Background information about the organ
The organ affected by Graves’ disease is the thyroid gland. The thyroid is thumb-sized and is located at the base of the neck in front of the windpipe and right below the Adam’s apple. The thyroid is a butterfly-shaped organ. It has two lobes connected to the isthmus in the middle. When it is in its normal size, the thyroid can be felt moving up and down when one is swallowing. The thyroxine (T4) and triiodothyronine (T3) and calcitonin are secreted in the thyroid which influences the body temperature, growth development and metabolism stability (McCance et al., 2014). The extensive blood supply gives the thyroid the reddish color. The thyroid gland secretes calcitonin which helps in the regulation of calcium ions in the blood and other body fluids. Parathyroid hormone (PTH) is released in the parathyroid gland, which is located on the posterior side of the thyroid gland. A negative feedback loop is attested in the control of secretion of thyroid hormones. Triiodothyronine and thyroxine are secreted and synthesized by the thyroid glands and are responsible for controlling metabolism in the body. This happens when thyroid releasing hormone (TRH) is secreted by neurons in the hypothalamus. The TRH the aids to the secretion of thyroid-stimulating hormone (TSH) by stimulating cells in the anterior pituitary. The thyroid-stimulating hormone helps in the secretion of thyroid hormones which affects almost all cells in the body. THS secretion is shut-off when TRH secretion is inhibited, which results in shutting off thyroid hormone secretion. Negative feedback is relieved when the hormone thyroid levels decay below the threshold.
Background information about the disease
Grave’s disease is an autoimmune illness that results in an overactive thyroid gland that is commonly termed as hyperthyroidism. The attack on a healthy issue by an immune system is what results in an autoimmune disorder. Graves’ disease occurs when the thyroid gland produces excessive thyroid hormones as a result of an abnormal immune response. Hyperthyroidism is stimulated by thyrotropin receptors. Hyperthyroidism is the main cause of Graves’ disease. The thyroid-stimulating immunoglobins, which are the thyroid-stimulating antibodies, override the normal regulatory mechanisms which result in the uncontrolled secretion of the thyroid hormones (McCance et al., 2014).
Graves’ disease was initially referred to as exophthalmic goiter, and it was first described in 1835 by an Irish physician known as Robert James Graves. The disease is the number one cause of hyperthyroidism. The disease is rarely a fatal disease, and not most individuals are well informed about it. In 1840, Karl Adolph van Basedow also described the disease naming it Basedow’s disease without knowledge that the disease had already been described before.
What leads to the development of this disease?
Graves’ disease is caused when the body’s disease-fighting immune system malfunctions. It develops from different factors ranging from environmental and genetic factors. The illness is categorized as an autoimmune disease since an antibody called TSI is created by the body, and once it is activated, it stimulates the thyroid to produce excess hormones that cause hyperthyroidism disorder. The amount of iodine intake in the bloodstream is known to have an active impact on hyperthyroidism and the enlargement of the thyroid gland, which is commonly visible as goiter.
Although Graves’ disease can affect anyone, It more common in young people and in women. There exist many other factors that heighten the risk of an individual acquiring the disease. Graves’ disease is an immune system disorder, and a person’s family history is a huge risk factor. A family history of Graves’ disease can make an individual more vulnerable to the condition. The risk of getting the illness is also heightened by the presence of other autoimmune diseases such as type 1 diabetes or rheumatoid arthritis. Pregnancy and smoking also increases the risk of the disorders (Menconi, Marcocci & Marinò, 2014). Cigarette smoking has a significant effect on the immune system which heightens the risk of getting the Graves’ disorder.
Virtually all the signs and symptoms of the Graves’ condition result from the indirect or direct impacts of hyperthyroidism. An excessive number of thyroid hormones can result in symptoms such as irregular heartbeat, fatigue, anxiety, increased sweating, diarrhea, bulging of the eyes, trouble sleeping and hand tremors. Additionally, the patient can experience frequent defecation, heat intolerance, weight loss and partial muscle weakness or paralysis, among other symptoms. Upon physical examination by the physician, other signs are evident such as diffusely enlarge and non-tender thyroid. People with the condition may also experience personality and behavioral change, including depression, agitation, psychosis and mania (McCance et al., 2014).
