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home : columns : ask the doctors September 30, 2020

7/17/2020 8:17:00 AM
Graves' disease causes hyperthyroidism

Dear Doctor: I saw my doctor because my heart was beating funny and I was losing weight even though I wasn't dieting. She did a blood test, and it turns out to be Graves' disease. Why did I get that? Is there a cure?

Dear Reader: When someone has Graves' disease, it means a malfunction of their immune system has caused their thyroid gland to become too active. Known as hyperthyroidism, it's a condition that causes the overproduction of thyroid hormones. Since these hormones play an important regulatory role in many parts of the body, the symptoms of Graves' disease can be quite varied.

The thyroid is part of the collection of glands located throughout the body known as the endocrine system. Their job is to produce hormones, which are chemical messengers. They regulate bodily processes such as metabolism, sleep, mood, growth and development, reproduction, tissue function and sexual function, to name just a few.

The thyroid itself is a small gland. It weighs less than an ounce and is shaped roughly like a butterfly. It's located at the base of the throat, just below the larynx, and consists of a pair of matching lobes that sit on either side of the windpipe. The thyroid takes the iodine in our diet and manufactures two main hormones, which help regulate vital functions throughout the body. These include heart rate, body weight, body temperature, muscle strength, breathing, cholesterol levels, the central and peripheral nervous systems, and in women, menstrual cycles. So you can see how any malfunction of the thyroid can have a wide-ranging effect on general health.

When it comes to Graves' disease, the cause is unknown. It usually develops before the age of 40, and is more common in women than in men. People with existing autoimmune disorders are at increased risk of developing Graves' disease, and family history can play a role. Cigarette smoking is a risk factor, as well.

Symptoms of Graves' disease include the unexplained weight loss and irregular heartbeat that you experienced, as well as anxiety or irritability, sleep disturbance, fatigue, reduced libido, sensitivity to heat, and tremor in the fingers or hands. Some people develop Graves' ophthalmopathy, which is a collection of eye-related symptoms such as pressure, grittiness, light sensitivity and vision problems. Graves' dermopathy, which is rare, causes the skin on the shins or tops of the feet to thicken and become red.  

Diagnosis is via blood tests to determine thyroid hormone levels, imaging tests to look at the size of the thyroid or tests that assess the rate at which the thyroid is using iodine. There is no cure at this time. Instead, treatment focuses on slowing thyroid activity. This can be achieved through radioactive iodine therapy, which gradually destroys overactive thyroid cells; medications that either interfere with the thyroid's ability to produce hormones or block the effects of thyroid hormones on the body; or thyroid surgery. Lifestyle changes such as a healthful diet, regular exercise and doing what you can to ease stress are also important for managing the condition. Complications can be serious, including heart disorders and problems during pregnancy, so it's important to seek treatment.

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