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Graves Disease is a rare autoimmune disorder that affects only 2% of our

population. The causes of Graves are as little understood as the rest of the
autoimmune diseases. It is a disorder of the thyroid gland that causes an increase
in the uptake of thyroid hormones, called hyperthyroidism. Also known as toxic
goiter, this disease can cause some very serious symptoms to occur, some of them
life threatening if not treated. The symptoms are:

Rapid heartbeat

Weight loss

Tremors and shaking of the hands

Diarrhea or frequent bowel movements


Sensitivity to heat

Inability or great difficulty in getting pregnant


Changes in vision

Excess perspiration

Muscle weakness-often severe

According to the findings as of today, Graves Disease is the only one of the
hyperthyroid disorders that cause a thickening around the eye, and the bulging
eyeballs of goiter. Another rare manifestation of Graves Disease is a thickening
of the skin on the shins, accompanied by a reddish scaly coarsening, known as
pretibial myexedema.

How is Graves disease diagnosed? Specialized thyroid tests including the thyroid
stimulating free hormone, in addition to the traditional Free T3 and T4 screening
tests, alert your physician that you have hyperthyroidism. Another thyroid assay
used to nail the diagnosis down is the TSI-Thyroid Stimulating Hormone test. Scans
can also be used to gauge the amount of enlargement and to check for the speckled
patterns seen in other autoimmune diseases.

The causes of Graves Disease are unknown. There does tend to be a familial history
of some form of hyperthyroidism in families, but that only raises the possibility
of Graves Disease developing. Stress plays a factor in some cases, caused either
by illness or major life events. Stress as a trigger both for developing
autoimmune diseases or having flares is a well documented aspect of autoimmune
disruption. There has been some indication as with SLE, that a woman's hormones
play a part in the development of this illness.

How is this disease treated? If the disease is in the mild to moderate stages, an
anti-thyroid medication can be prescribed, which modulates how much free thyroid
is in your system. Often this is enough to put the patient into remission.

Radioactive iodine is used for moderately severe Graves Disease. The uptake of the
substance kills off excess thyroid cells, and ultimately destroys the thyroid
gland, without resorting to surgery. You will need to be treated for
hypothyroidism for the rest of your life.
Removal of the thyroid gland surgically often effectively eliminates the risks
associated with the worst of this disease. Thyroid hormone replacement therapy,
using oral medication is a lifetime necessity for patients who have had their
thyroid glands removed. This is a small price to pay, as left untreated Graves
Disease can be a life threatening illness. One of the most dangerous crisis' is
thyrotoxic storm : "Thyrotoxic storm is a rare life-threatening condition that
develops in cases of untreated hyperthyroidism. It is usually brought on by an
acute stress, such as trauma surgery or infection. Symptoms are severe, with a
pounding heart, sweating, restlessness, shaking, diarrhea, change in
consciousness, agitation and confusion. Congestive heart failure can develop
rapidly and lead to death." ibid:

Cardiac symptoms and tremors can be relieved by the use of beta blockers such as
Lopressor or Inderal. Eye symptoms and discomfort can be eased with lubricating
gels and drops. Though if eye inflammation, bulging and visual disturbances are
severe, an opthamologist can perform surgery to remove supraorbital bone between
the eye socket and sinuses to relieve pressure by decompressing the area and give
the eyeball room to ease back in.

Graves can cause badly shortened eye muscles. If this is a problem, a surgeon can
detach the muscle, then reattach it further back in the socket. It often requires
more than one surgery to correct the issue. Double vision, another frequent side
effect of Graves Disease can in some cases be alleviated by the use of prisms in

Frequently the use of corticosteroids to tamp down hyperimmunity can be helpful in

alleviating many of the symptoms of inflammation to the eyes.

To make your life more comfortable it is suggested that you try the following

Sleep with the head of your bed elevated to relieve the pressure to your eyes.

Use compression bandages on your affected shin(s) along with cortisone creams to
ease swelling, itching and burning.

Always wear sunglasses with specially filtered lenses when outdoors to protect
your vulnerable eye area.

Use drops and gels to soothe and cool irritated eyes frequently.

Because you are at higher risk for osteoporosis, make certain to take enough
calcium, and get a bone density scan yearly. If you show signs of osteoporosis
there are medications you can take to increase bone density over time.

Recognize that symptoms of emotional instability such as excessive worry,

irritability and fatigue will improve over time with treatment. People with
autoimmune disorders during flare ups frequently evince such signs, which do go
away once the flare is brought under control.

Finally get support from others who have Graves Disease. You can find a group
online through the links I've posted below. That support is a critical component
in helping you get needed support during flares, and provides you with a "safe"
outlet for those often rocky moments. The best part of support groups is the
giving back. It is surprising how just as small few words of encouragement for
someone else can improve both your lives.