What Is Graves Disease?
Graves disease is an autoimmune disorder that makes the thyroid gland swell and become overactive.
It can also lead to eye problems, including double vision.
In this condition, the immune system mistakenly triggers the thyroid to produce too much hormone, a state known as hyperthyroidism.
This happens because immune cells create antibodies that stimulate the thyroid receptors, which are usually activated by a hormone called Thyroid Stimulating Hormone (TSH).
These antibodies are known as TSH Receptor Antibodies.
A blood test can confirm Graves disease by looking for these antibodies.
The ongoing stimulation causes the thyroid to enlarge (Graves Goitre) and overproduce hormones.
Without treatment, your eyes may be affected, causing redness (chemosis), bulging eyes (exophthalmos or proptosis), and eventually double vision (diplopia).
An eye exam may be needed to check for these symptoms.
Treatment of Graves Disease
Graves disease can be treated in three ways:
Medication
Radioactive iodine
Surgical management
Medical Management
Medical management of hyperthyroidism primarily involves the use of specific medications aimed at controlling the various symptoms associated with the condition.
Typically, drugs such as Carbimazole or Propythiouracil (PTU) are prescribed to effectively manage these symptoms and can sometimes lead to a remission of the disease.
However, it's important to note that some individuals may experience difficulty tolerating these medications, or there may be instances when they become less effective.
In such circumstances, alternative treatment options like surgery or radioactive iodine therapy may become necessary to ensure proper management of the condition.
Radioactive Iodine (RAI)
Radioactive Iodine (RAI) treatment involves the administration of iodine tablets that contain a small amount of radiation (I131) specifically designed to destroy overactive thyroid cells.
During the treatment process, patients are required to remain isolated for approximately 3 to 4 days to allow the radiation to effectively work within the body.
The side effects associated with RAI are generally minimal and differ markedly from those experienced with external radiation therapy.
As the thyroid gland absorbs the administered iodine, the radiation then acts to destroy the malfunctioning cells.
It is crucial to understand that following this treatment, patients may become hypothyroid and consequently require Thyroxine medication for life.
One of the significant advantages of RAI is the fact that it eliminates the need for surgical intervention, thereby allowing antithyroid medications to be discontinued.
However, it's worth noting that RAI may not always yield successful results, and there is a possibility that Graves' disease could recur, which may necessitate further surgical decisions.
Additionally, RAI is deemed unsafe for pregnant women and is not recommended for individuals who present with eye symptoms or those with a large thyroid gland that is causing swallowing or breathing complications, as this treatment could potentially exacerbate these issues.
Surgical Management
Surgical management is considered a definitive treatment option for Graves' disease.
The surgical procedure typically involves the complete removal of the thyroid gland, necessitating that patients take lifelong thyroxine medication post-surgery.
The primary benefit of undergoing this surgical intervention is its effectiveness in 'curing' Graves' disease, thereby eliminating the need for ongoing antithyroid medication.
Surgery is usually regarded as the most optimal choice when the thyroid gland is significantly enlarged and exerts pressure on surrounding anatomical structures, or when the patient is exhibiting eye symptoms that require prompt attention.