Physicians conduct physical examinations when diagnosing Graves’ disease to check on the signs and symptoms. The doctors may also discuss family history or medical history. If the signs and symptoms are not visible, the doctor may also conduct blood tests, radioactive iodine tests, ultrasound tests and imaging tests. The stimulating hormone (TSH) and the levels of thyroid hormones can be determined through blood tests. The rate at which the thyroid gland takes up iodine can be determined to help determine if Graves’ condition is the cause of hyperthyroidism. If the clinical tests are not clear, imaging tests such as CT scan or MRI are used to determine if a person has the condition (Menconi, Marcocci & Marinò, 2014).
Medication, thyroid surgery and radioiodine therapy are the most common forms of treatment of Graves’ disease. Radioiodine therapy is commonly used in the treatment of the condition and it involves taking a dosage of iodine capsules that are radioactive via the mouth. The radioactive capsules destroy the thyroid gland’s cells that secrete the thyroid hormones. Beta blockers are the medication taken to lessen the symptoms of Graves’ disease before other medications work. Antithyroid medicines are used to reduce the number of thyroid hormones produced (McCance et al., 2014). The medications do not offer a permanent cure for the disease but are the most suitable route for breastfeeding and pregnant mothers. The treatment method, which is less common is a surgery that helps to remove the thyroid. However, after the surgery, the patients have to take medication to keep the thyroid levels at a level which is safe.
The disease can be prevented by maintaining a healthy lifestyle such as reducing stressors, exercising regularly and avoiding smoking. Also, individuals should refrain from the disease by trying to obtain low iodine dairy products and seafood. Individuals should limit the amount of meat that they take in due to the high amounts of iodine that they contain. Also, it is key to keep a record of one’s family and medical history so that the right information can be communicated to the doctors for better management of the condition (Smith & Hegedüs, 2016).
Prevalence around the world
Graves’ disease affects around 1 in 200 individuals. The disease is more prevalent in women and young individuals who are below 40 years. The prevalence of the disease significantly varies according to race and ethnicity. It is the most common cause of hypothyroidism in the United States and in other countries globally. Globally, the disease occurs in about 0.5% individuals, and it happens 7.5 times more often in the women than men which are attributed to hormonal factors (Smith & Hegedüs, 2016). Mostly, the disease starts in individuals who are aged between 4o years and 80 years of age (Smith & Hegedüs, 2016).
The current research being embarked on is finding a cure for Graves’ disease. Scientists and researchers are working towards producing a regulating stimulus hormone for the TSI antibody. Scientist are therefore working towards finding a safer and more effective alternative cure for Graves’ illness (Smith & Hegedüs, 2016).
Graves’ disease is an autoimmune disorder which can have minimal or severe impacts depending on if the proper treatment was given and the time when the illness was diagnosed. The cause of the disease has not yet been determined, but it is attributed to genetic and environmental factors. The condition can be prevented by a healthier diet, exercise and low iodine intake. The symptoms should not be ignored, and the medication should be taken as administered by the physicians.
Menconi, F, Marcocci, C, & Marinò, M. (2014). Diagnosis and classification of Graves’ disease. Autoimmunity Reviews. 13(4–5): 398–402. doi:10.1016/j.
McCance, K. L., Huether, S. E., Brashers, V.L., & Rote, N. S. (2014). Pathophysiology: The biologic basis for disease in adults and children (7th ed.). St. Louis: Mosby. (ISBN: 9780-323-08854-1)
Smith, T. J., & Hegedüs, L. (2016). Graves’ disease. New England Journal of Medicine, 375(16), 1552-1565. Retrieved 13 September 2020, from https://www.researchgate.net/scientific-contributions/80926651-TJ-Smith.