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Wednesday, March 16, 2011

Graves Disease

Grave's disease is a disease of unknown cause, although fairly common. It is suspected to have a genetic origin. In this case the thyroid gland is diffusely enlarged, soft, non-tender. All the tissues within are also enlarged. Although it may develop at any age and in either men or women, Graves' disease is more common in women and usually begins after age 20. The most common symptoms of GD are nervousness and anxiety, although not all patients complain of being nervous. In fact, in elderly patients, the primary symptoms are apathy and depression, leading to the term "apathetic hyperthyroidism." There's no way to stop your immune system from attacking the thyroid gland, but treatments can decrease the production of thyroxine.
Graves' disease is the most common form of hyperthyroidism. This over-activity is also sometimes called "toxic diffuse goiter." The thyroid gland helps set the rate of metabolism, which is the rate at which the body uses energy. Once the disorder has been correctly diagnosed, it is quite easy to treat. Graves - Basedow disease , also known simply as Graves' disease , is a medical disorder that may manifest several different conditions, including goitre and hyperthyroidism (over-activity of thyroid hormone production), infiltrative exophthalmos (protuberance of one or both eyes and associated problems) and infiltrative dermopathy (a skin condition usually of the lower extremities). When you have too much thyroid hormone in your system, your body's metabolism rate can increase by 60 percent to 100 percent because thyroxine regulates your cells' metabolism. The goal in treating GD is to reduce thyroid hormone levels in the blood. Graves' Disease also tends to affect women between the ages of 20 and 40, although it occurs in infants, children, and the elderly .This can be accomplished with both conventional and alternative medicine, although patients with moderate to severe hyperthyroidism may initially require conventional treatment until their symptoms are in control.
First described by Sir Robert Graves in the early 19th century, Graves' disease is one of the most common of all thyroid problems. When the thyroid is too active, it makes more thyroid hormones than the body needs. This abnormal immune response can also affect the tissue behind your eyes as well as your skin, usually on your lower legs and feet. This disorder is the most common cause of hyperthyroidism. It is known to be related to an antibody mediated type of auto-immunity, but the trigger for the reaction is unknown. In some cases, Graves' disease goes into remission or disappears completely after several months or years. Left untreated, however, it can lead to serious complications even death. The anti–sodium-iodide symporter, antithyroglobulin, and antithyroid peroxidase antibodies appear to have little role in the etiology of hyperthyroidism in Graves disease Graves' disease is rarely life-threatening.

Causes of Graves Disease

The common Causes of Graves Disease :
  • The production of thyroid hormone is increased, causing a wide range of symptoms from anxiety and restlessness to insomnia and weight loss.
  • Graves disease is caused by an abnormal immune system response that attacks the thyroid gland, and causes too much production of thyroid hormones.
  • Eye muscles weakened by long periods of inflammation can lose their ability to control movement, resulting in double vision.
  • Environmental factors associated with susceptibility are largely unproven other factors include infection, iodide intake, stress, steroids, and toxins. Smoking has been implicated in the worsening of Graves ophthalmopathy.
  • In addition, the eyeballs may begin to stick out ( exophthalmos ), causing eye irritation and tearing.
  • Chronic thyroiditis (Hashimoto thyroiditis) - Although the primary cause of hypothyroidism, the disease process occasionally presents initially with thyrotoxicosis

Symptoms of Graves Disease

Some common Symptoms of Graves Disease :
  • Weight loss
  • Abnormal breast enlargement (men)
  • Increased appetite
  • Muscle wasting
  • Nervousness
  • Restlessness
  • Anxiety
  • Light menstrual periods
  • Increased eye tearing
  • Difficulty sleeping
  • Fatigue
  • Infrequent or absent menstrual periods

Treatment of Graves Disease

Here is the list of the methods for treating Graves Disease :
  • These medications, which include propranolol (Inderal), atenolol (Tenormin), metoprolol (Lopressor) and nadolol (Corgard), often relieve hyperthyroid signs and symptoms, such as a rapid heart rate, nervousness and tremors these medications aren't a cure for Graves' because your body will still produce too much thyroxine, but beta blockers block some of the action of the thyroid hormone.
  • If you can't tolerate an anti-thyroid drug and don't want to have radioactive iodine therapy, surgery to remove your thyroid gland (thyroidectomy) is an option after the surgery, you'll likely need thyroxine treatment to supply your body with normal amounts of thyroid hormones.
  • Sometimes use of prednisone (a steroid medication, which suppresses the immune system) is required to reduce eye irritation and swelling.
  • Hyperthyroidism is treated with antithyroid medications, radioactive iodine, or surgery.
  • Both radiation and surgery result in the need for lifelong use of replacement thyroid hormones, because these treatments destroy or remove the gland.
  • Atrial fibrillation due to thyroid storm may be refractory to rate control, and conversion to sinus rhythm may be impossible until after antithyroid therapy has been initiated.
  • Patients with severe thyrotoxicosis must be placed on a cardiac monitor the patient should be intubated if profoundly altered supplemental oxygen may be required. Aggressive fluid resuscitation may be indicated.

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