Graves Disease Graves Disease By Nicholas Laskovski Graves Disease is a disorder that affects the thyroid gland and results in a dramatic change in the bodys metabolism. This paper will discuss the manifestations of the disease in the body, recent research on the disease, and how Graves disease can be treated. By way of background, Graves disease dates from the early nineteenth century. Robert Graves (1796-1853) was an Irish physician, born in Dublin. He studied medicine in Edinburgh but took his MB in 1818 from Dublin.
After a few years of traveling through Europe, he returned to Dublin when he was appointed physician to the Meath hospital. He was an excellent diagnostician, best remembered today for his great description of Graves Disease (hyperthyroidism) (Chambers, pg. 620). The thyroid gland is a thin, butterfly shaped organ that is located in the lower part of the neck. It lies on the sides and in front of the windpipe, or trachea (drkoop.com). The picture below provides a graphic description of the thyroid.
(Could It Be My Thyroid?) In the diagram, T3 and T4 portray hormones containing iodine. (T4 includes four iodines and T3 includes three). Of the two, T3 is the more potent. One role of the thyroid is to create hormones. When a person has Graves disease, the thyroid becomes overly activated, creating more T4 and T3 than the body needs.
This overacting is called hyperthyroidism (drkoop.com). As a result, the metabolism of many organs within the body is affected, resulting in annoying symptoms and abnormal health effects (Could It Be My Thyroid?). Graves Disease is located on the fourteenth chromosome, or 14q31 (www.ncbi.nlm.nih.org). There have been many different opinions about the disease and many researchers have studied it. Among them, Bartels (1941), Martin and Fisher (1945), and Skillern (1972).
It is the opinion of the majority, that Graves disease is inherited as a simple autosomal recessive condition, with relative sex limitation to females. The diseases signs and symptoms can either be mild or severe, depending on the activity level of the thyroid. The disease affects the immune system directly. Since the symptoms develop slowly (over a period of approximately 3 months,) the carrier may not even be aware that he or she has Graves disease, until the condition becomes very severe. Some of the most common signs are weight loss, feelings of being hot or sweaty, tremors, and palpitations (racing of the heart), (www.ncbi.nlm.nih.org).
Other signs may also occur, including over activity of the intestines, resulting in frequent bowl movements. In addition, the breakdown of protein in muscles can lead to extreme weakness, resulting in trouble breathing and limited endurance. (The Thyroid Book). Mentally, the disease can be very disturbing. Mood swings and thinking impairment can be difficult to handle . Depression and crying spells are very common, and the patients entire personality may change (The Thyroid Book).
These problems make it very difficult for anyone to sustain work, (such as preparing five page long reports about Genetics!) Generally, the thyroid becomes enlarged in Graves disease, yet it is really not sore in anyway. The enlargement, called a goiter, can sometimes be seen in the neck. Even though it might not be visible, it can also be detected by examining the neck (www.drkoop.com). If a physician suspects that a patient might have Graves disease, (or some form of hyperthyroidism,) he or she is likely to order a TSH level test. The pituitary gland, which produces this TSH, is a great thermostat providing a picture of the activity of the thyroid gland.
If the thyroid is working too hard, the pituitary gland will detect that there is too much thyroid hormone in the blood, and it will automatically stop making TSH. As a result, the TSH level will be very low (and most of the time immeasurable.) (Could It Be My Thyroid?). By measuring levels of T4 and T3 in the blood, scientists can gauge the performance of the pituitary gland. The higher above normal these measures are, the more overactive the thyroid is. The lower, it is correspondingly less active. The TSH level tests determine hyperthyroidism. T4 and T3 tests determine the severity of the disease.
A physician can usually determine the type of hyperthyroidism, based on a number of factors, including: the age of a patient, the careful assessment of symptoms, and the size or consistency of the thyroid. Unfortunately, no one knows what triggers the onset of Graves disease, (or, for that matter, other thyroid problems, ) since an individual may have the genetic disposition for the disease, but it may not manifest itself. This means that preventing the disease is really still guesswork. (The Thyroid Book). Research has determined that the thyroid gland needs ample iodine to make hormones (www.drkoop.com).
In some parts of the world, this can be a problem, since iodine concentration is low (China, Africa, southern Europe et cetera). In the United States, iodine concentration is usually adequate because of our regular diet, so lack of adequate iodine is not usually a problem. Although too much iodine consumption may also be harmful to the thyroid, it may cause the levels of T4 and T3 to rise. Therefore, one needs to be careful in their nutritional supplements, aiming for a balance, or as close to a balance as possible. Graves Disease is usually treated with medication or surgery. However, this can be tricky. Hyperthyroid patients who are treated with radioactive iodine or surgery can experience a relatively uncommon health crisis called thyroid storm.
Thyroid storm is a life-threatening condition that occurs if too much thyroid hormone is suddenly released by the thyroid gland. Administering certain drugs that can block this sudden release can prevent it. PTU (propylthiouracil) and Tapazole are other drugs sometimes given to prevent thyroid storm (The Thyroid Book). However, it can take seven days before these drugs start to reduce hormone levels and two to three weeks to reach their full effect. Treatment needs to be monitored carefully, and modified as necessary. A person diagnosed with Graves disease, (such as former President George Bush and his wife, Barbara,) with early and correct treatment, can expect to gain control of the disease, and lead a normal life. (Graves Disease, The Heart of the Matter.) In conclusion, Graves disease is a common and serious disease of the thyroid, which has been known for many, many years.
The symptoms of Graves disease are observable, and can provide great discomfort, both physically and emotionally, to those who have it. Treatment of Graves disease requires a careful diagnosis, and watchful monitoring by a physician. Graves Disease is generally controlled through medication, although in extreme cases, surgery may be necessary. An individual diagnosed with Graves disease, who is treated properly by experts, can expect to gain control of the problem and lead a perfectly normal life. Bibliography Bibliography Chambers Biographical Dictionary, 1990 ed. GRAVES, Robert James. Graves Disease. http://www.ncbi.nlm.nih.gov, 2000 Rubenfeld, Sheldon.
Could It Be My Thyroid? Houston, TX, 1996. St. Germin, Dr. Donald. Facts About Graves Disease.
www.drkoop.com 1998-2000 drkoop.com. Surks, Martin I. The Thyroid Book. What Goes Wrong and How to Treat It. The Heart of the Matter. The Thyroid Society Newsletter, 1988, pages 1-2. Science.