Graves’ disease From thyroid storms to bulging eyes, it’s no wonder that a diagnosis of this disease can seem a bit scary at first. Despite the scary-sounding name, Graves’ disease is actually highly treatable and manageable, especially when detected early. We’re here at Dalili Medical to help you get clear answers to all your pressing questions about this disease.

What is Graves’ disease?

 

Graves’ disease is an autoimmune condition that causes the body to produce excess amounts of thyroid hormones (hyperthyroidism). Although different diseases can cause hyperthyroidism, Graves’ disease remains the main cause in most cases. The signs and symptoms of this disease can vary greatly as thyroid hormones affect many different body systems. Although Graves’ disease can affect anyone, it tends to affect women, especially those under the age of 40. The main goal of treatment is to reduce the severity of symptoms and reduce the amount of thyroid hormones the body produces.

**Causes of Graves' disease and bulging eyes**

 

After we learned what Graves' disease is, let's learn about the cause of infection, as the human body's immune system works to protect it from viruses and bacteria by producing antibodies, and in the case of Graves' disease, your immune system mistakenly fights healthy cells, and the symptoms of Graves' disease are the usual symptoms of hyperthyroidism, such as feeling hot despite the cold weather, increased pulse, excessive nervousness, lack of sleep, weight loss, and bulging eyes, and scientists believe that genetic factors, pregnancy, and some external influences such as infection with a viral infection play a role in the development of this disease.

What is the difference between Graves' disease and Hashimoto's?

 

Both diseases are autoimmune diseases that affect the functional performance of the thyroid gland, and the difference between them can be determined in that Graves' disease causes hyperthyroidism, while Hashimoto's disease causes hypothyroidism and decreased secretion of its hormone.

Is Graves' disease hereditary?

 

Although the exact causes of Graves' disease are not yet known, genetic factors play a major role in Graves' disease, but they are not the main cause of it.

Can bulging eyes be cured?

 

The main goal of treating bulging eyes is to prevent their development, and sometimes doctors may resort to surgeries to relieve pressure on the orbit (the great eye socket).

Does the thyroid gland affect the psychological state?

 

Depression and anxiety are among the most important symptoms of thyroid dysfunction.

**Graves' disease and bulging eyes**

In light of the discussion of what Graves' disease is, let us learn about the relationship between Graves' disease and bulging eyes, which begins when the immune system begins to attack the tissues and muscles of the eye; causing inflammation and swelling of the eye, and bulging eyes are a major component and an important symptom of Graves' disease, as the eye protrudes outward due to the accumulation of tissues with immune deposits behind it, and this may coincide with some other symptoms, including:

Blurred vision.

Dry eyes.

Increased eye pressure.

Sensitivity to light.

Causes of Graves' disease in children?

 

The incidence of Graves' disease in children increases during puberty, as the body produces antibodies that attack the thyroid tissue, stimulating it to produce too much thyroid hormone. This occurs as a result of the following reasons:

Autoimmune diseases.

Dietary iodine deficiency.

Congenital hypothyroidism.

** Common symptoms of Graves' disease **

Anxiety.

Irritability

Trembling hands or fingers

Sensitivity to heat

Warm, clammy skin

Sudden weight loss

Enlarged thyroid gland (goiter)

Change in menstrual cycle

Erectile dysfunction or decreased sex drive

Frequent bowel movements

Puffy eyes

Fatigue

Red, thick skin, usually on the shins or tops of the feet

Fast or irregular heartbeat (palpitations)

Sleep disturbances

Hair loss

**Risk factors**

Although Graves' disease can affect anyone, there are a number of things that can increase your risk, such as:

Genetics: There may be a gene or group of genes that can increase your risk of developing Graves' disease

Gender: Compared to men, women are more likely to develop Graves' disease.

Age: People under the age of 40 are more likely to be affected by Graves' disease.

Physical or emotional stress: People who have genes that increase their chance of developing Graves' disease may have the onset of the disease as a result of stressful life events or illness.

Pregnancy: Among women who have genes that increase their risk, pregnancy or recent childbirth may increase their chances of developing this condition.

Smoking: Smoking may weaken the immune system, thus increasing the risk of Graves' disease. Graves' ophthalmopathy is more likely to occur in smokers with Graves' disease.

Genetics: There may be a gene or group of genes that can increase an individual's risk of developing Graves' disease.

