Graves' disease
The thyroid gland
produces hormones that regulate several body functions, such as the nervous
system, brain development, and body temperature. In people with Graves'
disease, the thyroid gland produces more hormones than needed.
Excess thyroid
hormone production can cause severe heart, muscles, menstrual cycle, eyes, and
skin disorders if not appropriately treated. Although many other diseases can
cause
hyperthyroidism, Graves' disease is the most common cause of the condition.
Graves' disease
is most common in women and people younger than 40. However, basically, this
disease can be experienced by anyone.
Causes and Risk Factors for Graves' Disease
Graves'
disease occurs due to a disorder of immune system function. Under normal
conditions, the immune system protects the body from foreign disease-causing
organisms, viruses, and bacteria.
However, it is
not yet known precisely the cause of the immune system producing antibodies
that attack the thyroid gland. However, some of the factors below are known to
increase a person's risk of developing Graves' disease:
- Female sex
- Aged 20-40 years
- Have a history of Graves' disease in
the family
- Suffer from other autoimmune
diseases, such as rheumatoid arthritis or type 1 diabetes
- Experiencing stress
- Just gave birth in 1 year
- Have had a
mononucleosis infection
- Have a habit of smoking
Symptoms of Graves' Disease
Graves' disease
can cause varying symptoms. Symptoms generally appear mild at the beginning or
even invisible, then gradually develop into more severe. Some of the symptoms
are:
- Enlargement of the thyroid gland(mumps
disease)
- Tremors in the hands or fingers
- Heart palpitations(heart palpitations)or irregularly beating heart(arrhythmia)
- Changes in the menstrual cycle,
including late menstruation
- Erectile
dysfunction
- Losing weight without losing appetite
- Moods are easy to change
- Decreased sexual arousal
- Difficulty sleeping(insomnia)
- Diarrhea
- Hair loss
- Easily tired
- Easily sweat
- Sensitive to hot air
In addition to
some of the above symptoms, about 30% of people with Graves' disease
experience several typical symptoms: Graves' ophthalmopathy and Graves' dermopathy.
Graves' ophthalmopathy symptoms result from inflammation or
disruption of the immune system, which affects the muscles and tissues around
the eyes. Symptoms include:
- Protruding eyes (Exophthalmos)
- Dry eyes
- Pressure or pain in the eyes
- Swollen eyelids
- Reddened eyes
- Sensitive to light
- Double vision
- Loss of vision
Graves'
dermopathy is less
common. The symptoms are skin that is flushed and thickened like orange
peel. Graves' dermopathy most often occurs in the shin area and in
the back of the foot.
When to go to the doctor
Check with your doctor if you experience any of the symptoms mentioned above.
Early screening can improve the accuracy of the diagnosis and the effectiveness
of treatment.
See your doctor
or the nearest IGD if you experience heart-related symptoms, such as heart
palpitations, irregular heartbeats, or vision loss.
Diagnosis of Graves' Disease
To Diagnose a Serious
disease doctor will do Tanya's answer about symptoms and Complaints that the patient
has natural, history of disease Previous, and history of a healthy family.
After that, the
doctor will check the patient's vital signs, ranging from pulse, blood
pressure, body temperature, to breath rate. The doctor will also perform a
physical examination, especially an analysis of the thyroid gland in the neck,
and look for graves' ophthalmopathy and graves' dermopathy.
To confirm the
diagnosis, the doctor may perform several supporting examinations, such as:
- Blood tests to measure thyroid hormone
levels as well as levels of pituitary hormones that regulate hormone
production from the thyroid gland
- Radioactive iodine test, to see the
function of the thyroid gland by ingesting low doses of radioactive iodine
- Antibody test, to find out the presence of
antibodies that attack the thyroid gland
- CT scan or MRI to see an enlargement of the thyroid
gland
- Ultrasound, to see an enlargement of the thyroid
gland, especially in patients who are pregnant
Treatment of Graves' Disease
The treatment of
Graves' disease aims to reduce the overproduction of thyroid hormones and their
impact on the body. Some of the treatment options are:
Drugs
Medications that
can be given by doctors to treat Graves' disease include:
- Antithyroid drugs, such as
methimazole and propylthiouracil, inhibit thyroid hormone production
- Beta-inhibiting drugs, such as propranolol, metoprolol, atenolol, and nadolol, reduce the effects of
thyroid hormones on the body, such as irregular heartbeat, restlessness,
tremors, excessive sweating, and diarrhea.
Radioactive iodine therapy
Radioactive
iodine therapy is done by taking pills containing low doses of radioactive
iodine. The medicine destroys overactive thyroid cells and shrinks the thyroid
gland, so symptoms will gradually decrease over several weeks to several
months.
Radioactive
iodine therapy is not recommended in people with Graves' ophthalmopathy
because it can make symptoms worse. In addition, this therapy should also not
be used in pregnant women and nursing mothers.
Given that this
therapy works by destroying thyroid cells, patients will most likely need
additional thyroid hormones to increase the reduced amount of thyroid hormone.
Operation
After surgery,
the patient will need follow-up therapy in synthetic thyroid hormones to
increase low thyroid hormone levels due to removing the thyroid gland.
This action risks
causing damage to the vocal cord-regulating nerves. The risk of injury can also
occur in the parathyroid glands, which produce hormones regulating
calcium levels in the blood.
Graves' ophthalmopathy can persist even if Graves' disease
itself has been successfully treated. In fact, Graves's ophthalmopathy symptoms can still
worsen up to 3–6 months after treatment. This condition will usually last up to
a year, then begin to improve on its own.
If needed, Graves'
ophthalmopathy will be treated with corticosteroids or teprotumumab. In
some cases, surgery may be required to prevent blindness.
Self-care
After carrying
out the above treatments, people with Graves' disease are recommended to carry
out a healthy lifestyle by taking the following steps:
- Eating a balanced nutritious diet, such as vegetables and fruits
- Exercising regularly
- Manage stress well
Meanwhile, people
who experience Graves' ophthalmopathy are encouraged to do the following:
- Using artificial
tears, which can be
obtained in pharmacies
- Taking corticosteroid medications,
which have been prescribed by a doctor
- Use sunglasses so that the eyes avoid
sun exposure
- Puts a cold compress on the eyes
- Raise the head if you want to sleep
- Not smoking
Patients with
Graves' dermopathy symptoms can also be treated using corticosteroid
ointments and compressing the complained part of the foot to reduce swelling.
Complications of Graves' Disease
Graves' disease
that is not treated immediately can lead to the emergence of dangerous
complications, such as:
- Pregnancy disorders, such as
premature birth, thyroid dysfunction in the fetus, decreased fetal
development, high blood pressure in the mother (preeclampsia), heart
failure in the mother, to miscarriage
- Heart disorders, such as arrhythmias,
changes in heart structure and function, and heart failure
- Osteoporosis
- Thyroid crisis (thyroid storm)
Prevention of Graves' Disease
Graves' disease
is difficult to prevent because it is classified as an autoimmune
disease. However, you can lower the risk of Graves' disease by regularly
checking if you have a history of autoimmune diseases or have a family history
of Graves' disease.
In addition, the
risk of developing Graves' disease can also be reduced by changing lifestyle to
be healthier, such as not smoking, maintaining ideal body weight, and
exercising regularly.
