What is Grave’s Disease?
BDS (Bachelor of Dental Surgery), 10 years of experience
What is the meaning of Grave’s Disease?
Grave’s disease is an autoimmune disorder that leads to the thyroid gland becoming hyperactive, that is, working harder than required. Grave’s disease is one of the most common disorders of the thyroid, and the main cause of hyperthyroidism, which is a condition in which the thyroid gland produces too many hormones. The thyroid gland is a butterfly-shaped gland that is present in front of the neck and releases hormones for the regulation of metabolism. Grave’s disease is an autoimmune condition, which means that the body’s immune system (disease-fighting system) attacks the thyroid gland, leading to the overproduction of the thyroid hormones, leading to a number of problems. In this article, we will be discussing in detail Grave’s disease and treatment.
- What are the causes of Grave’s Disease?
- What are the risk factors of Grave’s Disease?
- What are the symptoms of Grave’s Disease?
- What is Grave’s ophthalmopathy?
- How to diagnose Grave’s Disease?
- What is the treatment of Grave’s Disease?
- What are the complications of Grave’s Disease?
- How to prevent Grave’s Disease?
- What is the cost of Grave’s Disease Treatment in India?
What are the causes of Grave’s Disease?
- Grave’s disease occurs due to a malfunction in the body’s immune or disease-fighting system. The cause of this is unknown.
- The immune system normally produces antibodies to target specific viruses, bacteria, or other foreign substances.
- In Grave’s disease, the immune system produces an antibody to one part of the cells in the thyroid gland, which is a gland present in the neck region and is responsible for the production of hormones.
- In normal conditions, the function of the thyroid gland is regulated by a hormone released by a tiny gland located at the base of the brain, known as the pituitary gland.
- The antibody which is associated with Grave’s disease is known as thyrotropin receptor antibody (TRAb), which acts as the regulatory pituitary hormone.
- The TRAb overrides the normal regulation of the thyroid gland, leading to an overproduction of the thyroid hormones, known as hyperthyroidism.
( Know more about- What are Thyroid Disorders? )
What are the risk factors of Grave’s Disease?
Some factors may increase the risk of developing Grave’s disease, and may include:
- Family history of Grave’s disease
- More common in women
- Age below 40 years
- Presence of other auto-immune disorders like type 1 diabetes (the immune system destroys the insulin-making cells in the pancreas), or rheumatoid arthritis (inflammatory condition of the joints)
- Stress
- Physical illness
- Pregnancy
- Recent childbirth
- Smoking
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What are the symptoms of Grave’s Disease?
The symptoms of Grave’s disease include:
- Anxiety
- Irritability
- Tremors of the hands or fingers
- Weight loss
- Sensitivity to heat
- Increased perspiration in moist, warm skin
- Goiter (thyroid gland enlargement)
- Reduced libido
- Erectile dysfunction
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- Changes in the menstrual cycles
- Frequent bowel movements
- Fatigue
- Bulging eyes (known as Grave’s ophthalmopathy)
- Irregular or rapid heartbeat (palpitations)
- Disturbances in sleep
- Thick, red skin on the tops or shins of the feet (Grave’s dermopathy)
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What is Grave’s ophthalmopathy?
- Grave’s ophthalmopathy occurs due to the buildup of certain carbohydrates in the tissues and muscles behind the eyes, the cause of which is not known.
- The antibody that leads to thyroid dysfunction may also have an attraction to the tissues that surround the eyes.
- Grave’s ophthalmopathy usually occurs at the same time as hyperthyroidism or several months later.
- The symptoms of ophthalmopathy may appear many years before or after hyperthyroidism and can occur even if there is no hyperthyroidism.
- The symptoms of Grave’s ophthalmopathy include:
- Bulging eyes
- Pain or pressure in the eyes
- Retracted or puffy eyelids
- Inflamed eyes
- Reddened eyes
- Sensitivity to light
- Gritty sensation in the eyes
- Vision loss
- Double vision
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How to diagnose Grave’s Disease?
- Physical examination: The doctor checks the patient physically. The symptoms of the patient are asked, along with the medical history and family history of the patient.
- Blood tests: Blood tests help the doctor in determining the levels of thyroid-stimulating hormone (TSH), the pituitary hormone which stimulates the thyroid gland, and the thyroid hormone levels. People with Grave’s disease normally have a low level of TSH and a high level of thyroid hormones.
- Radioactive iodine uptake: The body requires iodine to make thyroid hormones. The doctor gives a small quantity of radioactive iodine to the patient and later measures its amount in the thyroid gland with a specialized scanning camera. This helps the doctor to determine the rate at which iodine is taken up by the thyroid gland. This test may be combined with a radioactive iodine scan to obtain a visual image of the iodine uptake pattern.
