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You can lose weight due to diabetes or hyperthyroidism. But drastic weight loss coupled with excessive sweating and hair loss can also be due to Graves’ disease. It is an autoimmune disorder that affects the thyroid gland leading to overproduction of the thyroid hormones (T3 and T4) leading to hyperthyroidism. Our expert Dr. Girish Parmar, Consultant Endocrinologist and Metabolic Physician, Kokilaben Dhirubhai Ambani Hospital, Mumbai explains in detail about everything you should know about this disease.

What is Graves disease?

In this condition, autoimmune antibodies are produced in the body which are similar to endogenous TSH (thyroid stimulating hormones) released from the brain. As these abnormal proteins are similar to the TSH hormone, they stimulate the thyroid gland. This in turn causes overproduction of T3 and T4 hormones leading to hyperthyroidism.

Symptoms

As blood levels of T3 and T4 hormones are increased, the overall metabolic rate is increased. This in turn increases the energy in the body and functioning of the metabolic processes leading to increased activity. Hence, the symptoms of Graves disease include –

 

• Palpitation or increased heart rate


• Excessive sweating


• Tremors


• Excessive hair fall


• Frequent loose stools


• High fever (as excess heat is produced due to increased metabolic rate)


• Weight loss


• Irregular periods


• Eye problems

 

In 30 – 40 % of cases, the abnormal proteins present in the body increases the pressure on the muscles of the eye and thus, lead to frequent eye problems. These include swelling of the eyes (due to the pressure exerted behind the eyes), redness, bulging of the eyes and double vision.

Causes & Risk Factors

Graves disease is an autoimmune disorder in which your body cells produce antibodies. Although the exact cause of this is not known, there are several factors that increase your risk of suffering from the condition. These are –

• Gender – Females are at a high risk of Graves disease as compared to men.


• Age – Although people in their 40s and 50s are at high risk due to their age and low immunity, young people can also suffer from this disease.


• Pregnant women


• Stress


• Excessive exposure to iodine

Diagnosis

The diagnosis of Graves disease is usually based on the symptoms. You doctor might recommend a blood test to detect levels of thyroid hormones in the body. These tests usually include –

T3 and T4 test – High levels of T3 and T4 hormone sin the body might indicate Graves disease.

TSH test – Low blood levels of TSH (thyroid stimulating hormone) signify hyperthyroidism due to Graves disease.

TSH receptor antibodies – If you suffer from Graves disease, your blood levels of TSH receptor antibodies are high.

Thyroid technetium scan – In this, a radioisotope (technetium) is injected into the body. If you have Graves disease, the gland takes up the isotopes and thus shows excess radioactivity in the region, when viewed on a display.

Treatment

The treatment of Graves disease is usually classified into 3 stages –

1st line of treatment: Medications

The medications that are prescribed to treat this disease include carbimazole and propylthiourasil (PTU). As the risk of liver dysfunction is high in case of carbimazole, propylthiourasil is usually recommended during the first three months of pregnancy.

Advantages: It is effective, cheap and has fewer side-effects as compared to other modes of treatment.

Disadvantages: You have to take these medications for around one and half years to two. And with this treatment the chances of remission (cure) is 30 – 40% and recurrence is 50 – 60%. In case the blood levels of TSH receptor is high, the chances of remission is less and thus, medication therapy is effective in such cases.

2nd line of treatment: Radioactive iodine therapy

If the patient is not responding to the medical therapy, your doctor might go for radioactive iodine therapy. In this, radioactive iodine either in the form of capsule or liquid (injection) is given only once.

Advantages: It is cheap and also effective. One dose provides remission in 70 – 80 % of cases.

Disadvantages: With this treatment, there is a high chance of the person suffering from hypothyroidism (shrinking of the thyroid gland). And in such case, the patient has to be on hormones (as the body does not produce hormones) for the rest of his/her life.

3rd line of treatment: Surgery

In rare cases, your doctor might recommend thyroidectomy (surgical removal of the thyroid gland) to treat the condition.

Prevention

As there is no known cause of the disease, Graves disease cannot be prevented. However, If you are at a high risk of suffering from this disease, make sure your diet is low in iodine. Also, avoid seafood and cough syrup (as they contain high levels of iodine).

 

The content has been verified by Dr Girish Parmar, Consultant Endocrinologist and Metabolic Physician, Kokilaben Dhirubhai Ambani Hospital, Mumbai.