Gender: Compared to men, women are more likely to develop Graves' disease.

Age: People under the age of 40 are more likely to be affected by Graves' disease.

Physical or emotional stress: People who have genes that increase their chance of developing Graves' disease may have the onset of the disease as a result of stressful life events or illness.

Pregnancy: Among women who have genes that increase their risk, pregnancy or recent childbirth may increase their chances of developing this condition.

Smoking: Smoking may weaken the immune system, thus increasing the risk of developing Graves' disease. Graves' ophthalmopathy is more likely to occur in smokers with Graves' disease.

What are the symptoms of Graves' disease in children?

 

Signs of Graves' disease include symptoms of hyperthyroidism in children that may differ from those of adults, including:

Enlarged neck.

Slow heart rate.Mo.

Difficulty swallowing.

Unexplained weight loss.

Puffy eyes.

Increased appetite without gaining weight.

Difficulty concentrating.

Fatigue and general exhaustion.

Rapid heartbeat.

Increased sweating.

Sleep disturbances.

Hair loss.

Tremors.

Mood swings.

Increased urination or bedwetting in children.

What are the symptoms of Graves' disease in infants?

 

A newborn may suffer from bulging eyes (abnormal protrusion of the eyeball), due to an enlarged thyroid gland, known as congenital goiter.

Infants with Graves' disease also suffer from increased metabolic activity in the body, which leads to the appearance of many thyroid problems in children, such as:

Increased heart rate.

Diarrhea.

Vomiting.

Increased appetite without gaining weight.

Slow or failed growth.

Short stature in children.

Increased breathing rate.

Enlarged thyroid gland.

**Diagnosis**

Your doctor may perform a physical exam and look for symptoms of Graves' disease to make a diagnosis. He or she may also talk about your health and family background. To complete the diagnosis, your doctor may also recommend tests such as:

Blood tests: Your doctor can determine your thyroid hormone levels and thyroid-stimulating hormone (TSH) levels through blood tests. TSH is a hormone made by the pituitary gland that normally stimulates the thyroid gland. In patients with Graves' disease, TSH levels are often lower and thyroid hormone levels are often higher than normal.

Radioactive iodine uptake: Iodine is needed by your body to make thyroid hormones. Using a specialized camera, your doctor can check how much iodine is being absorbed by your thyroid gland. This is done by giving you a small amount of radioactive iodine, then measuring the amount in your thyroid gland. If Graves' disease or another condition is the source of your hyperthyroidism, it can be determined this way. A radioactive iodine scan can be used in conjunction with this test to produce a visual representation of the uptake pattern.

Antibody tests: To check for levels of antibodies that cause Graves' disease, your doctor may order another lab test. Antibodies are usually not needed to diagnose the disease. If the results show no antibodies, they may indicate another cause for the antibodies.

Ultrasound: An ultrasound creates images of internal body structures using high-frequency sound waves. It can show whether the thyroid gland is enlarged. Pregnant women and people who cannot tolerate radioactive iodine may benefit from this test.

Imaging tests: Your doctor may order specialized imaging tests to confirm whether you have Graves' disease.

How is Graves' disease diagnosed in children?

 

The doctor will ask questions about your child's health, family health history, and medical conditions. He or she will then examine your child physically and order some diagnostic tests to check for the disease, including:

Some blood tests to measure thyroid hormone levels, including TSH, T3, T4, and thyroid antibodies.

Thyroid ultrasound.

**People at higher risk for Graves' disease**

Although anyone can develop ophthalmoplegia, there are a number of factors that increase the chance of developing the disease, including:

Family history: There may be a gene or genes in your family that make you more susceptible to the disease.

Gender: Women are 7-8 times more likely to develop ophthalmoplegia than men.

Age: It usually occurs in people under the age of 40 and most cases begin by the age of 20.

Other autoimmune disorders: People with other immune system problems, such as type 1 diabetes, rheumatoid arthritis, or vitiligo, are at higher risk of developing Graves' disease.

Smoking: Smokers with ophthalmoplegia are more likely to have eye problems.

Pregnancy: Pregnancy or recent childbirth can increase the risk, especially in women who are genetically predisposed.

Emotional stress: Stressful life events or illness may be a risk factor for ophthalmoplegia, especially in people who are genetically predisposed.

Is Graves' disease dangerous?

