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Graves Disease
You can lose weight due to diabetes or hyperthyroidism. But drastic weight loss coupled with excessive sweating and hair loss can also be due to Graves' disease. It is an autoimmune disorder that affects the thyroid gland leading to overproduction of the thyroid hormones (T3 and T4) leading to hyperthyroidism. Our expert Dr. Girish Parmar, Consultant Endocrinologist and Metabolic Physician, Kokilaben Dhirubhai Ambani Hospital, Mumbai explains in detail about everything you should know about this disease.
What is Graves disease?
In this condition, autoimmune antibodies are produced in the body which are similar to endogenous TSH (thyroid stimulating hormones) released from the brain. As these abnormal proteins are similar to the TSH hormone, they stimulate the thyroid gland. This in turn causes overproduction of T3 and T4 hormones leading to hyperthyroidism.
Symptoms
As blood levels of T3 and T4 hormones are increased, the overall metabolic rate is increased. This in turn increases the energy in the body and functioning of the metabolic processes leading to increased activity. Hence, the symptoms of Graves disease include –
In 30 – 40 % of cases, the abnormal proteins present in the body increases the pressure on the muscles of the eye and thus, lead to frequent eye problems. These include swelling of the eyes (due to the pressure exerted behind the eyes), redness, bulging of the eyes and double vision.
Causes & Risk FactorsGraves disease is an autoimmune disorder in which your body cells produce antibodies. Although the exact cause of this is not known, there are several factors that increase your risk of suffering from the condition. These are –
The diagnosis of Graves disease is usually based on the symptoms. You doctor might recommend a blood test to detect levels of thyroid hormones in the body. These tests usually include –
T3 and T4 test – High levels of T3 and T4 hormone sin the body might indicate Graves disease.
TSH test – Low blood levels of TSH (thyroid stimulating hormone) signify hyperthyroidism due to Graves disease.
TSH receptor antibodies – If you suffer from Graves disease, your blood levels of TSH receptor antibodies are high.
Thyroid technetium scan – In this, a radioisotope (technetium) is injected into the body. If you have Graves disease, the gland takes up the isotopes and thus shows excess radioactivity in the region, when viewed on a display.
TreatmentThe treatment of Graves disease is usually classified into 3 stages –
1st line of treatment: Medications
The medications that are prescribed to treat this disease include carbimazole and propylthiourasil (PTU). As the risk of liver dysfunction is high in case of carbimazole, propylthiourasil is usually recommended during the first three months of pregnancy.
Advantages: It is effective, cheap and has fewer side-effects as compared to other modes of treatment.
Disadvantages: You have to take these medications for around one and half years to two. And with this treatment the chances of remission (cure) is 30 – 40% and recurrence is 50 – 60%. In case the blood levels of TSH receptor is high, the chances of remission is less and thus, medication therapy is effective in such cases.
2nd line of treatment: Radioactive iodine therapy
If the patient is not responding to the medical therapy, your doctor might go for radioactive iodine therapy. In this, radioactive iodine either in the form of capsule or liquid (injection) is given only once.
Advantages: It is cheap and also effective. One dose provides remission in 70 – 80 % of cases.
Disadvantages: With this treatment, there is a high chance of the person suffering from hypothyroidism (shrinking of the thyroid gland). And in such case, the patient has to be on hormones (as the body does not produce hormones) for the rest of his/her life.
3rd line of treatment: Surgery
In rare cases, your doctor might recommend thyroidectomy (surgical removal of the thyroid gland) to treat the condition.
PreventionAs there is no known cause of the disease, Graves disease cannot be prevented. However, If you are at a high risk of suffering from this disease, make sure your diet is low in iodine. Also, avoid seafood and cough syrup (as they contain high levels of iodine).
The content has been verified by Dr Girish Parmar, Consultant Endocrinologist and Metabolic Physician, Kokilaben Dhirubhai Ambani Hospital, Mumbai.
More From Graves diseaseWhat You Should Know About Bulging Eyes
If your eyes bulge more than is typical, it could be a serious health condition like hyperthyroidism. It's important to share your symptoms and medical history with your doctor. Depending on the diagnosis, they may prescribe treatment like medication or surgery.
Eyes that bulge or protrude out of their natural position could be a sign of a serious medical condition. Proptosis and exophthalmos are the medical terms used to describe bulging eyes.
While some people are born with eyes that protrude more than is typical, other people develop bulging eyes as a result of an underlying health condition.
In most cases, the white part of your eye shouldn't be visible above your iris (colored part of the eye) without lifting your eyelid.
If the white of your eye shows between your iris and your upper eyelid, it may be a sign of abnormal bulging. Your recommended treatment plan will depend on the underlying cause of your eye bulging.
Sudden bulging of only one eye is considered an emergency. You should seek medical attention immediately. It may be a sign of a serious medical problem.
The most common cause of bulging eyes is hyperthyroidism, or an overactive thyroid gland. The thyroid gland is located in the front of your neck and releases several hormones that help control your metabolism.
Hyperthyroidism occurs when your thyroid releases too many of these hormones.
An autoimmune disorder called Graves' disease is the most common cause of hyperthyroidism and bulging eyes. In this condition, tissues around the eye become inflamed, creating the bulging effect.
Anyone can develop Graves' disease. It most commonly affects people between the ages of 20 to 50 and is more frequent in women than men.
Other potential causes of bulging eyes include:
If you develop eye bulging in one or both eyes, make an appointment with your doctor as soon as possible.