- Ultrasound: This method uses high-frequency sound waves to create images of the internal organs of the body. It shows if there is an enlargement of the thyroid gland.
- Imaging tests: The doctor may recommend imaging tests like CT scans and MRI scans to create clear images of the internal organs of the body.
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What is the treatment of Grave’s Disease?
Grave’s disease is considered to be a lifelong condition. However, the following treatments can help in keeping the thyroid gland in check:
- Beta-blockers:
- Beta-blockers like metoprolol and propranolol are often used as the first line of treatment for Grave’s disease.
- These medicines help in regulating the heart rate and protecting the heart until the other treatments for hyperthyroidism take effect.
- Anti-thyroid medications:
- Medicines like methimazole and propylthiouracil block the production of thyroid hormones.
- Side-effects of these medications may include skin rashes, low white blood cell count, increased risk of infection, and occurrence of liver diseases (rarely).
- Radioiodine therapy:
- A dose of radioactive iodine is given in the form of a pill or liquid form.
- Over a period of two to three months, radiation slowly starts destroying the cells of the thyroid gland. The rest of the body is however not exposed to radiation.
- As the thyroid gland starts shrinking, the hormone levels return to normal.
- This treatment is not recommended for pregnant or breastfeeding mothers.
- Surgery:
- Thyroidectomy is the surgical removal of a part or all of the thyroid gland.
- After surgery a few people tend to produce too little thyroid hormone (known as hypothyroidism). If one develops this problem, the doctor may recommend taking thyroid replacement hormone medications like levothyroxine, or natural desiccated thyroid lifelong.
- Treatment of Grave’s ophthalmopathy:
- Mild cases of Grave’s ophthalmopathy can be treated by using artificial tears during the day and lubricating gels at night, as recommended by the doctor.
- Corticosteroids like prednisone can help in reducing the swelling behind the eyeballs.
- Teprotumumab medicine can be injected into the vein (intravenously) every three weeks, for a total of eight times.
- Prisms in glasses can help in treating double vision.
- Orbital decompression surgery is a procedure by which the doctor removes the bone between the eye socket (orbit) and the sinuses (air spaces next to the orbit) to give the eyes room to move back to their original position.
- Orbital radiotherapy uses targeted x-rays for many days to destroy some of the tissue behind the eyes.
( Know more about- What is Thyroidectomy? )
What are the complications of Grave’s Disease?
The complications of Grave’s disease are:
- Pregnancy problems like:
- Miscarriage
- Preterm birth
- Poor growth of the fetus
- Fetal thyroid dysfunction
- Maternal heart failure
- Preeclampsia (a serious condition causing high blood pressure and other symptoms in the mother)
- Heart disorders like:
- Disorders in the rhythm of the heart
- Changes in the function and structure of the heart muscles
- Heart failure (due to the inability of the heart to pump sufficient blood to the body)
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- Osteoporosis (the bones become weak and brittle)
- Thyroid storm or thyrotoxic crisis, which is a life-threatening condition, which is more likely when severe hyperthyroidism is not treated adequately or untreated. The quick and sudden increase in thyroid hormones can cause:
- Fever
- Vomiting
- Diarrhea
- Delirium (a state of mental confusion)
- Sweating
- Fatigue
- Seizures (abnormal muscle movements due to a burst of uncontrolled electrical activity between the brain cells)
- Irregular heartbeat
- Jaundice (yellowing of the skin and the white portion of the eye)
- Low blood pressure
- Coma
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Contact your doctor immediately if you notice any of the above complications.
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How to prevent Grave’s Disease?
Although Grave’s disease cannot be prevented, the following home remedies help in relieving the symptoms associated with Grave’s disease:
- Eat a well-balanced diet
- Exercise regularly
- Quit smoking
- Managing stress
- Application of cool compress to the eyes
- Wear sunglasses when stepping out
- Use lubricating eye drops to relieve the scratchy, dry sensation on the surface of the eyes
- Keep the head of your bed in an elevated position
What is the cost of Grave’s Disease Treatment in India?
The total cost of Grave’s disease treatment in India can range from around INR 75,000 to INR 4,00,000, depending on the type of treatment done. However, many prominent hospital doctors in India specialize in Grave’s disease treatment. But the cost varies across different hospitals.
If you are coming from abroad, apart from the cost of Grave’s disease treatment, there will be an additional cost of living in a hotel and the cost of local travel. So, the total cost of Grave’s disease treatment in India comes to a total of INR 1,00,000 to INR 5,00,000.
We hope that we could answer all your questions regarding Grave’s disease and its treatment through this article.
If you need more information and treatment of Grave’s disease, you can contact an Endocrinologist.
We only aim to provide you with information through this article. We do not recommend any medication or treatment to anyone. Only a qualified doctor can give you the best advice and correct treatment plan.
