Graves disease
introduction
The disease Graves disease affects the thyroid. She is one of the Autoimmune diseases. This means that your own immune system turns against the body and destroys important cells or tissues. In the vast majority of cases there is a characteristic constellation of symptoms that occur together. These are the goiter (Goiter), Tachycardia (Racing heart) and a disease of eyes (endocrine orbitopathy).
With this disease it is noticeable that Women significantly more often got Graves' disease as men. Mostly are people of reproductive age affected.
root cause
A genetic disposition can be mentioned as the cause in many patients. This causes the disease to break out. In addition, people who consume too much iodine are affected significantly more often than those who consume iodine less. As a result, people from developed countries such as the USA are often affected much more often.
Environmental factors such as mental disorders or stress also play a significant role as contributing factors. Specific triggers are not yet known.
A thyroid scintigraphy may be necessary to differentiate between an autonomic adenoma and Graves' disease, a disease that is also associated with an overactive thyroid. Read more on the subject below: Autonomous adenoma of the thyroid gland
Diet as a cause of Graves' disease
Normal foods like bread are hardly iodized. So it doesn't matter at all to ingest it. Most common will be excessive amounts of iodine but mostly through appropriate Antibiotics taken. Nevertheless, one should also use large amounts of Sea products and Marine animals dispense. What are meant by it Seaweed, but also Shellfish or fishes.
Symptoms
In addition to other areas of the body, such as the eyes, the disease also affects the thyroid gland itself. In most cases a goiter (goiter) forms and, in addition, often an overactive thyroid (Hyperthyroidism). Hyperthyroidism alone brings with it several characteristic symptoms, such as insomnia, irritability, hot flashes, nervousness, weight loss, although patients with hyperthyroidism tend to have cravings and eat a lot and numerous changes in the heart such as tachycardia and atrial fibrillation. In addition, the muscles become weaker and the stool frequency increases. Menstrual irregularities are often found in women. In severe cases, it can even lead to infertility.
The goiter often causes a tightness in the throat. Some people even feel like they are suffocating because the goiter takes up so much space in the throat. In addition, there are often swallowing difficulties and problems with wearing a collar.
In addition to hair loss, osteoporosis is also a not uncommon symptom.
When looking at the symptoms of Graves' disease, one should definitely not forget about the psychological effects. Like most chronic illnesses, some patients with this illness develop mental illnesses such as depression. Especially when orbitopathy occurs, it is a major problem for many people, often women, because the eyes protrude so far and appear so dominant on the face.
Heat intolerance perceived as hot flashes affects many patients with hyperthyroidism. How does this come about and what therapy options are there? In our next article you will get further information explained to laymen: Hot Flashes and Thyroid - What is the Link?
Triad
Triad means that three characteristic symptoms occur together. In the case of Graves' disease, as mentioned above, these are the Goiter (Goiter), Tachycardia (Racing heart) and a Eye disease (Orbitopathy). These three symptoms are also called together Merseburg Triassic.
Of the Goiter is usually clearly visible and bulges out strongly. The thyroid gland is significantly larger than it normally should be. However, its function does not have to be changed, but can still work normally. Most frequently is it caused when the Patient too little iodine and other trace elements. If but significantly too much iodine is recorded, so can here too form a goiter. It is important that you take in the recommended daily amount and no more and no less. Tachycardia is a racing heart, which can be extremely uncomfortable for the patient. Often times this is the reason why Affected do not sleep through the night can, but often wake up, which naturally affects the Ability to concentrate affects during the day. Orbitopathy is explained later in the text.
Graves disease and eye diseases
In connection with Graves' disease, one occurs in very many cases Eye disease (Orbitopathy) on. she is a organ-specific autoimmune disease, that means that they only focus on the eyes, on the Orbit (Eye socket) limited. Since women are also significantly more likely to develop Graves' disease, they also have a lot more often women an orbitopathy. You can usually see the disease very clearly at a glance, because the Eyeballs protrude noticeably from the eye socket and the eyelids are wide open. So the patients have wide eyes.
This is caused by Changes in muscles and adipose tissue. The disease arises because the body's own immune cells direct against the body and attack certain tissues. In most cases, these are T lymphocytes. The attack leads to Inflammation of the muscles of the eye and the fatty tissue which are both behind the eye. Since the tissue behind the eye expands, the eyes protrude so far out of the eye socket in front. It can happen that the two Eyes do not protrude equally, but that absolutely one side more affected is.
