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Graves' disease is a thyroid disease characterized by the excess of hormones of this gland in the body, causing hyperthyroidism. It is an autoimmune disease, which means that the body's own antibodies end up attacking the thyroid and altering its functioning.
This disease is the main cause of hyperthyroidism, and affects more women than men, mainly between 20 and 50 years old, although it can appear at any age.
Graves' disease is treated and can be well controlled through the use of drugs, radioactive iodine therapies or thyroid surgery. Generally, it is not said that there is a cure for Graves' disease, however, it is possible that the disease will go into remission, staying "asleep" for many years or for a lifetime.
Main symptoms
The symptoms presented in Graves' disease depend on the severity and duration of the disease, and on the age and sensitivity of the patient to the excess of hormones, usually appearing:
- Hyperactivity, nervousness and irritability;
- Excessive heat and sweat;
- Heart palpitations;
- Weight loss, even with increased appetite;
- Diarrhea;
- Excess urine;
- Irregular menstruation and loss of libido;
- Tremor, with damp and warm skin;
- Goiter, which is the enlargement of the thyroid, causing swelling in the lower part of the throat;
- Muscle weakness;
- Gynecomastia, which is breast growth in men;
- Changes in the eyes, such as protruding eyes, itching, watery eyes and double vision;
- Pink plaque-like skin lesions located on body regions, also known as Graves' dermopathy or pre-tibial myxedema.
In the elderly, signs and symptoms may be more subtle, and may manifest with excessive tiredness and weight loss, which can be confused with other diseases.
Although Graves' disease is the main cause of hyperthyroidism, it is important to be aware that overproduction of thyroid hormones can be caused by other problems, so see how to identify the symptoms of hyperthyroidism and the main causes.
How to confirm the diagnosis
The diagnosis of Graves' disease is made through the evaluation of the symptoms presented, blood tests to measure the amount of thyroid hormones, such as TSH and T4, and immunology tests, to see if there are antibodies in the blood against the thyroid.
In addition, the doctor may order tests such as thyroid scintigraphy, computed tomography or magnetic resonance imaging, including to assess the functioning of other organs, such as the eyes and heart. Here's how to prepare for thyroid scintigraphy.
How the treatment is done
The treatment of Graves' disease is indicated by the endocrinologist, guided according to the clinical condition of each person. It can be done in 3 ways:
- Use of antithyroid drugs, such as Methimazole or Propylthiouracil, which will decrease the production of thyroid hormones and antibodies that attack this gland;
- Use of radioactive iodine, which causes destruction of thyroid cells, which ends up decreasing its production of hormones;
- Surgery, which removes part of the thyroid to decrease its production of hormones, being done only in patients with the disease resistant to treatment with drugs, pregnant women, suspected cancer and when the thyroid is very bulky and presents symptoms such as difficulties to eat and speak , for example.
Medications that control the heartbeat, such as Propranolol or Atenolol can be useful to control palpitations, tremors and tachycardia.
In addition, patients with severe eye symptoms may need to use eye drops and ointments to relieve discomfort and moisturize the eyes, and it is also necessary to stop smoking and wear sunglasses with side protection.
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It is not often said about curing serious illness, but there may be spontaneous remission of the disease in some people or after a few months or years of treatment, but there is always a chance that the disease will come back.
Pregnancy Treatment
During pregnancy, this disease should be treated with the minimum doses of medication and, if possible, discontinue the use of medications in the last trimester, since antibody levels tend to improve at the end of pregnancy.
However, special attention is needed to the disease during this stage of life because, when at high levels, thyroid hormones and drugs are able to cross the placenta and cause toxicity to the fetus.