Graves’ Disease

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Definition
Graves’ disease is an autoimmune disease characterized by hyperthyroidism. It is most commonly affects the thyroid, frequently causing it to enlarge. The body produces antibodies to the receptor for thyroid-stimulating hormone (TSH). These antibodies cause hyperthyroidism because they bind to the TSH receptor and chronically stimulate it.

 

Age / Sex of Graves' disease

The typical age range is 20-40 years.
Most affected women are aged 30-60 years.
Hyperthyroidism due to Graves disease has female-to-male ratio 8:1

Causes of Graves' disease

• Genetic
• Viral or bacterial infection such as Yersinia enterocolitica and Borrelia burgdorferi.
• Emotional stress
• Trauma to the thyroid.

Graves' disease Signs and Symptoms

• General fatigue, weakness
• Anxiety
• Neuromuscular- Tremors, easy fatigability.
• Skeletal- Back pain
• Cardiovascular- Palpitation, dyspnea, chest pain, odema.
• Dermatologic- Warm, moist, fine skin, sweating, vitiligo, alopecia
• Gastrointestinal- increased bowel motility with increased bowel movement
• Renal- polyuria, polydypsia
• Hematologic- Easy bruising
• Metabolic- Heat intolerance, weight loss despite increase appetite
• Ophthalmologic- Photophobia, eye pain, protruding eye, diplopia, visual loss.
• Endocrine/Reproductive: Irregular menstrual periods, gynacomastia, impotency.
• Psychiatric: Restlessness, anxiety, irritability, insomnia.

Investigations for Graves' disease

• Ultrasensitive thyrotropin assay
• Free T4 levels or the free T4 index is usually elevated
• Assays for thyrotropin-receptor antibodies (particularly TSIs) almost always are positive.
• Detection of TSIs is diagnostic for Graves disease.
• A CBC count with differential should be obtained at baseline and with the development of fever or symptoms of infection.

Differential diagnosis of Graves' disease

• Anxiety disorder
• Hashimotos disease
• Hyperemesis Gravidum
• Sub acute thyroiditis
• Toxicity,Cocaine
• Struma ovarii

Treatment for Graves' disease

• Radioiodine treatment
• Antithyroid medication
• Beta blockers
• Surgery

Prognosis of Graves' disease

• Depression
• Mental and physical sluggishness

Complications of Graves' disease

• Hoarsness of voice
• Eye problems (Graves ophthalmology)
• Rapid heart rate
• Atrial fibrillation
• Thyroid crisis
• Low calcium levels
• Increased risk of osteoporosis

Homeopathic treatment for Graves' disease

Iodum:
Mainly acts on glands; thyroid ,testes, mesenteric and mammary, first get swollen ,hard and heavy then begin to dwindle.
Feels always too hot.
Adenoids,Goitre hard with sensation of constriction.
Eyes protrotruding.

Spongia:
Effects heart, trachea and glands. Hard swelling of glands.
Worse: Dry cold wind, before 12 p.m
Better: Warm drinks, Descending
Thyroid gland swollen even with the chin.
Throat symptoms amel. Lying on back.
Goiter with suffocative attacks, agg: touching neck, pressure.

Nat mur:
Uvula hangs to one side.
A dry, sore spot in the throat , tickles and causes cough etc.
Throat glistens.
Exophthalmic goiter. Sensation as of a plug in throat.
Salt desire too much.
Emaciation while eating well.