To talk about Graves' Disease, you must talk about the thyroid also. The thyroid gland is hyperactive, this is rarely a life-threatening condition. Graves' disease may develop at any age and either sex, it is seen more often in women aged 20 to 60 years old.
The cause of Graves' disease is unknown, but the disease can affect the thyroid gland, eyes, and skin. Current research, suggests that a defect in the immune system may be the underlying cause of the disorder. Under normal circumstances, the immune system uses antibodies (protein substances that the body makes) to protect itself against viruses, bacteria, and foreign substances that invade the body. In Graves' disease the immune system mistakenly attacks the thyroid gland, eyes, and skin of the lower legs causing the disease's symptoms.
The thyroid gland is a butterfly-shaped organ that is located just in front and on each side of the windpipe just above the breast bone. This gland releases hormones into the blood that helps the body process the rate of metabolism, body temperature, muscle tone and vigor and controls the growth hormone secretions.
Normally thyroid activity is directed by the pituitary gland, but with Graves' disease, the thyroid is driven by an antibody. This antibody triggers the thyroid to become overactive and produce more hormones than the body needs.
Symptoms of hyperthyroidism are weight loss even though eating increases, become irritabile, female changes in menstrual patterns, lower tolerance of heat, and an irregular heartbeat or pounding of the heart.
Your physician will suggest the best treatment for hyperthyroidism. It could be one of the following:
1. Anti-thyroid medications - These medications block the action of the thyroid hormones
2. Radioactive iodine - This solution contains radioactive iodine and it is drunk. The iodine collects in the thyroid gland destroying large amounts of thyroid tissue.
3. Surgery - The removal of most of the thyroid gland
The thyroid often becomes underactive (hypothyroidism) after treatment and this causes the symptoms to subside. But when the thyroid becomes underactive, the physician will then prescribe a thyroid hormone to achieve a balance.
Other organs undergo changes during Hypothyroidism. They include the skin and eyes.
Some with Graves' disease suffer from an irritating skin condition. The skin over the shins will appears red and swollen. The top of the feet may also be affected this way. Physicians may recommend creams or ointments to reduce the swelling and redness.
When Graves' disease affects the eyes, it is called Graves' ophthalmopathy (opf-thal-mop-athy). Eyes may bulge or appear red and swollen. The space between the lids may widen. Excessive tearing and discomfort may occur in either or both eyes. Patients may experience sensitivity to light, blurring or double vision, inflammation, or decreased movement.
A person with Graves' ophthalmopathy will show the eyeball protruding beyond its protective orbit because the tissues behind the eye attract and hold water. When this happens the tissues and muscles swell causing the eyeball to move forward in the orbit. The front surface of the eye can dry out. Eye symptoms and hyperthyroidism symptoms typically appear within 18 months of each other.
Physicians will recommend treatment of Graves' ophthalmopathy according to each person's symptoms. Sometimes combinations of the following procedures are used. Your physician may recommend cool compresses, sunglasses, eyedrops or raising your head at night. Medications or radiation to shrink the tissues, orbital decompression surgery, prisms for your glasses or eye muscle surgery, eyelid surgery, or both.
In orbital decompression surgery the procedure removes the bone between the eye socket and the sinuses is removed. If successful the procedure improves vision and provides room for the eye to slip back into the eyesocket.
The possible complications of the surgery, are you may experience lip numbness for several months after the operation. Double vision may persist or it may develop again after surgery. Leaking of cerebrospinal fluid that surrounds and protects the brain is a rare complication of the surgery. Recovery from this surgery ususally begins with a short hospital stay with follow-up office visits scheduled after discharge.
Your physician may prescribe prisms for your glasses to correct any double vision. Prisms may be added temporarily or permanently ground into your lenses. Unfortunately, prisms do not work for all people experiencing double vision. Sometimes eye muscle surgery is a more effective treatment.
Double vision occurs because the eyes are out of alignment. Misalignment is caused by one or more eye of the muscles are too short or "tight" caused by scar tissue from Graves' ophthalmopathy. This scar tissue is a result from the change in the eye because of inflammation. The goal of eye muscle surgery is to achieve single vision when looking straight ahead and when reading. Usually eye muscle surgery does not require an overnight stay in the hospital, but more than one surgery is sometimes required. If orbital decompression and eye muscle surgery are to be done, the orbital decompression surgery is usually done first.
Eyelid Surgery is generally performed as the final procedure in the series. Graves' ophthalmopathy will generally cause the eyelids to open more widely than normal. The front surface of the eyeball therefore, becomes exposed beyond the eyelids and causes discomfort and excessive tearing. Surgically repositioning the eyelids can reduce the irritation.
Although Graves' disease may affect your comfort, vision, or appearance, many of these problems can be treated successfully, your physician will help determine an appropriate treatment plan.