The Definition Of Graves’ Disease: What Does It Mean?

Graves' disease is caused by an autoimmune disorder that disrupts the function of the thyroid. From this, the thyroid becomes overactive, also known as hyperthyroidism. This article explains the symptoms, treatment, and outcomes of Graves' disease and when to see a doctor.

The role of the thyroid

The thyroid is a small butterfly-shaped gland that sits near the front of your neck. Its main purpose is to produce hormones and secrete them into your body.

The hormones that the thyroid gland produces are:

• Calcitonin

• Triiodothyronine (T3)

• Tetraiodothyronine (T4)

For Graves’ disease, T3 and T4 are of primary interest because these hormones are involved in many bodily processes. Calcitonin is involved in fewer processes.

Some of the bodily processes that the T3 and T4 hormones are involved in are:

• Regulating metabolism

• Growth and brain development

• Regulating body temperature

• Regulating heartbeat

• Activation of the nervous system

• Digestion

When the thyroid becomes overactive, it will release more of these hormones. Due to these extra hormones circulating in the body, the processes mentioned above will work faster.

When Graves’ disease is left untreated, the symptoms that arise from an overactive thyroid can become severe. Therefore, anyone with this disease should seek medical advice as soon as possible.

What causes Graves’ disease?

Graves’ disease is caused by a dysfunctional immune system. Also known as an autoimmune condition, this occurs when the immune system attacks the body instead of foreign cells.

With Graves’ disease, the immune system produces antibodies against cells in the thyroid. These antibodies latch onto the thyroid cells, causing the thyroid to start releasing more hormones.

While scientists and doctors are sure that an autoimmune response is the cause of this disease, there is no clear reason why the immune system starts attacking the thyroid in the first place.

What is hyperthyroidism?

Sometimes the term 'hyperthyroidism' is used interchangeably with Graves’ disease. Hyperthyroidism refers to any illness that makes the thyroid overactive. In the US, about 1 in 100 people over the age of 12¹ have hyperthyroidism, four out of five² of whom have Graves' disease.

Two main causes of hyperthyroidism are Graves’ disease and thyroiditis (inflammation of the thyroid gland).

However, other contributing factors can cause hyperthyroidism. These include:

• Overactive thyroid nodules

• Too much iodine

• When too much thyroid medicine is given to a person with an underactive thyroid

• Non-cancerous pituitary gland tumors

You might have also heard of the term 'hypothyroidism.' Because it sounds very similar to hyperthyroidism, it can be easy to get these two words confused.

Hypothyroidism means that the thyroid is underactive. Hyperthyroidism means it is overactive.

An underactive thyroid secretes fewer hormones than it should. Conversely, an overactive thyroid secretes more hormones than it should.

People with Graves’ disease have an overactive thyroid. Understanding this difference is important because the symptoms of both conditions vary.

Why is Graves’ disease called that?

Although the name sounds unusual, rest assured that Graves’ disease has nothing to do with graves! It is named after Robert James Graves,³ an Irish doctor who discovered the illness in 1835.

Many diseases are commonly named after the person who discovered the disease. For example, Hashimoto’s disease, another thyroid condition, was named after a Japanese doctor named Hakaru Hashimoto.

Symptoms and complications of Graves’ disease and hyperthyroidism

The symptoms and complications of Graves’ disease can worsen if left untreated. If you are diagnosed with Graves’ disease, you need to be aware of these aspects to monitor your situation.

Symptoms

Since Graves’ disease results in an overactive thyroid, many symptoms of Graves’ disease are the same as for hyperthyroidism.

Graves’ disease does not affect everyone in the same way. Although there are several possible signs and symptoms of Graves’ disease, you are unlikely to encounter everyone.

Here are some symptoms of Graves’ disease:

• Weight loss

• Increased appetite

• Irregular heart rate

• Rapid heart rate

• Nervousness

• Jitteriness

• Difficulty sleeping

• Daytime tiredness

• Fatigue

• Menstrual changes

• Frequent or irregular bowel movements

Many of these symptoms are caused by increased T3 and T4 hormones. Since elevated levels of these hormones cause bodily processes to speed up, problems arise.

Complications

While there are many symptoms of Graves’ disease, the complications are another aspect of the disease. Graves’ disease is not simply one disease; it can be many disorders present at once, all caused by the same underlying factor.

Some complications that occur after Graves’ disease develops are:

• Goiter

• Ophthalmopathy (eye problems)

• Dermopathy (skin problems) (rarely)

• Thyrotoxic myopathy (muscle problems)

Goiter is a condition in which the thyroid swells up, making the neck look puffy. The goiter will bulge out further and press against the airways and esophagus if left untreated. From this, eating and breathing become more difficult.

Graves' ophthalmopathy is a condition where the eyes become puffy, irritated, sore, and sensitive to bright light. Some people report the sensation of painful pressure in their eyes, and in some cases, people also develop blurred vision.

Graves' dermopathy is a rare skin condition characterized by reddish areas, rough texture, and thickening of the skin. The shins and feet are common places where this is likely to occur. Compared to other complications of Graves’ disease, this one is rare.

Thyrotoxic myopathy⁴ is a muscle complication that occurs when the thyroid hormones reach a level that is toxic to muscles. The characteristics of this complication are:

• Muscle weakness

• Tender muscles

• Muscle fatigue

• Muscle tremors

• Shaky hands

• Heat intolerance

• Wasting of the muscles around the pelvis and shoulders

Lastly, other complications that might occur are osteoporosis (thinning of the bones), problems with fertility and pregnancy due to menstrual changes, heart failure, and blood clots which can cause strokes.

The outcome of Graves’ disease

Some of the symptoms and complications of Graves’ disease can be quite severe. If you are worried about how this disease will impact your quality of life, talk to your doctor.

The symptoms of Graves’ disease can vary between people, so it may impact your life differently from someone else's. Discussing this with your doctor will help you find a treatment plan that suits you.

Some people eventually go into remission, and the problems become less severe. However, it may also become worse. If it does, your doctor will look at other treatment options.

What does it mean if you are diagnosed with Graves’ disease?

If you have been diagnosed with Graves’ disease, you have an underlying autoimmune disorder. You will need to start treatment so that you can improve your condition.

Being diagnosed with Graves’ disease also means that your thyroid is overactive and that you have hyperthyroidism. Because of this, the treatment you take will aim to reduce the activity of your thyroid.

Graves’ disease has several complications; it is a disease that can cause other disorders to occur.

You will need to monitor your symptoms and have regular appointments with your doctor. Doing so will improve your quality of life as much as possible.

Lastly, you may also wish to tell your family if you feel comfortable doing so. Thyroid disorders can be hereditary, and alerting family members of this can help them detect any issues sooner rather than later.

When to see a doctor

If you have not been diagnosed yet but are experiencing some signs and symptoms of Graves’ disease, talk to your doctor.

To confirm whether or not you have a thyroid disorder, your doctor will order some tests for you. The tests will help determine what thyroid disorder is present and help your doctor give you the best treatment plan possible.

If you have been diagnosed but your symptoms are getting worse, or if you start developing any of the complications, then you should see a doctor immediately.

To improve your quality of life, you must monitor your condition so that you can stay on top of the disease.

The lowdown

Graves’ disease is an autoimmune disease in which the body's natural defense system attacks thyroid cells. It is important to understand the symptoms, complications, and implications of what it means to live long-term with this disorder.

Do not hesitate to talk to your doctor if you have any concerns.