The condition that would come to be known as Graves' disease was first, and briefly, documented by the English physician Caleb Hillier Parry in the late 1700s when he made the connection between an enlarged thyroid gland (goiter), rapid heartbeat and cardiovascular complications.However, the real breakthrough in studying this disorder took place when Robert James Graves, an Irish physician, discovered in the 1830s that several of his patients not only displayed an enlarged thyroid gland with a rapid or irregular heartbeat, but also enlarged and protruding eyes.
Some people inherit an immune system that can cause problems. Their lymphocytes make antibodies against their own tissues that stimulate or damage them
With Graves' disease, the immune system makes antibodies that act like TSH, causing the thyroid to make more thyroid hormone than your body needs. This is called an overactive thyroid or hyperthyroidism.
Graves’ disease (An autoimmune Disease)
Cherry Kristine Gomez Lavador
Biologist of Caraga State University
The thyroid gland is a butterfly-shaped
endocrine gland that is normally located in the
lower front of the neck. The thyroid’s job is to
make thyroid hormones, which are secreted into
carried to every tissue in the body. Thyroid
hormone helps the body use energy, stay
warm and keep the brain, heart, muscles,
and other organs working as they should.
Graves' disease is an autoimmune disease in
which the patient's own immune system attacks
the thyroid gland, causing it to produce too much
thyroxine. Thyroxine (T4) is a hormone produced
by the thyroid gland that has four iodine molecules
attached to its molecular structure. T4, as well as
other thyroid hormones help regulate growth and
control metabolism in the body.
Although Graves' disease may develop at
any age in both women and men, it more
commonly affects women aged 20 years or more.
Currently, there are no medications or treatment to
stop the patient's immune system from attacking
their thyroid gland. However, treatments do exist
which can ease the symptoms and bring down the
production of thyroxine.
The syndrome typically includes two major
to Graves’ disease, and caused by the autoimmunity
include the exophthalmos, thyroid enlargement and
thyroid stimulation, and the dermal changes.
The second set of problems is caused by the
excess thyroid hormone. This thyrotoxicosis, or
hyperthyroidism, does not differ from that induced by
any other cause of excess thyroid hormone.
What causes Graves’ disease?
Graves’ disease is triggered by some process in the
body’s immune system, which normally protects us from
foreign invaders such as bacteria and viruses.. In Graves’
disease, antibodies bind to the surface of thyroid cells and
stimulate those cells to overproduce thyroid hormones.
The cause of Graves' disease is thought to be
related to many factors including genes, gender,
stress, pregnancy and possibly infections.
If, for some reason, the thyroid gland secretes an
overabundance of these hormones, the body's metabolism goes
into high gear, producing the pounding heart, sweating, trembling,
and weight loss typically experienced by hyperthyroid people.
production orders through another chemical called thyroidstimulating hormone(TSH), released by the pituitary gland in the
malfunction in the body's immune system releases abnormal
TSH. Spurred by these false signals to produce, the thyroid's horm
one factories work overtime and exceed their normal quota.
Table 1 - Important Thyroid-Related Hormones and Elements
Thyroid Stimulating Hormone; secreted by the pituitary gland.
Stimulates the thyroid, causing it to release thyroid hormones.
Triiodothyronine; a less abundant but more potent thyroid
hormone. Aids in regulating metabolism and heart rate.
Thyroxine; the most important thyroid hormone. Processes iodine
in the thyroid, affects mitochondrial activity, regulates protein
synthesis and breakdown and carbohydrate metabolism. This
T4 hormone stimulates the central nervous system and the endocrine
system, and remains active in the body for up to a month. Too
much thyroxine can cause over-stimulation of the
nervous/endocrine systems as well as increased metabolism.
An important element necessary for healthy thyroid functioning.
Too much stored iodine in the thyroid is a sign of
hyperthyroidism. Iodine deficiency or allergy can result in a
goiter (swollen thyroid gland).
Breast enlargement in men (possible)
Eyeballs that stick out (exophthalmos)
Eye irritation and tearing
Irregular menstrual periods in women
Rapid or irregular heartbeat (palpitations or arrhythmia)
Restlessness and difficulty sleeping
Shortness of breath with activity
Weight loss (rarely, weight gain)
Older patients may have these symptoms:
Rapid or irregular heartbeat
Weakness and fatigue
Tests to diagnose Graves' disease
Thyroid function tests
-A blood sample is sent to a lab to see if your body has the right amount
of thyroid hormone (T4) and TSH. A high level of thyroid hormone in the blood
plus a low level of TSH is a sign of overactive thyroid. Sometimes, routine
screening of thyroid function reveals mild overactive thyroid in a person without
symptoms. In such cases, doctors might suggest treatment or watchful waiting to
see if levels return to normal.
Radioactive iodine uptake (RAIU)
- An RAIU tells how much iodine the thyroid takes up. The thyroid
takes up iodine and uses it to make thyroid hormone. A high uptake suggests
Graves' disease. This test can be helpful in ruling out other possible causes of
-A blood sample is sent to a lab to look for antibodies that suggest
Treatment is aimed at controlling your overactive
thyroid. Medicines called beta-blockers are often used to
treat symptoms of rapid heart rate, sweating, and anxiety
until the hyperthyroidism is controlled. Hyperthyroidism is
treated with one or more of the following:
If you have radiation or surgery, you will need to take
replacement thyroid hormones for the rest of your life,
because these treatments destroy or remove the gland.
Some of the eye problems related to Graves disease
usually improve when hyperthyroidism is treated with
medications, radiation, or surgery. Radioactive iodine can
sometimes make eye problems worse. Eye problems are worse
in people who smoke, even after the hyperthyroidism is cured.
Sometimes prednisone (a steroid medication that
suppresses the immune system) is needed to reduce eye
irritation and swelling.
You may need to tape your eyes closed at night to prevent
drying. Sunglasses and eye drops may reduce eye irritation. In
rare cases, surgery or radiation therapy (different from
radioactive iodine) may be needed to prevent further damage
to the eye and loss of vision.