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Grave's Disease
Graves'
disease is a treatable condition caused by overproduction of thyroxine; a
hormone produced by the thyroid gland.
Cause and Risk Factors for Grave's Disease
Graves'
disease is caused by the immune system attacking the
thyroid gland and
causing it to overproduce thyroxine. Although no cause for this disease is
known, there are several risk factors for Graves'
disease including:
Symptoms
Graves'
disease can cause many symptoms including anxiety, irritability, insomnia,
weight loss, tremor in the hands and fingers and goiter. Graves'
ophthalmology, a condition where the eyes protrude outward due to soft
tissue swelling behind the eyeball, is present in about 40% of cases.
Some of the more serious complications of untreated Graves'
disease include cardiac problems and
osteoporosis. Hyperthyroidism can cause
a rapid heart rate, rhythm problems and congestive heart failure.
Thyroid
hormones also interfere with calcium absorption and lead to weaker bones.
Prompt diagnosis and treatment of this disease is critical.
Diagnosis
Accurate diagnosis of Graves'
disease requires several different tests. First, your physician will perform
a physical examination and medical history. This examination will include
checking the eyes, the size of the thyroid gland, looking for signs of
trembling and measuring pulse and blood pressure.
If Graves' disease is
suspected, your physician will order a blood sample to be taken and checked
for two hormones; thyroid stimulating hormone (TSH) and thyroxine. Low to
normal TSH, but high thyroxine levels, confirm hyperthyroidism. However, to
determine weather the hyperthyroidism is due to Graves'
disease, further testing is required.
A radioactive iodine uptake test may be ordered to give a definitive
diagnosis. Radioactive iodine will be injected into your blood and the rate
at which it is absorbed into the thyroid gland will be measured. A fast
uptake of the iodine from the bloodstream to the thyroid indicates Graves'
disease.
Treatment
No treatment exists to cure Graves'
disease; all that can be done is to prevent the symptoms associated with it.
The main goal of treatment is to control the symptoms by either blocking the
production of thyroxine or blocking the action of thyroxine. Treatment
options for Graves' disease include:
Beta blockers
Beta-blockers relieve the symptoms of rapid heart rate,
high blood pressure,
and tremors, although they do not block the actions of thyroxine.
Propranolol, atenolol, and metoprolol are most-commonly prescribed. However,
additional therapies should be administered to address the high thyroxine
production.
Anti-thyroid medications
Anti-thyroid medications, such as methimazole and propylthiouracil, block
the thyroid gland from producing too much thyroxine. While long-term
treatment with these drugs can cause the disease to go into remission,
relapses are common. Patients typically stay on these drugs for 6 months to
2 years depending on the severity of the disease and the response to the
medication. These drugs are usually well tolerated. Minor side effects such
as rash, fever, sore throat and nausea are seen in 1 of every 8 patients.
Radioactive iodine treatment
Iodine is needed to produce thyroid hormone. Treatment with radioactive
iodine in an injection or a capsule causes the iodine to collect in the
thyroid gland and destroy the overactive cells. Over time, the thyroid gland
will shrink and produce less thyroxin. Life-long thyroxine treatment is
usually necessary to offset these effects.
Surgery
A final treatment option, surgery, is available if other therapies fail or
if the patient has serious complications such as a goiter compressing the
airway. Several different types of thyroid surgery exist including a total
removal of the thyroid gland, a subtotal thyroidectomy, where the bulk of
the thyroid gland is removed and a bilateral subtotal thyroidectomy, where
most of each lobe of the gland is removed. Subtotal thyroidectomy is the
most commonly performed surgery with a total removal reserved for special
circumstances. Treatment outcomes among the different
surgery types are
similar. Thyroxine treatment is necessary in many patients after the surgery
to maintain normal thyroid hormone levels.
Prognosis
The outlook for patients with Graves'
disease is positive if they receive prompt treatment for their condition.
However, untreated Graves'
disease can result in potentially life-threatening complications and even
early death. Patients must be continually monitored for hypothyroidism,
which may warrant additional treatment if detected. Because Graves'
disease cannot be cured, patients must remain vigilant in taking medications
and attending scheduled checkups. Patients must also be vigilant with their
diets and consume plant foods in abundance which are rich in
phytonutrients and other
natural
vitamins in order to help alleviate the symptoms of Graves Disease.
Graves' patients must
maintain a healthy weight and, in the presence of hypothyroidism and a lower
metabolic rate, this can be challenging. Graves'
patients must be educated about how to eat nutritious, phytonutrient and
vitamin rich lower calorie meals and to exercise regularly in order to
offset the effects of a lower metabolism.
Patients with Graves'
disease are also prone to depression, and especially so if they also show
physical symptoms of Graves'
ophthalmology. These patients often have a low
self-image, are dissatisfied
with their appearance and are more socially isolated. Aside from regular
exercise and maintenance of a healthy body weight, identifying and
socializing with family, friends and support groups can also improve quality
of life and provide these patients with a better outlook on life.
You must seek approval from your doctor
before starting any new diet.
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