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What question can I ask after reading this post? ” Graves’ disease is an autoimmune disease that affects the function of the thyroid gland; it is the most common cause of hyperthyroidism, accounting for 60%-80% of cases(Pokhrel, Bhusal, 2023). Graves’ disease is more common in women than men and primarily affects those between the ages of 20 – 50 (Pokhrel, Bhusal, 2023). B lymphocytes within thyroid cells, lymph nodes, and bone marrow will produce thyroid stimulating immunoglobulin (TSI) which will bind to thyroid-stimulating hormone (TSH) receptors to stimulate the action of TSH (Pokhrel, Bhusal, 2023). After binding to the receptors, thyroid hormone synthesis begins and thyroid glad growth occurs; this action causes hyperthyroidism and thyromegaly (enlarged thyroid). Some of the outward characteristics of Graces disease are bulging eyes and thick, discolored, “orange peel” appearing skin especially on the shins and feet (Mayoclinic, 2024). Other characteristics of the disease are gritty feeling in the eyes, blurred vision, light sensitivity, fatigue, cardiac arrhythmias, tremors, and a palpable goiter (Mayoclinic, 2024). Rarely, patients will have clubbing of nails and swelling of metacarpal bones. Early detection of Graves’ disease is necessary to prevent a thyroid storm that has higher rates of morbidity and mortality, and sever cardiac complication (Pokhrel, Bhusal, 2023). After diagnosis through a thyroid function test, history, and physical, providers will recommend different treatments based on severity. Treatment in the earlier stages is mainly focused on symptom management and reduction of thyroid hormone secretion, this is done through medications. The medication prescribed usually consists of a beta-adrenergic blocker to manage cardiac effects; these medication are usually something like atenolol or propranolol (Pokhrel, Bhusal, 2023). Providers will then recommend a calcium channel blocker if heart rate cannot be controlled; medications like diltiazem and verapamil are the usually the first to be prescribed (Pokhrel, Bhusal, 2023). Thionamides (anti-thyroid medications) are used to decrease thyroid hormone secretion. For patients who are not having reduction in symptoms with medications or the condition is diagnosed in later stages, radioactive iodine (RAI) treatment is done or a more definitive partial or full thyroidectomy is performed. With definitive treatment, patients no longer have to worry about symptoms of Graves’ disease, but they do have to be concerned about hypothyroidism and may need to be on hormone replacement to counteract hypothyroidism. Those that have symptoms managed by medication can enter remission once they are symptom free for about 1 year, but can have a reemergence of symptoms and require additional or more definitive treatment.”
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