Graves-Basedow disease: symptoms, causes and treatment.

A problem caused by the Thyroid glands and affecting the eye region.

Thyroid hormones are a substance produced by the thyroid glands. These hormones perform countless functions in our body, especially in metabolic processes, but are especially known for their role in the regulation of energy and body temperature.

Without their functioning, however, our body would find it very difficult to survive, their overproduction can also lead to various physical diseases, one of which is Graves-Basedow disease.. Therefore, we will dedicate this article to talk about what is Graves' disease and what are its symptoms, causes and treatment.

What is Graves-Basedow disease?

Graves' disease, also known as Graves-Basedow disease, is a disease of the immune system that affects the thyroid and is the most common cause of hyperthyroidism. That is, the excessive and abnormal production of thyroid hormones.

Since these thyroid hormones have various roles in several different body systems, the symptoms of Graves' disease can be very varied and can significantly interfere with a person's overall health.

Of all these symptoms, perhaps the best known is the development of an ocular protrusion caused by Graves' ophthalmopathy, which often causes eye problems.Graves' ophthalmopathy, which usually causes severe eye problems in 25-80% of affected individuals.

The specific causes of Graves-Basedow disease have not yet been elucidated.. However, a combination of genetic and environmental factors is hypothesized to cause this condition. Regardless of the cause, there is a treatment for this disease which may consist of radioactive iodine therapy, drug therapy or thyroid surgery.

According to studies, Graves' disease occurs seven times more often in women than in men, with a 0.5% chance of occurrence in men and a 3% chance in women. Usually, the first symptoms of this disease usually appear around 40 to 60 years of age, but the reality is that anyone can be affected by it.

What are the symptoms?

As mentioned above, thyroid hormones play a fundamental role in any metabolic and functional process of our tissues, so any alteration in their production can cause a myriad of symptoms.

In the specific case of Graves' disease there is a hyperactivation of the thyroid glands (hyperthyroidism), so the symptoms of the disease are related to the excessive production of thyroid hormones.

The main symptoms of Graves' disease are:

• Mild tremor in hands and fingers
• Sensitivity to heat
• Increased sweating and/or warm, clammy skin
• Weight loss in spite of maintaining normal eating habits
• Goiter or enlarged thyroid glands
• Altered menstrual cycle
• Erectile dysfunction and/or decreased sexual desire
• Increased bowel movements
• Graves' ophthalmopathy
• Graves' dermopathy
• Palpitations
• Feeling of fatigue
• Anxiety
• Irritability

Of all the above symptoms, Graves' ophthalmopathy and Graves' dermopathy are the most easily identifiable. They are explained below:

Graves' ophthalmopathy

Although it does not necessarily occur in everyone, about 30% of cases of Graves' disease show signs and symptoms of a condition called Graves' ophthalmopathy.. This type of disorder is characterized by an alteration of the immune system that causes inflammation of the muscles and tissues surrounding the eyes. As a result, the person develops bulging eyes very characteristic of this disease.

In addition, this eye disorder often leads to discomfort and symptoms related to vision. These include:

• A gritty sensation in the eyes
• Eye pressure or pain
• Swollen or retracted eyelids
• Red or inflamed eyes
• Hypersensitivity to light
• Double vision
• Loss of vision

Graves' dermatopathy

The second most visible and characteristic sign of Graves' disease is a very rare dermal manifestation, called Graves' dermopathy, which consists of reddening and thickening of the skin, especially at the level of the shins or on the top of the foot.

Causes

Because of its autoimmune nature, Graves' disease is known to be caused by a malfunction of the immune system.. However, the exact reason for this defect has not yet been determined.

In a properly functioning immune system, there is a normal antibody-producing response to the appearance of a virus, bacteria or any pathogen for the purpose of attack. However, in Graves' disease, for reasons that are not yet understood, the body produces antibodies to attack part of the cells of the thyroid glands.

These Graves' disease-related antibodies, called thyrotropin receptor antibodies, act like a pituitary regulatory hormone. As a result, this antibody overrides the normal regulation of thyroid function, causing an overproduction of thyroid hormones or hyperthyroidism.

Risk factors

Although it is not known exactly what triggers Graves' disease, there are a number of associated risk factors, there are a number of risk factors associated with the development of Graves' disease.. Risk factors for Graves' disease include:

• Family history with cases of Graves' disease.
• Sex: women have a higher incidence of this condition.
• Age: the likelihood of developing Graves' disease increases after the age of 40.
• Experiencing emotional or physical stress
• Pregnancy
• Smoking

Is there a treatment?

The main goal of treatment for Graves' disease is to inhibit the production of thyroid hormones and block their effect on the body. For this purpose, the patient can undergo the following treatments for Graves' disease.

1. Radioactive iodine therapy

By administering radioactive iodine orally, a decrease in the size or shrinkage of the thyroid gland is produced, so that the symptoms gradually diminish over several weeks or months.

2. Antithyroid drug therapy

Antithyroid drugs, such as propylthiouracil and methimazole, interfere with the functioning of the thyroid glands to decrease hormone production.

3. Beta-blocker drugs

Unlike antithyroid drugs, beta-blockers do not inhibit the production of thyroid hormones, but block their effect on the body. These drugs include:

• Propranolol
• Atenolol
• Metoprolol
• Nadolol

4. Surgery

Thyroidectomy or subtotal thyroidectomy is the partial or complete removal of the thyroids. After surgery, it is very possible that the person may need supplements to supply the body with the normal amounts of thyroid hormones needed.

5. Treatment of Graves' ophthalmopathy

While people with mild eye problems may resort to the use of eye drops, artificial tears or lubricating eye gels, the following interventions or treatments are recommended for more severe cases of Graves' ophthalmopathy:

• Corticosteroids
• Glasses with prisms to eliminate double vision.
• Orbital decompression surgery
• Orbital radiation therapy

Referencias bibliográficas:

• Menconi, F., Marcocci, C. & Marinò, M. (2014). Diagnosis and classification of Graves' disease. Autoimmunity Reviews, 13(4–5): 398–402.
• Brent, G. A. (2008). Clinical practice. Graves' disease. The New England Journal of Medicine, 358 (24): 2594–2605.