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What Is Graves’ Disease? Symptoms and Treatment Options to Know About
Wendy Williams announced a three-week break from her eponymous talk show — the first ever for its host. Williams revealed her doctor had prescribed three weeks rest due to complications with her Graves’ disease, a thyroid condition the celeb has dealt with for years.
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She’s not alone: Graves’ disease affects approximately 1 in 200 people, according to the National Institutes of Health, and it occurs much more often in women than men. The condition is an autoimmune thyroid disease, meaning the antibodies of the immune systems affect the function of the thyroid, a gland located in your neck. But instead of attacking the gland, these antibodies stimulate it, causing the production of more and more hormones.
“The normal physiology is out the window,” explains endocrinologist Dr. Leonard Wartofsky, a past president of the Endocrine Society. “There are effects on virtually every tissue in the body, every organ, every system … The thyroid is important for heart, kidney, and muscle function, but in the case of hyperthyroidism it’s excessive.”
Read on to learn more about this unusual condition.
Who gets Graves’ disease and why?
Right now doctors aren’t exactly sure what triggers these antibodies to affect the thyroid. Some possible theories including stress or an infection, according to Dr. Wartofsky. What doctors do know is that they bind to the thyroid instead of the usual pituitary hormone. These antibodies don’t have a turnoff mechanism either, so the gland continues to make thyroid hormones instead of self-regulating.
While women are more likely to develop Graves’ disease than men, a key risk factor is a family history of hyperthyroidism or hypothyroidism, including conditions like Hashimoto’s disease. According to the Mayo Clinic, the disease also usually develops in people younger than 40.
What are the symptoms?
Since the thyroid affects almost every part of the body, the signs of Graves’ disease are widespread. The most common ones include hyperactivity, anxiety, nervousness, increased perspiration, and heat sensitivity. Since hyperthyroidism increases the metabolism, many patients also experience weight loss. This can also lead to muscle weakness and osteoporosis, since they lose not only fat but mass from their muscles and bones.
Dr. Wartofsky says most people will seek out their GP when they notice palpitations or a rapid heart beat, another side effect.
What about the bulging eyes?
In her statement, Wendy Williams attributed her Graves’ disease to another unusual characteristic: bulging eyes. While this sign is perhaps one of the most noticeable ones, it’s actually quite rare. Only about 5% of patients experience this to a significant degree, Dr. Wartofsky says. Other sensations like burning, pain, and stinging will affect the eyes in most cases. The inflammation behind the eye can also lead to puffiness, pain, or redness.
How is it diagnosed?
If you suspect you might suffer from Graves’ disease, it’s luckily diagnosed very easily. Visit your primary physician and they can use a blood test to check your hormone levels. If they’re abnormal, your GP will likely refer you to an endocrinologist for further testing and confirmation.
What are the treatment options?
Right now there are three primary ways doctors address Graves’ disease, and all of them have their pros and cons. The most extreme of the bunch is a thyroidectomy, or a surgery that permanently removes the thyroid. This aggressive method is often the last resort, as patients then need to take hormone replacement pills for the rest of their lives.
The second method is a radioactive iodine treatment. This technique is also used to treat thyroid cancer, but in higher doses. “Iodine is incorporated by the gland when it make thyroid hormone, and we take advantage of the fact by fooling it and giving a dose of radioactive iodine,” Dr. Wartofsky explains. The radioactivity then gradually destroys thyroid cells without surgery, although in most cases the patients do eventually end up on hormone replacement as well.
The final, least aggressive option is medical therapy. There are two drugs patients can take to keep the thyroid in check: PTU and methimazole, known by the brand name Tapazole. After months or years on medication, about 35 to 40% of patients will experience a remission and can go off the drug. “The hyperthyroidism goes away as mysteriously as it came,” Dr. Wartofsky says, “but it can recur again years later.” The other 60% then turn to one of the other two options.
While these seem extreme, if Graves’ disease goes untreated, it can pose a serious danger. A severely hypothyroid patient enters something called thyroid storm, a life-threatening condition where a heart attack or failure can occur. With that in mind, always see a GP if you suspect something’s up with your health, and just like Wendy, prioritize the rest and treatment it takes to get better.