction and decreased
sex drive in men
• Increased bowl movements and the
occurrence of diarrhea
• Eyes that tend to bulge out
• Thick, lumpy skin, especially on the
tops of the feet and also on the shins
The most common manifestation of Graves’ disease, in addition to weight loss, is bulging eyes. This is known as Graves’ Exophthalmos.
How is Graves’ disease diagnosed?
This is usually diagnosed on a routine general medical examination, and that is one reason why I recommend a general medical examination for everyone once a year or differently as directed by your doctor. A simple blood test evaluating thyroid status can aid in the diagnosis of Graves’ disease.
Additionally, if you experience any or several of the symptoms listed above, you should talk to your physician for evaluation. There is no way to prevent Graves’ disease; however, there is an increased incidence occurring in family members and also in persons who smoke excessively and/or drink heavily.
Graves’ disease treatment
The goal of the treatment of Graves’ disease is to reduce the overproduction of thyroid hormones by your thyroid to bring it back into normal production levels. Sometimes the condition will resolve on its own. In other cases, the condition can be treated by using a radioactive material that produces less thyroid hormones.
Another option is to use medications that reduce the output of thyroid hormones. A last option would be surgery to remove part or the entire thyroid. Your doctor will recommend the best treatment for you. If there are other complications, such as bulging eyes, this too needs to be managed and is often done so in consultation with an experienced ophthalmologist.
The bottom line
Graves’ disease is a common over-active, autoimmune thyroid disorder that can be treated.
Charles E. Crutchfield III, MD is a board certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He has been selected as one of the top 10 dermatologists in the U.S. by Black Enterprise magazine and one of the top 21 African American physicians in the U.S. by the Atlanta Post. Dr. Crutchfield is an active member of the Minnesota Association of Black Physicians, MABP.org.