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Grave’s Disease

What Is Graves’ Disease?

Graves’ disease is an autoimmune disorder that is considerable cause of Hyperthyroidism. Autoimmune disease occurs with unspecified causes. Most of responsible causes come from family history(Genetically) and environment factors.

Graves’ disease releases antibodies commonly called thyroid stimulating immunoglobulins (TSIs) , attack on thyroid cell receptors.  Thyroid stimulating immunoglobulins enable thyroid cell receptors to send signals to TSH (Thyroid stimulating hormones) who then releases thyroid hormones T3 and T4. The level of TSH falls down as the level of T3 and T4 overcome and cause hyperthyroidism. 

There are other many causes of hyperthyroidism but Graves’ disease is common cause.

Who Can Be Affected ?

Graves’ disease main causes are unknown but genetic and environment factors define it. Further, other factors that can be responsible are:

  • Progression in stress, infection or giving birth.
  • Already have autoimmune disease such as Rheumatoid Arthritis and Type I Diabetes.
  • Smoking can increase the risk.


Symptoms of Graves’ disease are:

  • Goiter
  • Excessive Sweating
  • Heat intolerance
  • Increased appetite
  • Weight reduction
  • Shaking hands
  • Tremors
  • Diarrhea
  • Defecation
  • Hypertension
  • Rapid heartbeat
  • Anxiety, Depression
  • Insomnia
  • Hair loss
  • Vision problem
  • Erectile dysfunction or libido
  • Menstrual changes


Diagnosis of Graves’ disease depend upon different factors:

Physical Exam

This is first step to consider patients for next test for Graves’ disease. Physical exam include:

  • Eyes problem
  • Thyroid gland enlargement, Goiter
  • Swelling or inflammation
  • Weight loss
  • Skin colour
  • Thought, speech, Behavior
  • Tremors, weakness of muscles
  • Hair texture
  • Onycholysis
  • Rapid heart rate or overactive heart

Laboratory Test

TSH level testing

This test is used to check the level of TSH to determine the amount of T3 and T4 hormones. TSH is thyroid stimulating hormones released from pituitary gland and helps thyroid to produce T3 and T4 hormones.

Testing will show low level of TSH while increase of T3 and T4 hormones. Sometimes this test is not sufficient for doctors to identify the disease type.

T3 and T4 Test

This test used to identify the exact level of these two thyroid hormones in the blood. T3 is triiodothyronine and T4 is thyroxine, two hormones whose increase level is main cause of hyperthyroidism.

T3 and T4 hormones are needed in our body to regulate the cellular metabolism such as body temperature, heart rate and metabolism. Diagnosis depends upon abnormal level of these two hormones in test reports.

Radioactive iodine uptake

In this test, a iodine pill is given to patient to check the functioning of thyroid gland or how thyroid gland act after receiving iodine. After the 6-7 hrs. of swallowing of pill, test is performed with the help of scan. This test will determine whether hyperthyroid is due to Graves’ disease or others factors are responsible.

Ultrasound and X-ray

This test is specially performed in person who can’t take radioactive iodine uptake and those pregnant women. High frequency sound waves will pass from inside our body to check the enlargement or structure of thyroid gland.

X-ray, MRI, CT scan are some imaging tests to check the presence of Graves’ disease and those clinically failed assessments.


Graves’ disease is a cause of hyperthyroidism so the treatments starts to control over production of thyroid hormones. Some treatments are:

Anti-thyroid Medications

Anti thyroid medication inhibit the release of excess amount of thyroid form thyroid gland. There are two types of medicine for hyperthyroidism used

  • Propylthiouracil (PTU)
  • Methimazole (Tapazole)

Side effects of these medicines include skin rashes, itching, hives, heartburn, metallic taste, nausea, vomiting and pain in joints and muscles. In pregnant women, selection of medicine is important and most of time doctor can suggest use of PTU instead of Methimazole in pregnancy.

Radioactive Iodine (RAI)

This treatment is not good in pregnant women or in breastfeeding. In some cases medicines can not show their affect, RAI is preferred. 

It is a iodine pill given in hyperthyroid condition or Graves’ disease and acts on thyroid cells to destroy them. It is safe as picked up by thyroid cells and destruction is normal that no widespread side effects.


Surgery is recommended in those who can not tolerate anti thyroid medicines and if you are pregnant so you can not take medicine, surgery is preferred.

It is type of thyroidectomy to remove the enlargement of thyroid gland and thus excess production of thyroid hormones. This type of surgery also included in nodular thyroid goiter. Surgery can pose a small risk on vocal cord and parathyroid glands.

Each given treatments have their own risk and benefits which depend upon your types of symptoms and severity of disease that you have.

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