Thyroid Disease
Overview
Graves' disease is an autoimmune disease.
  • It most commonly affects the thyroid, causing it to grow to twice its size or more (goiter), be overactive, with related hyperthyroid symptoms such as increased heartbeat, muscle weakness, disturbed sleep, and irritability. It can also affect the eyes, causing bulging eyes (exophthalmos).

Graves Disease
Photograph of a patient with proptosis due to Thyroid-related Orbitopathy

  • It affects other systems of the body, including the skin and reproductive organs. It affects up to 2% of the female population, often appears after childbirth, and has a female:male incidence of 5:1 to 10:1. It has a strong hereditary component; when one identical twin has Graves' disease, the other twin will have it 25% of the time.
     
  • Smoking and exposure to second-hand smoke is associated with the eye manifestations but not the thyroid manifestations. Diagnosis is usually made on the basis of symptoms, although thyroid hormone tests may be useful, particularly to monitor treatment
     
  • GO is often mild and self-limiting, and probably declining in frequency, with only 3–5% of cases posing a threat to eyesight
     
  • The thyroid is one of the largest endocrine glands in the body. This gland is found in the neck inferior to (below) the thyroid cartilage (also known as the Adam's apple in men) and at approximately the same level as the cricoid cartilage. The thyroid controls how quickly the body burns energy, makes proteins, and how sensitive the body should be to other hormones.

 

Signs and Symptoms related to an Abnormal Thyroid Level

Hypothyroidism Hyperthyroidism 
  • feeling slow or tired
  •  drowsiness
  • poor memory
  • muscle cramps
  • dry and course skin
  • milky discharge from the breasts
  • husky voice
  • feeling cold
  • slow heart rate
  • difficulty concentrating
  • weight gain
  • heavy menstrual flow
  • infertility
  • feeling depressed

 

  • fast heart rate
  • eyes may bulge forward
  • nervousness
  • increased sweating
  • muscle weakness
  • trembling hands
  • weight loss
  • skin changes
  • increased frequency of bowel movements
  • decreased menstrual flow and less frequent menstrual flow

 

 

  • When Graves' disease affects the eyes, it is called Graves' ophthalmopathy.  Eyes may bulge or appear red and swollen. 
  • The space between the lids (palpebral fissure) may widen. Excess tearing and discomfort may occur in either or both eyes (see below). 
  • Patients may experience sensitivity to light, blurring or double vision, inflammation, or decreased movement.

Thyroid Disease Treatment

  • Two goals for treating thyroid disease 
    • return thyroid hormone levels to normal 
    •  remove potentially cancerous lumps. 

 

   

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