 

Most diseases can get worse and more complicated if left untreated. The danger of Graves' disease lies in the complications associated with it if left untreated, including:

Eye disorders: Bulging is one of the most common symptoms associated with Graves' disease. Bulging is accompanied by other symptoms such as difficulty seeing, inflammation and dry eyes.

Heart disorders: Graves' disease affects the heart and its ability to pump blood, which increases the risk of heart failure. Its symptoms also include irregular heartbeat.

Osteoporosis: The strength and hardness of bones depend on the calcium and other minerals they contain. When the thyroid hormone is secreted excessively, the bones' ability to absorb calcium is affected, leading to osteoporosis.

Is it possible to completely recover from Graves' disease?

 

It is unfortunate to say that Graves' disease is a chronic disease, but treatment methods aim to control the secretion of thyroid hormone and reduce its effect on the rest of the body. Treatment includes one of the following methods.

Treatment by using thyroid hormone inhibitors.

Radioactive iodine therapy.

Surgical intervention.

It is noted that treatment begins with medication with hormone inhibitors.. then surgically (removal of the thyroid gland) to remove the immune burden in the body until the eye returns to normal. We give the eye special importance in treatment, as we recommend medications such as drops and ointments to avoid dry eyes. We also advise the patient to cover the eye when there is double vision. We may sometimes resort to surgeries to relieve pressure on the orbit (the great eye socket), and cortisone is used in medically prescribed doses to stop the deterioration of the condition.How can Graves' disease be treated?

Treatment of Graves' disease (exophthalmoplegia) depends on the child's age, medical history, and severity of the condition. Treatment options include:

Antithyroid medications, which block the production of thyroid hormone, leading to a decrease in T3 and T4 levels.

Radioactive iodine therapy, a type of radiation therapy, is used in cases where medications do not respond to them and kills thyroid cells, thus preventing the production of thyroid hormone.

Thyroidectomy, which is used by the doctor if the child's body does not respond to other treatments.

**Treatment**

Beta blockers: Propranolol and metoprolol are examples of beta blockers that are frequently used as a first line of treatment. Until hyperthyroidism treatments take effect, these medications control the heart rate and protect the cardiovascular system.

Thyroid blockers: Propylthiouracil and methimazole, which are two antithyroid medications that prevent the thyroid from producing thyroid hormone. These medications may increase your risk of infection by causing a rash and low white blood cell counts in a small percentage of patients. This can rarely cause liver disease.

Radiation therapy: Thyroidectomy involves removing all or part of your thyroid gland. After surgery, some people do not produce enough thyroid hormones, a condition called hypothyroidism. If you develop this condition, you may need to take levothyroxine or naturally occurring desiccated thyroid as a lifelong treatment.

Surgery: Thyroidectomy involves removing all or part of your thyroid gland. After surgery, some people do not produce enough thyroid hormones, a condition called hypothyroidism. If you develop this condition, you may need to take levothyroxine or naturally occurring desiccated thyroid as a lifelong treatment.

Treatment of Graves' eye disease (ophthalmopathy): Over-the-counter artificial tear lubricants can be used to treat mild symptoms of Graves' ophthalmopathy. Lubricating gels are usually used at night. Your doctor may recommend the following if your symptoms are more severe:

Corticosteroids: Prednisone or another corticosteroid treatment may help reduce eyelid swelling. Possible side effects include fluid retention, weight gain, high blood sugar and blood pressure, and mood swings.

Teprotumumab: This medication can treat Graves' ophthalmopathy. It is given eight times, every three weeks, through a vein in your arm. It may cause negative side effects including nausea, constipation, muscle cramps, and high blood sugar. Because this medication is new, its effectiveness in treating Graves' ophthalmopathy has not yet been proven.

Prisms: Double vision may be a symptom of Graves' disease or a side effect of Graves' disease surgery. Although they may not always work, prisms in your glasses can eliminate your double vision.

Orbital debulking surgery: In this procedure, your surgeon removes the bone that connects your sinuses, the air spaces near your orbit, and your eye socket (orbit). As a result, your eyes will have enough space to return to their normal position. This treatment is usually used when pressure on the optic nerve threatens to cause vision loss. Double vision is one potential issue.

Orbital radiotherapy: Although the benefits are unclear, this treatment has been widely used. Some tissue behind your eyes is destroyed over several days using focused X-rays. Your doctor may suggest this if your eye problems are getting worse and corticosteroids alone are not working or are not well tolerated.