Graves’ Disease: A Risk Analysis

Affecting one in 200 people in the United States, Graves' Disease is characterized by an overactive thyroid.

What is Graves' Disease?

Graves’ Disease (“Graves’”) is a multisystem autoimmune disorder that is characterized by hyperthyroidism or overactive thyroid. It is usually associated with an enlarged thyroid gland and exophthalmos (abnormal protrusion of the eyeballs).[1] Graves’ is the most common cause of hyperthyroidism in the United States, affecting one in 200 people.[2] You’ll find that Graves’ is a middle-aged woman’s disease in my risk analysis. Also, genetics and environment are linked to the disease.

Cause or Possible Cause of Graves’ Disease

To date, no definitive cause for Graves’ has been determined. Researchers believe that the disease is developed from a combination of genetics and environmental influences like a virus:

Genetics: The most convincing evidence for genetic predisposition of Graves’ is provided by twin studies. Model-fitting analysis showed that 79 percent of the predisposition is attributable to genetic factors.[3]

Environment: Results from twin studies indicate that individual specific environmental factors not shared by twins play a 21percent role in the predisposition of Graves’.[4] Viruses such as Epstein-Barr has also been linked to Graves’.[5]

Newer research indicates that Graves’ may only be a secondary disease acquired by immunodeficiency that results in autoimmunity once certain triggering events occur. This may be why there is a low response to anti-thyroid treatment.[6]

What Graves’ Disease Does to the Body

Common symptoms of Graves’ include[7]:

  • Anxiety
  • Insomnia
  • Fatigue
  • Restlessness, irritability, or nervousness
  • Hand tremors
  • Sensitivity to heat
  • Increased sweating
  • Bulging eyes
  • Vision problems or changes
  • Cardiovascular problems (chest pain, elevated blood pressure, rapid or irregular heartbeat, shortness of breath or difficulty breathing)
  • Muscle weakness
  • Irregular menstrual periods
  • More frequent stools or diarrhea
  • Unexplained weight loss (despite an increase in appetite)

What Happens as Graves’ Disease Progresses

Many complications can erupt if Graves’ isn’t treated[8]:

Heart Disorders: Heart rhythm irregularity and heart failure.

Thyroid Storm: A sudden increase in thyroid hormones that can result in heart failure and pulmonary edema.

Pregnancy Problems: Miscarriage, preterm birth, fetal thyroid dysfunction, maternal heart failure, and preeclampsia.

Brittle Bones: Osteoporosis.

Risk Influence for Graves’ Disease

Graves’ disease affects primarily women by 93 percent. Ages vary from 21 to 59 years with a median age of 40.6 years. Genetics and high stress play a role.[9] People with Graves’ have an increased risk of developing other autoimmune disorders such as Celiac disease, type 1 diabetes, lupus, rheumatoid arthritis, Addison disease, pernicious anemia, and vitiligo.[10]

Conventional Treatment for Graves’ Disease

People with Graves’ currently have three treatment options in allopathic medicine, and the therapy used depends on factors such as a person’s age, pregnancy, and/or medical conditions. Radioiodine therapy is the most common treatment which slowly destroys the cells of the thyroid gland that produce thyroid hormone. Other anti-thyroid medicines may also be used, as well as beta blockers to reduce symptoms. The least common treatment for Graves’ is surgery to remove the thyroid gland. Surgery treats people with large goiters and those who may have allergic reactions to thyroid medications.[11] Unfortunately, 50 percent of people with Graves’ are non-responders to anti-thyroid medications.[12]

Conclusion

With half of Graves’ patients not having good results with conventional medicines to reduce their thyroid hormones, there has to be a better way for treatment and reducing symptoms. Cigarette smoking must be eliminated, as well as other environmental toxins. However, managing stress levels and eating an anti-inflammatory diets are crucial. Learn how to read your thyroid lab results by checking out my article How to Understand Your Thyroid Panel Results.

References

[1] Graves’ Disease (n.d.). The Free Dictionary by Farlex (Medical Dictionary). Retrieved from https://medical-dictionary.thefreedictionary.com/Graves%27+disease.

[2] Burch, H. & Wartofsky, L. (2017, September). Graves’ Disease. U.S. Department of Health and Human Services: National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved from https://www.niddk.nih.gov/health-information/endocrine-diseases/graves-disease.

[3] Ploski, R. Szymanski, K. & Bednarczuk, T. (2011, December). The Genetic Basis of Graves Disease. Current Genomics, 12(8), 542-563. Doi: 10.2174/138920211798120772. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3271308/.

[4] Ploski, R. Szymanski, K. & Bednarczuk, T. (2011, December). The Genetic Basis of Graves Disease. Current Genomics, 12(8), 542-563. Doi: 10.2174/138920211798120772. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3271308/.

[5] Nagata, K., Kumata, K., Nakayama, Y., et al. (2017, April). Epstein-Barr Virus Lytic Reactivation Activates B Cells Polyclonally and Induces Activation-Induced Cytidine Deaminase Expression: A Mechanism Underlying Autoimmunity and Its Contribution to Graves’ Disease. Viral Immunology, 30(3), 240-249. Doi: 10.1089/vim.2016.0179. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5393416/.

[6] Struja, T., Kutz, A., Fischli, S., et. al. (2017, September 25). Is Graves’ Disease a Primary Immunodeficiency? New Immunological Perspectives on an Endocrine Disease. BMC Medicine, 15, 174. Doi: 10.1186/s12916-017-0939-9. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5611589/.

[7] Sargis, R. (2017, April 4). Graves’ Disease Symptoms. EndocrineWeb. Retrieved from https://www.endocrineweb.com/conditions/graves-disease/graves-disease-symptoms.

[8] Marks, L. (2015, December 21). What is Graves’ Disease? Everyday Health. Retrieved from https://www.everydayhealth.com/graves-disease/guide/.

[9] Jankovic, S., Radosavlijevic, V. & Marinkovic, J. (1997, January). Risk Factors for Graves’ Disease. European Journal of Epidemiology, 13(1), 15-18. Retrieved from https://www.everydayhealth.com/graves-disease/guide/.

[10] Graves Disease. (n.d.) U.S. National Library of Medicine: Genetics Home Reference. Retrieved from https://ghr.nlm.nih.gov/condition/graves-disease#sourcesforpage.

[11] Burch, H. & Wartofsky, L. (2017, September). Graves’ Disease. U.S. Department of Health and Human Services: National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved from https://www.niddk.nih.gov/health-information/endocrine-diseases/graves-disease.

[12] Struja, T., Kutz, A., Fischli, S., et. al. (2017, September 25). Is Graves’ Disease a Primary Immunodeficiency? New Immunological Perspectives on an Endocrine Disease. BMC Medicine, 15, 174. Doi: 10.1186/s12916-017-0939-9. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5611589/.

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