Be prepared to share your complete medical history with them. You may want to include a list of any prescription or over-the-counter medications and supplements that you take.
Your doctor will also want to know the specifics of your symptoms, such as:
After conducting a physical exam, your doctor may order one or more tests. These may include:
Your recommended treatment plan will depend on the underlying cause of your bulging eyes. For example, depending on your diagnosis, your doctor may prescribe one or more of the following:
If you're diagnosed with Graves' disease or another thyroid condition, your doctor may recommend:
If you have eye problems associated with hyperthyroidism, smoking can make them worse. Quitting may help to reduce your symptoms. Your doctor may recommend a combination of prescription drugs, nicotine replacement therapy, or counseling to help you quit smoking.
Bulging eyes may leave you feeling self-conscious. Emotional support is important to your well-being. Depending on the cause, you may be able to correct the problem with treatment.
If you notice that your eyes are protruding from their natural position, it could be a sign of a serious medical condition. You may want to speak with your doctor. Potential causes could include hyperthyroidism, neuroblastoma, leukemia, or another type of cancer.
During your appointment, share your medical history with your doctor, as well as a list of any medications you're currently taking. Your doctor will likely ask about your symptoms and conduct a physical exam. They may conduct additional tests like a vision test, CT, or MRI.
Based on the diagnosis, your doctor can then prescribe treatment. This could be something like eye drops, antibiotics, or corticosteroids. Certain conditions may require surgery, chemotherapy, or radiation might be required.
For people with Graves' disease or another thyroid condition, treatment could include medication, radioactive iodine, surgery, or replacement thyroid hormone.
I Went Sober After Being Diagnosed With An Autoimmune Disorder. It Helped Me Go Into Remission And Grow My Hair Back.
Editor's note: Business Insider has verified all medical records mentioned in this article.
When I was 50, I was diagnosed with Graves' disease, a common autoimmune disorder that causes an overactive thyroid.
I was a textbook case. I experienced the main symptoms — rapid weight loss, high blood pressure, hair loss, fatigue, inflammation, anxiety, depression — all at the same time. I lost 15 pounds in two weeks and was completely debilitated. I couldn't get out of bed.
There is no cure for Graves' disease. Some people can go into remission after undergoing a thyroidectomy or taking short-term medication, though success rates aren't high. A year into treatment, my endocrinologist didn't give me much hope for getting better; she was throwing different prescriptions at me and they weren't leading to much improvement in my health.
She told me that my diet, which I considered balanced, wouldn't cure me. I wasn't convinced. Because I was sick and tired of feeling sick and tired, I decided it couldn't hurt to cut a few things out.
While I never drank heavily, I was used to having wine with dinner or grabbing a few cocktails at a concert. I knew alcohol is a toxin and that no amount is safe to consume, so I stopped drinking.
Between going sober and cutting out some inflammatory foods like red meat, I started to feel better. My thyroid tests gradually yielded normal levels, and have stayed that way since 2018.
I've also grown my hair back, stopped experiencing panic attacks, and feel happier than ever.
Related stories I became more mindful of what I consume
Even before my Graves' diagnosis, I thought about going sober; I knew how a few drinks could add up.
I also gave up foods that could make my symptoms worse, like seafood, which is high in iodine and can trigger hyperthyroidism. I essentially followed a more plant-based version of the Mediterranean diet.
About six months after making these changes, I saw my endocrinologist again. She said my thyroid levels were getting better. By 2017, they were normal.
Since then, I've loosened up my diet a little — I eat cheese in moderation, for example. I fluctuate, listening to how my body feels.
Still, I haven't given up sobriety.
Going sober fixed my worst symptoms Mina Grace WardOne of my most distressing Graves symptoms was hair loss. I was losing so much that I was actually balding on the top of my head. Since changing my diet, I fully changed course: my hair feels fuller and healthier.
My moods were also impacted by Graves' — anxiety and depression are common symptoms, and I experienced both.
I realized that I felt worse when I drank. I cried all the time. Since quitting, I stopped feeling the sadness I used to. I also no longer have panic attacks. At my worst, I had them three or four times a day.
The biggest change was in my energy levels. Fatigue is a major symptom of Graves' — I was always exhausted. Going booze-free improved my sleep; I started getting a full eight hours and waking up more rested and refreshed. My energy came back.
Even though I didn't have Graves' in my 20s and 30s, I know drinking eventually catches up to you as you age. While I had fun when I was younger, I now want to focus on living longer and maintaining the highest quality of life I can.
I am still in remissionTo be considered in remission from Graves' disease, you have to have normal thyroid levels for two years without medication.
At first, I was close to hitting remission. My doctor weaned me off hyperthyroidism medication and I reached a year and 10 months with good test results. Because I underwent a very stressful time in my life, my symptoms were triggered again. I was put back on medication, and this time, I made sure to follow my new diet as closely as possible and try stress-relieving exercises. Within three months, my numbers went back to normal.
I've now been in remission for seven years, since 2018. I try to use my experience to make a difference: I wrote a cookbook of recipes that helped me reduce my symptoms. My four sons, who work at an Italian restaurant I started with my ex-husband, recently included more vegetarian, vegan, and gluten-free options on the menu after seeing how much they helped me.
I turned 60 this year. I know I'm so much happier because I chose to go sober and change my diet. I absolutely love life; I've never felt this healthy and this alive, all because I started taking care of my body.
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