“Their eyes were protruded from their sockets, faces exhibited an appearance of agitation and distress, the heartbeat was so violent that each systole of the heart shook the whole thorax…” words written by Caleb Hillier Parry, the first to describe the features of hyperthyroidism in 1786. Graves’ disease is a condition that affects the thyroid, which is a butterfly-shaped gland in the lower neck. The thyroid gland hormones influence growth, development, and metabolism. In Graves’ disease, an over-activity of the gland occurs.
The symptoms of thyroid disease can be mild while others may experience significant features. These may include rapid and irregular heartbeats, strokes, heart failure and osteoporosis, trouble sleeping, weight loss in spite of an increased appetite. Just 10 to 20% may develop significant eye disease known as Graves’ ophthalmopathy, which is characterized by bulging eyes, double vision, dry eyes, and swollen eyelids, light sensitivity, and in rare instances, vision loss. This complication may be due to the compression of the optic nerve connecting the eye and the brain. Others may develop nervousness or anxiety, extreme tiredness, hand tremors, frequent bowel movements or diarrhea, increased sweating, and difficulty tolerating hot conditions. A small percentage of people with Graves’ disease develop a skin abnormality called pretibial myxedema. This abnormality causes the skin on the front of the lower legs and the tops of the feet to become thick, lumpy, and red. It is not usually painful.
Regarding women, they may experience menstrual irregularities, such as an unusually light menstrual flow and infrequent periods. Pregnancy problems may include miscarriage and stillbirth. The majority of people with thyroid issues do not develop goiters. However, some people may develop an enlargement of the thyroid. Depending on its size, it can cause the neck to look swollen and may interfere with breathing and swallowing.
Many children with Graves’ disease suffer from a family history. The condition can arise at any point during childhood but is most likely to begin in adolescence. Teenage girls may have lighter and less frequent menstrual periods. They may also have difficulty concentrating, restlessness, fatigue, or anxiety, which can sometimes be mistaken for conditions such as attention deficit hyperactivity disorder or anxiety disorders. Over time, it can lead to growth problems.
Graves’ disease is relatively common affecting one in every 100 Canadians and about one in every 200 Americans. According to the national organization for rare disorders: Graves’ disease affects females more often than males by a ratio of 5-10 to 1. The disorder usually develops during middle age with a peak incidence of 40-60, but can also affect children, adolescents, and the elderly. Graves’ disease occurs in almost any part of the world. Graves’ disease is estimated to affect 2%-3% of the general population. Graves’ disease is the most common cause of hyperthyroidism. Further, According to the British Thyroid Foundation, Cigarette smoking is identified to have a key influence on Grave’s disease and on thyroid eye disease (TED).
Graves’ disease is thought to result from a combination of genetic factors and other environmental factors. Graves’ disease is classified as an autoimmune disorder, where the immune system creates an antibody called thyroid-stimulating immunoglobulin that signals the thyroid to increase its production in an uncontrollable manner. It is estimated that 70% of graves’ disease is genetic and then something in the environment triggers the production of antibodies such as virus, pregnancy or
menopause, diet, drugs, or possibly extreme stress. Moreover, people with Graves’ disease have an increased risk of developing other autoimmune disorders, including rheumatoid arthritis, pernicious anemia, systemic lupus erythematosus, Addison disease, celiac disease, type 1 diabetes, and vitiligo.
About 60 percent of people with thyroid disease are usually undiagnosed. A TSH (thyroid stimulating hormone) blood test, in combination with physical examination helps doctors make the most accurate diagnosis of thyroid disease. A lump on the neck is not necessarily an enlarged thyroid (goiter). Other causes of a neck lump could be a swollen lymph node or cyst. Often a radioactive iodine uptake and scan are ordered in hyperthyroid patients to differentiate Graves’ disease from thyroiditis or hyper functioning thyroid nodule(s). Sometimes measurement of TSH receptor antibodies is used as well. Only five percent of thyroid nodules are cancerous. Aggressive thyroid cancer is uncommon but these nodules will be large, firm, fixed, and fast-growing. A thyroid ultrasound may be ordered to confirm the diagnosis as well.
Diet cannot alone regulate problems of the thyroid. Moreover, Excess iodine can trigger thyroid dysfunction. Eating a well-balanced diet with plenty of vitamins and minerals is recommended. A gluten free diet may be helpful with patients with Hashimoto's disease as they may be suffering as well from other autoimmune conditions such as Celiac disease. Some antioxidants and nutrients may help alleviate symptoms or reduce flares. These include calcium-rich foods preventing brittle bones and osteoporosis such as broccoli, almonds, kale, sardines, and okra.
The purpose of medical treatment for Graves’ disease is to stop your thyroid from producing too much hormone, while still giving you enough hormone so that your body can function properly. The most common antithyroid drug is methimazole. Some women either cannot tolerate it, want to become pregnant or who are in their first trimester cannot take it. In these cases, doctors prescribe propylthiouracil. However, recent evidence of side effects of Propylthiouracil on liver function, especially in children, the FDA has issued a warning for its use. Another medication that can be given to treat the symptoms of hyperthyroidism is Propranolol or other beta-blockers, which block the effects of excess thyroid hormones on the heart, blood vessels, and nervous system. An iodine supplement of 150mcg daily is recommended for women in the UK pre-conception, during pregnancy, and during breastfeeding. If hyperthyroidism persists or recurs then consideration of radioactive iodine or surgery is recommended.
Cardiovascular disease, as heart attacks, heart failure, and strokes, is the most common cause of death in patients with hyperthyroidism. Another potentially life-threatening complication is known as a thyroid storm. This occurs in case of untreated hyperthyroidism suffering from major stress, such as trauma, heart attack, or infection. It is characterized by an attack of fever, confusion or agitation, irregular heart rhythms, or heart failure. Patients who develop thyroid storms have a 20 to 50% chance of dying.
Like humans, Hyperthyroidism in dogs is a serious condition, which can be caused by an error in medications usually including a synthetic form of thyroxine. Fresh real food is advised for dogs with hyperthyroidism, preferably lightly cooked or raw. Highly processed food is not recommended. If left untreated the condition can cause heart and kidney failure. It is advisable to avoid unnecessary chemicals or environmental hazards, which are all possibilities that contribute to the disease as over-vaccinating, Flea and tick preventatives, Unnecessary Steroids, antibiotics and NSAIDs, Food preservatives especially red dye found in processed food and treats.