Unfortunately, the visible symptoms do not stop there, but develop often severe pain and Loss of vision, such as inability to move the eyes. The loss of vision can occur because the Optic nerve (Of the Optic nerve) can be compressed. Since the eye muscles are no longer flexible enough, it often comes to Dehydration of the cornea, because regular eyelid closure is usually responsible for that Tear fluid to distribute over the eye.
The disease can often be diagnosed very well, as it usually appears in the course of Graves' disease and typical appearance patterns having. It will be a anamnese made and then with one Ophthalmologist by means of Exophthalmometer. In addition, a Computed Tomography and other imaging techniques are used to identify a possible tumor to exclude. The Eyesight comes with appropriate tests and Perimetry measured.
Usually the symptoms are often with Cortisone supplements treated. It can also eye drop given against dryness of the eye. So there is a symptomatic treatment. Since the disease usually occurs in the course of Graves' disease, the underlying disease needs to be treated. Operations are only carried out when the The disease is very advanced is.
diagnosis
The diagnosis is usually not very difficult to make, since noticeable side effects like orbitopathy usually occur in addition. After a detailed anamnesis you can deal with various imaging procedures examine the thyroid gland more closely. In addition, a Blood count be made. Here you can see hormone changes.
At first it can happen that you get Graves' disease from other diseases like Hashimoto's thyroiditis cannot fully delimit. Since the courses ultimately differ completely, the correct disease can be inferred a little later.
Basedow's disease antibody
Graves disease is one of the autoimmune diseases of the thyroid gland.
An autoimmune disease occurs when our immune system mistakenly attacks the body's own cells. To do this, it forms antibodies that bind to specific antigens in the respective cells.
As a result, the regular organ function is disturbed and the thyroid gland in Graves' disease stimulates increased hormone production.
Two antibodies are mainly used to diagnose Graves' disease:
- TRAK and
- TPO-AK.
1. TRAK stands for TSH receptor antibodies. If the value is above 2 IU / L, there is a high probability that Graves' disease is in the acute stage. In rare cases, TRAK can also be elevated in another autoimmune thyroid disease, Hashimoto's thyroiditis.
2. TPO antibodies are directed against a hormone-producing enzyme in the thyroid gland. In about 60% of cases, an increase in antibodies to over 35 U / ml can be measured in the acute phase. Values below this are to be regarded as physiological. The exact limit values differ depending on the laboratory. Antibodies against thyroglobulin (Tg-AK) play no role in the diagnosis of Graves' disease.
Basedow's disease antibody detection
Graves disease is one of the autoimmune diseases of the thyroid gland. An autoimmune disease occurs when our immune system mistakenly attacks the body's own cells.
To do this, it forms antibodies that bind to specific antigens in the respective cells. As a result, the regular organ function is disturbed and the thyroid gland in Graves' disease stimulates increased hormone production.
Two antibodies are mainly used to diagnose Graves' disease:
TRAK and TPO-AK. TRAK stands for TSH receptor antibodies. If the value is above 2 IU / L, there is a high probability that Graves' disease is in the acute stage.
In rare cases, TRAK can also be used in another autoimmune thyroid disease called the Hashimoto's thyroiditis, be increased. TPO antibodies are directed against a hormone-producing enzyme in the thyroid gland. In about 60% of cases, an increase in antibodies to over 35 U / ml can be measured in the acute phase.
Values below this are to be regarded as physiological. The exact limit values differ depending on the laboratory. Antibodies against thyroglobulin (Tg-AK) play no role in the diagnosis of Graves' disease.
therapy
The most important point of treatment for Graves' disease is undoubtedly the one Drug administrationso that the thyroid function is shut down, as an overactive thyroid develops, this is done with Anti-thyroid drugs. These drugs inhibit the secretion of thyroid hormones. An exclusively drug treatment is only used if the disease is in Initial stage and no recurrences are known. So that the overfunction completely healed can, but must be a Radioiodine therapy or one surgery can be applied. The accompanying symptoms such as goiter or palpitations should also be treated. However, since the cause is not really clear, a symptomatic therapy applied.
forecast
The prognosis can be extreme differently be. Some patients do spontaneous healing, but with significantly more patients there is one chronic course or to one Relapse.
